21.01.2021

Hydrocephalus. For what reasons does a child have water in his head

Dropsy in the head is one of the colloquial names for the disease hydrocephalus. The term “hydrocephalus” comes from two Greek words – “hydro” (water) and “cephalus” (head). That is, hydrocephalus is a pathology in which the child has excess water in the head.

But strictly speaking, the head does not contain water, but a clear cerebrospinal fluid. With excess, it can have a harmful effect on the head and brain.

What is brain dropsy?

Hydrocephalus is a disease in which there is an excessive accumulation of cerebrospinal fluid in the brain.

Normally, cerebrospinal fluid circulates inside and outside the brain and spinal cord, it is produced by the vascular plexuses and is absorbed back into the bloodstream.

Cerebrospinal fluid plays an important role:

  • Acts as a shock absorber in the brain.
  • Delivers nutrients to the brain and removes metabolic products.
  • Compensates for changes in intracranial blood volume, moving between the skull and spine.

Normally, a healthy person has an exact balance between the production and absorption of cerebrospinal fluid. Since it is produced continuously, diseases that block the outflow or absorption of cerebrospinal fluid lead to its accumulation and the development of dropsy in the head.

Most often, hydrocephalus is observed in children, therefore it is the parents who are interested in why the newborn child may have excess water in the head.

Types of hydrocephalus

Hydrocephalus is congenital or acquired. Congenital dropsy of the brain is already present in newborn babies at the time of birth. Acquired hydrocephalus develops in childbirth or after some time, it can occur at any age.

Hydrocephalus is also divided into communicating (open) and non-communicating (closed or occlusal). An open dropsy of the brain develops when the outflow of cerebrospinal fluid is blocked after it leaves the ventricles. With a closed dropsy of the head, its outflow is blocked inside the ventricular system.

Causes and Risk Factors

Hydrocephalus is caused by an imbalance between the production and absorption of cerebrospinal fluid.

Cerebrospinal fluid is produced in the ventricles of the central nervous system, it flows from them through the channels into the space surrounding the brain and spinal cord, where it is absorbed into the blood vessels.

Excess cerebrospinal fluid in the ventricles occurs for one of the following reasons :

  • Obstruction. The most common cause of hydrocephalus is a partial overlap of the normal outflow of cerebrospinal fluid from the ventricles to the subarachnoid space.
  • Poor absorption. The problem of insufficient absorption of cerebrospinal fluid by blood vessels is less common. Its development is most often associated with inflammation of the brain tissue.
  • Excessive production. Even more rarely, enhanced or accelerated production of cerebrospinal fluid is observed, in which it does not have time to be absorbed by the blood vessels.

Causes of congenital dropsy of the brain in a newborn:

  • Malformations of the brain stem, in which there is a narrowing of the channels for the outflow of cerebrospinal fluid. This is the reason for about 10% of all cases of dropsy of the head in newborns.
  • Dandy-Walker syndrome is a malformation of the cerebellum and cerebrospinal fluid channels. In about 2-4% of babies with the accumulation of water in their heads, this reason is observed.
  • Arnold-Chiari malformation is a congenital malformation of the brain.
  • Congenital toxoplasmosis is an infectious disease that develops when a fetus is infected with toxoplasma before birth.
  • Bickers-Adams Syndrome is a genetic disease responsible for 7% of cases of dropsy in newborn boys.

All the causes of congenital hydrocephalus, which is why a newborn baby can accumulate water in the head, are associated with the development of brain defects in the fetus.

Causes of acquired dropsy in infants and children:

  • The presence of formations in the brain – these include tumors, cysts, abscesses, hematomas. Approximately 20% of cases of accumulation of water in the head in infants and older children are caused by these reasons.
  • Bleeding inside the ventricles of the brain associated with prematurity, head trauma, rupture of the aneurysm.
  • Infectious diseases – meningitis, cysticercosis.
  • Increased pressure in the venous system of the brain.
  • Iatrogenic hypervitaminosis A – in this condition there is an increase in cerebrospinal fluid production and the permeability of the blood-brain barrier.
Symptoms

Manifestations of dropsy of the head in a child depend on his age.

In newborns up to 1 year, the first signs of a dropsy of the brain is an increase in the size of the head. The bones of their skulls are thin and loosely connected together, there are seams between them. They allow the skull to grow in size to accommodate the excess cerebrospinal fluid. As a result, a child with hydrocephalus has a large head and an unusual shape.

Other signs of brain dropsy in infants:

  • protrusion of fontanelles on the head;
  • divergence of sutures between the bones of the skull;
  • rapid increase in head size;
  • enlarged veins on the head;

Depending on the severity of hydrocephalus, children may also experience drowsiness, fussiness, vomiting, convulsions, developmental delay.

In older children, such obvious symptoms as an enlargement of the head do not develop, since the bones of their skull are tightly interconnected and cannot expand. In these cases, the pressure inside the skull rises, which causes a severe headache, which can wake the child at night or early in the morning.

In children with dropsy of the head can also be observed:

  • nausea and vomiting;
  • drowsiness;
  • problems with balance and coordination of movements;
  • double vision;
  • cramps
  • personality changes, loss of new developmental abilities (for example, a child may stop talking or walking), memory impairment.
Diagnostics

A child with signs of hydrocephalus should be immediately shown to a doctor. To establish a diagnosis and the reasons why there may be an excess of water in the child’s head, doctors recommend a thorough examination, including ultrasound, computed tomography or magnetic resonance imaging, and measurement of intracranial pressure.

Treatment

To avoid severe consequences – you need to start treatment of dropsy of the brain in newborns immediately after diagnosis.

Drug treatment

Medication for hydrocephalus is used to delay surgery. It can be tried in preterm infants with dropsy after intraventricular bleeding. They have normal absorption of cerebrospinal fluid may resume after some time.

Medication is ineffective as a long-term therapy for chronic hydrocephalus, therefore it should be used only as a temporary measure.

Medicines can affect the accumulation of water in the head in the following ways :

  • decreased production of cerebrospinal fluid – Acetazolamide and Furosemide;
  • increased absorption of cerebrospinal fluid – Isosorbite.
Surgery

In most cases, surgery is the only way to remove excess water from the head of a newborn toddler or older child.

I do two types of operations for children with hydrocephalus:

  • Endoscopic ventriculostomy with coagulation of the vascular plexus  is a relatively new treatment method. With this minimally invasive operation, a tiny instrument with a video camera is inserted into the brain with the help of which the surgeon makes an opening in the ventricle. This creates a way to evacuate excess cerebrospinal fluid from the brain. After a ventriculostomy, the surgeon coagulates (cauterizes) part of the vascular plexus, which produces cerebrospinal fluid. Such an operation is more effective than traditional bypass surgery, but it can be performed for children older than 1 year.
  • Bypass  surgery is a traditional surgical procedure used in brain dropsy for many decades. It consists in placing one end of the flexible catheter inside the ventricle of the brain, and the other in the abdominal or pleural cavity, the heart chamber. Excess cerebrospinal fluid is removed from the brain via this catheter to these places where it is absorbed into the bloodstream. The disadvantage of such operations is that almost half of the shunts begin to function poorly during the year, which may require reoperation.
Folk methods

All parents should understand that if the child has excess water in her head, this can only be treated by a doctor. The use of folk remedies is dangerous to the health and life of the baby. All alternative medicine, the descriptions of which are given on the Internet, can be experienced by adult patients whose hydrocephalus is not as dangerous as in children.

A sane person should understand that giving a child, especially a newborn, a decoction or tincture of a plant supposedly possessing healing properties, in itself, can be dangerous. Moreover, the accumulation of water in the head of the baby is most often a disease in which there is an anatomical barrier to the outflow of fluid from the brain. This barrier can only be removed surgically. A delay in contacting a doctor can lead to irreparable consequences.

Complications and consequences

If hydrocephalus progressed to the time of birth, it can cause significant intellectual and physical impairment, brain damage, and death. To improve the prognosis in children with dropsy of the brain can only early diagnosis and timely treatment.

Can dropsy be prevented?

The development of hydrocephalus cannot be prevented.

Nevertheless, it is possible to reduce her risk in a child by using the following measures:

  • regular visits to the doctor during pregnancy;
  • infectious disease prevention;
  • injury prevention and the use of protective equipment (such as a helmet).

After the diagnosis of dropsy in the head of an infant or an older child is established, many parents wonder what it is. Hydrocephalus is a disease in which excess fluid accumulates in the brain. It must be remembered that the sooner you see a doctor and carry out the correct treatment, the better its results.

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