Intracranial pressure in infants: 3 visual diagnostic methods

After the birth of a child, every mother will have to constantly visit the doctors. If the baby is the first, then many terms will be new and scary for mommy. Intracranial pressure is one of the most common diagnoses in children. Let's look specifically at what it is and why it is dangerous.

Our brain is filled inside with cerebrospinal fluid, called cerebrospinal fluid. When circulating, it creates pressure inside it, which is intracranial. Liquor regulates respiratory activity, blood circulation, participates in the excretion of certain metabolic products, protects the brain from mechanical damage, and performs transport and immune functions. During the day, from 40 ml is formed in a newborn healthy child, to 1 liter of cerebrospinal fluid in an adult.

IMPORTANT: intracranial pressure is not a diagnosis, it is inherent in everyone. But an increase or decrease in its norm serves as an indicator of the development of any disease.

Measuring intracranial pressure in children

ICP is determined in the smallest children using the safest methods of all, which will be listed below in the text.
This is due to the high sensitivity of infants’ bodies to various medications and developmental characteristics. One of the methods for children is neurosonography. In a similar way, it is possible to measure ICP in children whose age does not exceed 10 years. Neurosonography is also used to assess the condition of the ventricles of the brain.

Neurosonography

Another popular method is echoencephaloscopy. It makes it possible to track some important indicators. Due to the fact that the brain, cerebrospinal fluid and blood in the vessels are capable of exerting pressure on each other, any change in the volume standards of any of these media can provoke an increase in intracranial pressure.

This is why it is so important to regularly measure ICP. This will prevent any unpleasant consequences associated with high blood pressure. It is best to measure it over time. This method will provide much more valuable diagnostic results.

It should be understood that it is possible to safely measure intracranial pressure only in specialized medical institutions. You should not try to do this at home, otherwise the child will have much more serious problems than ICP.

In order to find out the ICP as accurately as possible, you should place the pressure gauge in a liquid medium that characterizes the pressure. It is best to place this device in the cerebrospinal fluid. This can be done if the pressure gauge is located in the area of the spinal cord or at the level of the skull.

In children, the need to measure blood pressure usually occurs if signs such as:

too high excitability;
constant anxiety;
the appearance of a venous network;
severe vomiting;
bulging fontanel;
strabismus.

If the child is somewhat older, he may experience convulsions, vomiting, constant headaches, or fatigue. All this indicates that the baby needs to measure ICP. In children, the examination consists of performing a neurosonography procedure. It is produced through the fontanel.

Despite numerous concerns, the process cannot be called painful or unsafe. The method is used only for examining children. With its help, you can study in as much detail as possible the state of the ventricles located in the brain.

CT scan

If a child’s ICP is elevated, this will be noticeable by an increase in the size of the ventricles. For older children, other measurement methods are used. The fact is that their fontanel has become prolonged, so they have to use computed tomography and MRI.

Many children do not like to undergo this procedure, so this method is not suitable for everyone, but it helps to conduct an effective diagnosis of the brain. Also today, many people use the echoencephalographic method.

A number of indicators can be assessed in this way. For example, pulsation of blood vessels. ICP can be determined by pulsation. The only problem with this method is that it is not very accurate.

Many experts prefer a monitoring system. Also, modern medical centers have the ability to measure ICP using a wide variety of methods: non-invasive and invasive.

Diagnostics

Diagnosis and treatment of ICP should be carried out by a neurologist. To confirm the presence of a suspected pathology, the doctor may prescribe:

Ultrasound examination (ultrasound) of the brain. This accessible and relatively safe method is most suitable for children under one year old, since it is carried out through the fontanel opening. When it closes with bone, at an older age, ultrasound is no longer able to go to soft tissues. It is important to identify the dynamics of the increase in the size of the ventricles of the brain.
Computed tomography (CT) and magnetic resonance imaging (MRI) are warranted in cases where the fontanel has already closed. The method is quite expensive and unsafe, so it is used infrequently.
Echoencephalography (EchoEG) is a rather outdated method. It is based on the use of ultrasound to establish certain parameters, including the pulsation of brain vessels. It does not allow us to establish the full picture of violations and is rarely used.

In addition, if an ICP disorder is suspected, an examination by an ophthalmologist and increased attention to the dynamics of the growth of the cranium are required.

Examination of the fundus of the eyeball can reveal possible enlarged veins and swelling of the optic discs - information that helps in diagnosis.

Measuring head circumference is included in the mandatory monthly monitoring plan for any baby. In children under one year old, this figure should not exceed the chest circumference by more than 1.5 cm. An increase in volume of more than 7 cm per month should be a cause for concern.

Invasive methods

In the case of invasive methods, the sensor can contact the brain directly.

Currently, we can list a number of invasive methods used to measure ICP:

epidural. This method involves creating a hole in the skull. Before doing this, the specialist must numb the area where the hole will appear. Before this, you will have to cut off all the hair and treat the scalp with a special antiseptic. Afterwards an incision is made. Once this is done, remove the skin and drill a hole. The next stage is the introduction of a sensor between the dura mater of the brain and the skull. This method allows you to measure ICP, but it will not help reduce it. Another disadvantage of this method is that it is strictly contraindicated for young children and is only suitable for older children;
subdural. It is possible to measure ICP using a similar method, but it is used quite rarely. This is due to the complexity of the measurement process. To measure pressure using this method, a subdural screw must be inserted into the skull. This is an extremely complex procedure;
method using a catheter. This method can be called the most effective and modern. Its essence is that the doctor needs to insert a catheter into the burr hole. With the help of a catheter, you can obtain only the most necessary information. The main advantage of using the device is that it allows you to pump out fluid and reduce pressure, because the catheter is able to reach the lateral ventricle in the brain.

Each of the described methods is a complex process that only experienced and talented doctors can perform.
In addition, each of the methods poses a great threat to the patient’s health. Just a couple of wrong movements can cause severe consequences for a person, so each of the methods listed should be used only in emergency situations.

For example, they can be useful for cerebral edema. If such a threat does not exist, it is better to use other means.

Medications

Treatment using the capabilities of classical medicine is aimed at improving blood circulation in the skull and eliminating the consequences of postpartum and birth injuries. An important aspect is the normalization of the patient’s sleep.

To correct increased intracranial pressure in children, the following are used:

diuretics;
medicines containing potassium;
corticosteroids.

In case of hypotension, apply:

nootropics;
amino acids;
vitamins;
caffeine-containing medications.

Non-invasive methods

It is also possible to measure intracranial pressure using non-invasive methods. They are much safer and can be used even in outpatient settings. In this case, pressure can be assessed indirectly, without the need for precise (quantitative) analysis. The main disadvantage of such methods is the inconvenience of use.

Today, there are the following non-invasive methods for measuring ICP:

dopplerography. This method is based on the principle of determining the degree of effectiveness of cerebrospinal fluid pressure. If it is necessary to evaluate the increase in ICP, then an analysis of blood flow is used in the area where the largest artery of the brain flows into the sinus. Periorbital Doppler sonography is used to determine blood resistance. Vascular assessment is performed using duplex Doppler ultrasound;
MRI. Used as an auxiliary method;
CT scan. Needed to visualize the changes that occur in the body;
optoacoustic method. Necessary for assessing the position of the eardrum. If there is an increase in pressure in the cochlea, then intracranial pressure also becomes higher. This can be assessed visually.

How to warn?

There are no specific preventive methods to prevent the occurrence of ICP in babies and older children. The risk of developing intrauterine pathologies can be reduced if a woman is constantly observed by a gynecologist, follows all his instructions, and treats internal diseases in a timely manner. For older children, it is important to completely cure various infectious diseases and prevent head injuries and injuries. If symptoms of ICP are severe, do not self-medicate, but immediately contact a pediatrician. Only adequate and timely prescribed therapy under the supervision of a doctor will help prevent life-threatening consequences for the baby.

https://youtu.be/mgCCNGxGRtg

Fundus examination

A fundus examination is usually performed by an ophthalmologist. He can tell whether the patient has any problems related to ICP. This procedure is usually performed in a medical facility. Most often, the examination is done in a regular clinic.

What does a fundus examination include:

At the very beginning, the child should be given a special solution. A couple of drops will be enough. Usually a solution of Scopolamine or Homatropine is used;
After some time has passed, the ophthalmologist takes a specially designed magnifying glass and mirrors and conducts an examination. Usually the fundus is examined at some distance in a semi-dark room. In order for the study to be as accurate as possible, an ophthalmoscope is used. It allows you to see the smallest details without the use of additional tools;
Usually, during the fundus examination, the ophthalmologist is opposite the patient. The distance can be approximately 50 cm, and a mirror is placed in front of one of his eyes. An electric lamp with a power of 60 to 100 W is installed near the patient. Also, the ophthalmologist’s pupil should be located approximately on the same line as the opening of the mirror and the center of the magnifying glass;
If all the equipment is installed correctly, then the doctor has a chance to determine the condition of the fundus. If a child has high blood pressure, he or she may notice changes in the color of the tissue and disc. This also applies to vessels that can be dilated.

If the ophthalmologist can notice such changes, he will refer the patient to a neurologist. It is he who will carry out further diagnosis of increased ICP using various methods.

Prevention

Breastfeeding is a good prevention of such pathology in babies.
High blood pressure in a child is treated and prevented using measures such as:

regular walks in the air;
positive atmosphere;
surrounding the child with love, affection and attention;
proper nutrition, enriched with vitamins and minerals;
breast-feeding.

To prevent the occurrence of congenital changes, it is necessary to undergo a thorough examination and appropriate treatment during pregnancy planning. You should also protect the expectant mother from stressful situations, take enough vitamins and monitor your health.

https://youtu.be/lHv8kkSo92E

Symptoms of intracranial pressure in children

Signs of intracranial pressure in a child vary depending on age and the nature of the pathology. Several age groups are distinguished to differentiate the clinical picture - children from 2 to 5 years old are classified as the younger group, and from 5 to 9 years old - to the older group. Due to the ossification of the skull structures, intracranial pressure responds well to conservative treatment in older children (10 and 11 years old) - which is why it is not critically dangerous for them.

Intracranial pressure can fluctuate under the influence of atmospheric pressure, so a slight increase does not necessarily indicate any pathology.

Symptoms common in young children include:

Restlessness in the evening and at night, sleep disturbances, severe crying. The reason is an increase in intracranial pressure due to the horizontal position of the body. In this case, the venous system of the skull receives more blood, so the sinuses swell and the pressure increases.
Nausea and vomiting. Associated with pressure on the structures of the medulla oblongata, which are responsible for the gag reflex. It is necessary to distinguish this symptom from vomiting associated with overfeeding a child or food poisoning. Vomiting of central origin is not associated with food intake, occurs several times a day, and the nature of the vomit does not change.
Increase in head size. This is possible in a baby under 1 year of age, since in older children the fontanelles ossify. In young children, the cartilaginous structures in the skull dominate, so the fontanelles swell, the sutures of the skull separate, and the frontal lobe enlarges significantly. Visually this is manifested by an enlargement of the head.
Prominent subcutaneous venous network. If a child has high cranial pressure, the veins are full-blooded and contrast under the skin in the form of a clearly visible vascular network.
Graefe's symptom. This sign is specific to birth trauma, but sometimes manifests itself when pressure in the cerebrospinal fluid system increases. It is characterized by spontaneous downward movements of the eyes, with a white stripe of sclera visible between the upper edge of the iris and the upper eyelid.

Nonspecific symptoms associated with increased intracranial pressure indirectly include frequent crying, refusal to feed, developmental delays, lethargy and lethargy.

Children are especially sensitive to changes in intracranial pressure due to the special vulnerability of the nervous system due to age, as well as the presence of cartilaginous structures in the skull.

Older children may complain of subjective sensations caused by high blood pressure. In this case, diagnosing the pathological condition is somewhat easier. Main features:

Vomiting that does not bring relief. Occurs due to irritation of the vomiting centers. Repeated many times, the child complains of nausea, which does not go away after a bout of vomiting.
Headache. Pain is felt behind the eyeballs (cerebrospinal fluid presses on the space behind them), as well as in the area of the frontal and temporal lobes.
Symptoms of irritation of the optic nerves. The child complains of flashes before the eyes, colored trails that trail behind objects, and double vision.
Sleep disorders. Caused by increased compression of the brain and pain when lying down.

High intracranial pressure deprives the child of appetite, making him lethargic and moody throughout the day.

A further increase in intracranial pressure can lead to the development of dangerous consequences. On the part of the nervous system, this is a delay in mental development (especially dangerous during the active formation and development of the brain - at 3-4 years), retardation in physical development, visual impairment and other neurological disorders.

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First of all, the doctor notes that intracranial pressure changes frequently, regardless of age. And this problem is being successfully solved. It is necessary to build on normal indicators, taking into account what phase of wakefulness the child is in. During sleep, cerebrospinal fluid moves more slowly through the spinal cord.

Even minor problems such as cough or stomach upset affect the intracranial pressure ratio. In this vein, a parallel can be drawn between blood pressure and intracranial pressure. The latter is more difficult to control due to specific diagnostics.

An accurate result can be obtained by inserting a special needle into the spinal canal. But this examination option is extremely dangerous. For children it is used in exceptional cases.

Modern research has proven that increased intracranial pressure is a symptom of many diseases. But the main disease that stimulates ICP is hydrocephalus. It comes in varying degrees of severity. This is a congenital problem that needs to be treated as early as possible. One of the first signs is a noticeable enlargement of the head. Moreover, it is not so much the size that is important as the dynamics of change. But hydrocephalus is quite rare.

As for newborns, ICP rarely increases. But this is fraught with serious consequences. Therefore, medical assistance and hospitalization are necessary. In rare cases, surgery is required. But the priority is the use of medications.

Causes of increased intracranial pressure

What causes increased pressure inside the skull? All causes of high cerebral fluid pressure are divided into organic and functional. The former suggest the presence of organic pathology, and the latter – a dysfunction of the cerebrospinal fluid circulation. It is necessary to understand that there is no direct evidence other than measuring blood pressure, and its optimal indicators are individual for everyone; there are only average age standards.

Due to the ossification of the skull structures, intracranial pressure responds well to conservative treatment in older children (10 and 11 years old) - which is why it is not critically dangerous for them.

Organic causes include:

brain injuries with subsequent deformation of brain structures;
infectious diseases of the brain: encephalitis, meningitis;
brain tumors;
toxic damage to brain tissue;
intracerebral hemorrhage.

Functional reasons include:

a large amount of cerebrospinal fluid in the ventricles of the brain;
poor conditions for circulation of cerebrospinal fluid - deterioration of its outflow or passage through the appropriate channels;
vegetative-vascular dystonia, impaired muscle tone.

Intracranial pressure can fluctuate under the influence of atmospheric pressure, so a slight increase does not necessarily indicate any pathology.

Traditional methods

There are many folk methods of relieving headaches, some of them make it possible to treat intracranial pressure in children.

Mulberry decoction. Freshly prepared solution is consumed 2 times a day, before meals. For preparation, mulberry branches are used, which are boiled for 15 minutes in a liter of water.
A mixture of hawthorn, valerian, mint and cloves. Take 25-50 grams before meals and have a sedative effect. Valerian and hawthorn are taken 100 grams each, mint - 25, cloves - 10.
Honey and flower pollen. Mix in a ratio of 1:2. The mixture is used for head massage.
A combination of lemon and garlic. To make it, take 2 heads of garlic and 2 lemons, which are soaked in 1.5 liters of boiled water for a day. Next, the infusion is filtered and consumed daily in diluted form. The course of treatment is no more than 2 weeks.
Lavender decoction. 1 tablespoon of dried flowers is boiled in a liter of water for 3 minutes, after which the solution is infused for about half an hour. The decoction is used for a month, with a break of 14 days. In addition to internal use, rubbing it into the scalp before bed has a positive effect.

You cannot make an independent choice of medications or methods, and before using tablets, injections or traditional practices, you should consult with your doctor, who will determine the causes of the pathology and prescribe a therapeutic set of measures.

The therapy process should include fairly long walks, balanced stress on the body and normalization of sleep. If a child has increased intracranial pressure, then the psychological factor is important. Frequent examinations and visits to hospitals cause an inferiority complex; To prevent this, pay due attention to your child. Take a break from household chores or work problems and devote at least a few hours a day to activities with your son or daughter.

How to determine intracranial pressure in children

It will not be possible to independently establish a diagnosis and find out the exact value of intracranial pressure - for this you need to contact a neurologist. He will collect anamnesis, interview parents about the primary manifestations, and also examine the child and determine which symptoms are most pronounced. The doctor pays special attention to pathological reflexes of the eyeball and bulging fontanelles. To understand whether the condition is independent or caused by another disease, it is necessary to measure the pressure of the cerebrospinal fluid and compare it with the age norm.

If increased intracranial pressure is suspected, the child should be examined by an ophthalmologist

If the neurologist identifies characteristic signs, the patient is referred for a consultation with an ophthalmologist. The ophthalmologist will check your vision (long-term increased intracranial pressure causes its deterioration), examine the fundus of the eye, where angiopathy can be detected, which indicates a persistent and long-term increase in pressure in the skull.

Nonspecific symptoms associated with increased intracranial pressure indirectly include frequent crying, refusal to feed, developmental delays, lethargy and lethargy.

What to do next? The next step in diagnosis is neurosonography, or ultrasound of the brain. This method is most informative in young children with soft areas of the skull. Neurosonography allows you to see deformation of the midline structures of the brain, changes in the size and position of the ventricles of the brain, and displacement of the median interhemispheric fissure. This method is non-invasive and harmless to the child if the examination frequency is observed. In children 6, 7 and 8 years old, when the fontanelles are already completely overgrown, a CT (computed tomography) and MRI (magnetic resonance imaging) of the brain is performed.

If the diagnosis of increased intracranial pressure is confirmed and has a morphological basis, treatment is prescribed.

What complications can there be?

In the absence of timely treatment, complications are possible that threaten health much more than ICP. The child may experience developmental delays. Pathology associated with increased intracranial pressure is not common. But such children quite often experience poor development in comparison with their peers.

With advanced hydrocephalus, the risk of brain damage increases. Possible physical disability. But such an illness does not mean that a person cannot lead the usual lifestyle for everyone. The correct treatment system plays an important role.

In the absence of qualified help, a child will suffer from headaches from childhood. Psychomotor skills are impaired, and the emotional state is unstable.

Prevention

To prevent ICP in infants, constant walks in the fresh air are recommended. This normalizes the child's emotional state. In addition, a sufficient amount of oxygen has a positive effect on the condition of the cerebrospinal fluid.

It is necessary to provide a complete set of vitamins for the child. This is especially difficult with artificial feeding. It is important to remember that the child is sensitive to any strong sound. Therefore, the atmosphere around should be calm.

In the case of ICP in young children, there is no need to panic. This disorder can be eliminated with proper treatment. But you don't need to try to deal with this problem on your own. It is also important to pay attention not only to clinical symptoms, but also to changes in the child’s behavior and mood.

In most cases, this problem can be detected at home. And then you should undergo diagnostics at the clinic. Also, do not refuse hospitalization. Home treatment is not as effective.

https://youtu.be/XJRmnFXJEbc

Treatment of intracranial pressure in children

How to relieve high intracranial pressure? To do this, complex therapy is prescribed, aimed at reducing clinical manifestations and removing the primary cause of the pathology. At the same time, they take preventive measures that significantly increase the effectiveness of treatment - normalize sleep and wakefulness, ensure that the child spends daily in the fresh air, a balanced diet, moderate but regular physical activity (in particular, swimming).

Drug therapy consists of the use of diuretics, which remove moisture from the body, reduce the volume of circulating blood and, accordingly, the amount of cerebrospinal fluid formed in the ventricles of the brain, thereby helping to relieve swelling with accompanying pain. Nootropics and other drugs are also prescribed to normalize cerebral circulation - these drugs compensate for blood stagnation and improve cerebral circulation.

It will not be possible to independently establish a diagnosis and find out the exact value of intracranial pressure - for this you need to contact a neurologist.

Additionally, wide-spectrum cerebroprotectors can be used - they affect brain tissue, the endothelium of the vessels supplying the brain, normalize electrolyte balance after the use of diuretics, and improve the conductivity of brain impulses. Painkillers and sedatives (sedatives) are also used to relieve unpleasant symptoms and improve night sleep.

Treatment methods

Treatment of increased ICP is prescribed depending on the reasons that led to the pathological changes. Correct therapy in newborn babies allows you to compensate for neurological disorders by 2-3 months of life.

To treat benign (occurring without neoplasms inside the cranial cavity and without changes in the composition of the cerebrospinal fluid) intracranial pressure in infants, methods such as conservative therapy and surgery are used. Surgical methods for intraventricular hemorrhages are aimed at temporary and permanent regulation of the outflow of cerebrospinal fluid. The first (temporary) include:

Lumbar puncture.
Ventricular puncture.
Ventricular drainage of external type.
Ventricular subgaleal shunt.
Creation of an external ventricular reservoir.

The listed methods are effective in 20-80% of cases. Methods of permanent regulation include ventriculoperitoneal or ventriculoatrial shunting.

Surgery is performed if an increase in ICP values is caused by a space-occupying formation localized in the brain structures.

If the primary disease is caused by a bacterial or viral infection, appropriate drug therapy using antibacterial and antiviral agents is indicated. Hydrocephalus is difficult to treat with medication. Usually, in this case, surgery (bypass surgery) is performed.

Shunting is an invasive treatment method that involves installing a shunt (artificial vessel) to divert cerebrospinal fluid from the cranial space to other parts of the body (usually into the abdominal cavity - ventriculoperitoneal shunting, or into the bloodstream - ventriculoatrial shunting). The shunt system consists of silicone tubes equipped with valves. Drug therapy aimed at lowering ICP levels involves taking the following medications:

Diuretics (Glycerol, Acetazolamide).
Metabolic agents to eliminate potassium ion deficiency (Potassium, magnesium aspartate, Magne B6).
Venotonics to improve cerebral blood flow (Vinpocetine, Cavinton).
Nootropic agents for increasing resistance to stress, stimulating cellular metabolism and higher mental functions (Hopantenic, Acetylaminosuccinic acid).

Rehabilitation measures for a slight increase in intracranial pressure include massage and passive exercises to eliminate muscle and nervous strain. These procedures will not reduce the pressure of the cerebrospinal fluid, but will improve the overall well-being of the infant with a mild form of cerebral hypertension. The child should pay more attention and take him for walks in the fresh air more often.

https://youtu.be/E8MRPQiiZZw

Increased intracranial pressure in a child

If a child is diagnosed with increased intracranial pressure, it is necessary to undergo examination and urgently treat the disease. Because the consequences of pressure in an infant can be very different and dangerous.

The brain is surrounded by several membranes and between them there is cerebrospinal substance. The brain has a system of ventricles connected to each other. The ventricles are also filled with this substance. This component is called cerebrospinal fluid, which helps protect the brain from accidental injury. When the pressure of cerebrospinal fluid on the brain exceeds normal, high pressure forms inside the skull.

Increased intracranial pressure is a common diagnosis in children. Such problems are diagnosed in almost every second newborn. The disease is highly treatable without surgery. This diagnosis is not for life. The potential for recovery in a child's brain is quite high. Therefore, hypertension is a disease of children under six months. Only in some cases the treatment is longer. Children whose hypertension has not improved after six months require special care and peace of mind. Otherwise, the baby will suffer from epilepsy and develop poorly.

Symptoms of ICP in older children

In children of preschool and school age up to 10 years old, the symptoms of increased intracranial pressure vary. Most often, the child’s condition worsens in the evening or at night. Main features:

Undeveloped speech.
Problems with remembering and assimilating new information.
The appearance of nausea. Vomiting does not bring relief, as with food poisoning, because nausea is caused by irritation of parts of the brain.
Pain in the eye area, double vision and flashes. This is explained by the pressure of the cerebrospinal fluid on the organs of vision.
Headache in the evening.
Increased fatigue and irritability.
Bad handwriting.
Increased heart rate.
The appearance of bruises under the eyes.
Poor coordination of movements.
Drowsiness.
Cramps.

Symptoms

Symptoms of pathology are easy to identify. In infants, increased pressure can cause the head itself to increase in size. In children under one year of age, the distances between the bones of the skull are large. But a one-year-old child and older do not have fontanelles, so the head does not enlarge with pressure.

Up to a year

In children under one year of age, increased blood pressure manifests itself as restlessness and anxiety. The child cannot fall asleep, during the day he is calm, but in the evening, on the contrary, he is restless and excited - this is determined by the structure of the cerebrospinal fluid and venous system. In the evening, the baby lies in a horizontal position and the venous outflow proceeds slowly. The veins of the brain become congested, which increases the volume of cerebrospinal fluid, which presses on the skull.

Symptoms include nausea, vomiting, and nosebleeds, which can be quite dangerous in the first years of life. With increased pressure, the centers of the medulla oblongata, which are responsible for nausea, are irritated. Constant regurgitation can also be due to overfeeding or swallowing air during feeding. Therefore, such symptoms cannot clearly indicate the appearance of ICP.

The following symptoms are an increase in the size of the skull. Signs appear in the form of swelling of the fontanelles, enlargement of the frontal area of the head, and separation of the seams of the bones of the skull. An enlarged skull indicates that cerebrospinal fluid has accumulated in the cerebrospinal fluid, causing hydrocephalus.

Symptoms in babies under one year of age are a clearly visible venous network under the skin of the brain. High blood pressure may be accompanied by a large accumulation of blood in the venous network and blood stagnation; the saphenous veins become visible.

In a child under one year old, Graefe's symptoms may also appear - the work of the oculomotor nerves is disrupted, manifested by an uncontrolled downward deviation of the eyeballs. Additionally, a light stripe is visible between the edge of the iris and the upper eyelid. Such signs occur periodically.

Frequent refusals to eat can also be a cause of ICP. During feeding, blood pressure increases. If there is a pathological process, the child may experience pain. The baby loses weight because he eats little or refuses to feed at all. Children also lag behind in psycho-emotional and physical development.

In a child older than one year

With high blood pressure, older children often vomit. The child feels sick due to irritation of the centers of the medulla oblongata. Pathological vomiting is not capable of bringing relief, which occurs with food poisoning. Therefore, the urge to vomit repeats again.

Sometimes children complain of eye pain, which is also considered a symptom of high blood pressure. Painful sensations appear due to the fact that the cerebrospinal fluid presses on the eye area. Painful sensations are accompanied by double vision and flashes. Such symptoms are a consequence of irritation of the optic nerves.

With high blood pressure, older children experience headaches, which increase especially in the evening. Painful sensations are accompanied by tearfulness and irritability.

How to understand that ICP is increased

Of course, a child who was born very recently will not be able to communicate his problems verbally. By what signals should parents begin to “sound the alarm”? This is noticeable in the behavior of the baby:

the baby is unreasonably capricious;
lethargy;
the child has difficulty falling asleep;
the baby is not eating well or refuses to eat at all;
regurgitation is profuse and occurs more often than it should;
sensitivity to sudden changes in light or sound. If these processes cause discomfort, the baby will certainly let you know about it - with an unexpected scream or cry;
the newborn has seizures.
The presence of one or two of the listed signs does not indicate a serious pathology. If the symptoms “pop up” at the same time, this is a reason to consult a doctor.

Treatment

In order to begin treating high or low intracranial pressure with medications or folk remedies, you need to consult a specialist. Methods used to normalize pressure:

normalize the child’s feeding and sleep patterns;
long walks outside;
light physical activity, swimming;
treatment with diuretics – Diacarb and similar drugs;
treatment with drugs that improve cerebral circulation: nicotinic acid, Piracetam;
prescribe treatment with neuroprotectors and sedatives;
it is necessary to do physiotherapeutic procedures;
use surgical treatment for tumors;
if hydrocephalus appears, then it is necessary to do a ventriculo-peritoneal shunt.

Drugs

In order to start treatment with Diakarb or folk remedies, it is worth undergoing a full examination by specialists. Thus, it is possible to determine why ICP develops and to establish the source of the disease. Common methods of drug therapy are medications to improve blood circulation in the brain, vitamin complexes.

Experts also advise supplementing treatment with physiotherapeutic procedures and herbal infusions that help calm children who often have headaches from hypertension.

Diakarb

Not all hypertension medications treat the underlying cause of the disease. Many only relieve symptoms. However, Dicarb tablets can reduce blood pressure in children and adults. If treatment with Diacarb occurs quickly, then the negative consequences of the disease can be eliminated and a long-term effect can be achieved so that normal intracranial pressure is present throughout life. However, before starting treatment with Diacarb, you should consult with experts.

Dicarb is a diuretic, a diuretic drug that removes fluid through the kidneys. The effect of the drug Diakarb is the outflow and decrease in the volume of cerebrospinal fluid.

Folk remedies

In medicine, there are a large number of recipes for treatment with folk remedies that will help to effectively lower blood pressure and relieve a child from pain. Traditional treatment can be used as an addition to traditional medications. To lower blood pressure, people prepare all kinds of decoctions and infusions from various herbal preparations and medicinal plants.

Lavender

Lavender decoction is ideal for a child. The medicine should be made from one spoon of dried lavender flowers, poured with boiling water. The broth must be boiled for 3 minutes. and then leave for 30 minutes. Treatment with such folk remedies should be completely safe and beneficial. You should drink the folk medicine for 30 days, then take a break for 14 days and repeat the treatment again. Lavender infusion can also be rubbed into the scalp before bed.

Mulberry

Mulberry decoctions are considered effective folk remedies. Mulberry decoctions cope well with blood pressure, fever and headaches. For preparation, use a small bunch of plant branches and 1 liter of distilled water. Mulberries are boiled for 15 minutes, filtered and the broth is divided into several parts. This folk remedy should always be drunk fresh and prepared every day.

Causes of ICP disorders

Both increased and decreased intracranial pressure in children pose a health hazard. Both pathologies are caused by problems with the release of cerebrospinal fluid or the process of its absorption. You need to understand that difficulties of this kind are not a disease, but only a symptom of serious deviations in the state of the body.

Diseases that may cause high intracranial pressure in a child:

Benign and malignant tumor. In the process of the appearance of neoplasms, the pressure of the cerebrospinal fluid and the structure of the nerve tissues change. Both types of pathology are detected in the early stages of life.
Meningitis. Accompanied by cerebral edema; during suppuration, the density of the cerebrospinal fluid changes, due to which the process of its absorption slows down.
Encephalitis. Inflammation of brain tissue leads to swelling, which changes its volume.
Toxic cerebral edema. Caused by phenols, alcohols, gasoline, etc.
Hydrocephalus. A rapid increase in intracranial pressure in children with this disease occurs due to a violation of the outflow of cerebrospinal fluid through the channels. The liquid continues to form, as during normal circulation, but does not have time to be distributed.
Genetic defects. Congenital pathologies in which there is an abnormal structure of the liquor channels. The disease precedes hydrocephalus.
TBI (traumatic brain injury). A blow of any severity is accompanied by cerebral edema. With a subdural hemorrhage, the brain matter is compressed by the hematoma.
Stroke (rarely diagnosed in children). The space occupied by the lesion puts pressure on the surrounding tissues and causes intracranial pressure to increase.
Premature union of the bones of the head: fusion of the fontanelles and cranial sutures. A child's intracranial pressure gradually increases as the brain continues to develop and there is no more free space.

In 80-90% of cases, cerebrospinal fluid hypertension in a child is the result of trauma during childbirth or pathologies that arose during intrauterine development.

Reduced ICP is also a symptom of a number of diseases. When physical injuries occur, both an increase and a decrease in the level of load on the center of the nervous system occurs. Various types of infections, vitamin deficiencies, endocrine and cardiovascular diseases are not all the reasons that cause disturbances in the circulation of intracranial fluid.

How to measure intracranial pressure

ICP syndrome is often observed in infancy. How to check intracranial pressure in a child? The most informative method is a spinal puncture, but the method is used in special cases when the baby’s skull bones are not overgrown, in a clinical setting. Parents can indirectly determine the presence of pathology. Since one of the symptoms is an increase in the size of the head, it is necessary:

take a measuring tape;
measure the circumference of the head above the eyebrows and along the most protruding part at the back of the head;
the average at birth is 34 cm, increasing by 1 cm every month.

It is very difficult to objectively measure intracranial pressure, so there are other techniques that help diagnose a child. The following are carried out in turn:

detailed examination by a neurologist - changes in the size of the skull, developmental deviation are noted, information about symptoms is collected;
neurosonography - ultrasound examination of the brain - used for infants - the presence of pathologies is detected;
study of the fundus – vascular abnormalities and changes in the optic nerve head are recorded.

To clarify the diagnosis, hardware diagnostics are prescribed to more accurately determine the symptoms of intracranial pressure in the child. Methods used:

Dopplerography – studies cerebral circulation, reveals the condition of blood vessels;
MTP – examines tissues and liquor spaces;
encephalography – determines the situation with blood vessels based on pulse rate;
Computed tomography examines changes in the structure of the brain using X-rays.

Normal intracranial pressure

It is very difficult to accurately measure increased intracranial pressure. Many factors influence the values of indicators in children. This could be high or low room temperature, poor sleep. Often, elevated ICP values can appear in a baby when he is upset for some reason. Even the position in which the measurement is taken has an effect - it should be performed correctly while lying down. A spinal cord puncture is performed to indirectly determine the compression of the cerebrospinal fluid. The normal intracranial pressure is in mmHg:

for newborns – 1.6-6;
in children – 3-7.

Causes

Increased intracranial pressure is a possible consequence of other serious diseases.

To understand the essence of the occurrence of a negative phenomenon, let us turn to the anatomy of the brain. The ventricles inside the brain are connected to each other. They are filled with cerebrospinal fluid or cerebrospinal fluid (CSF), which performs a protective function. Just as blood circulates through the vessels, cerebrospinal fluid moves through the ventricles of the brain and the spinal canal. Forming in special vascular plexuses and passing its way, the cerebrospinal fluid is absorbed into the blood in the venous sinuses.

Problems are caused by excessive accumulation of cerebrospinal fluid, which leads to increased pressure on brain tissue. In turn, the formation of CSF, the intensity of its movement and absorption depend on:

the physiological activity of the child at the moment: he is sleeping or awake, lying quietly or performing intense movements;
ambient temperature and own body temperature.

When it comes to intracranial hypertension caused by increased synthesis of cerebrospinal fluid, this is usually a symptom of such serious diseases as:

meningitis;
encephalitis;
stroke;
tumor;
a disease of severe metabolic disorder.

Common causes of increased intracranial pressure (ICP) in infancy are various complications during the mother's pregnancy:

premature aging of the placenta or its detachment;
severe toxicosis in the first trimester;
umbilical cord wrap;
poor choice of medications, side effects from their use;
child's head injury during childbirth;
lack of oxygen.

Scientists name different ranges of acceptable values for intracranial pressure in infants. Some call the numbers 80-140 mm of water column, others expand the boundaries to 60-200 mm of water. Art. This applies to measurements in a supine position.

Signs of intracranial pressure in a child

In childhood, the symptoms of ICP may be similar to other diseases and require careful diagnosis. The cause is not always an excess of cerebrospinal fluid in the brain. Characteristic signs of intracranial pressure in a child:

restless behavior, especially in the evening and at night;
sleep problems;
nausea, regurgitation in infants;
refusal to eat;
increased head size;
Graefe's symptom - lowering of the eyeballs;
dilation of veins under the scalp;
developmental delay.

Intracranial pressure in infants

There are several symptoms that should cause parents to sound the alarm. How does intracranial pressure manifest in infants, which is dangerous? It is necessary to urgently contact a neurologist if you have:

pulsation, swelling of the fontanel, especially at rest;
periodic twitching;
uneven muscle tone;
systematic seizures;
open eyes during sleep;
lethargy;
freezing spells;
involuntary movements of the pupils;
loss of consciousness.

Intracranial pressure increases in infants in the evening, which is associated with a slow outflow of venous blood during a long horizontal position of the body. This leads to anxiety and tearfulness. Signs of ICP in a baby:

divergence of cranial sutures;
refusal to feed;
regurgitation;
nausea;
lowering of the eyeballs;
visible veins on the head, overflowing with blood;
slow physical development;
slight weight gain;
severe vomiting.

Convex forehead on a baby

One of the symptoms of intracranial hypertension in a child is a significant increase in head size. The appearance of a convex forehead in an infant is due to the widening of the opening between the bones of the skull due to increased ICP. The following picture is observed:

the forehead is disproportionate to the size of the head and has a convex shape;
A pronounced overhang forms on the back of the head.

Intracranial pressure in adolescents

At older ages, with increased ICP, other manifestations occur. The following symptoms of intracranial pressure in adolescents are observed:

double vision;
increased heart rate;
severe headache at night, in the morning;
bruises under the eyes;
apathy towards previously loved activities;
vomit;
drowsiness;
the appearance of strabismus;
convulsions;
the appearance of flashes before the eyes;
fast fatiguability.

Fundus of the eye with intracranial pressure

How to diagnose increased intracranial pressure? One of the research methods is checking the fundus. With the disease, the outflow of blood is disrupted, and indirect signs of ICP are observed. The ophthalmologist examines the fundus of the eye for intracranial pressure and detects symptoms in the child:

increased tortuosity of blood vessels;
spasm of the arteries;
dilation of retinal vessels;
swelling of the optic discs;
changing their fabrics, contours, colors.

What is high intracranial pressure?

Intracranial hypertension can be divided into two categories: acute and chronic.

Acute intracranial hypertension in children often develops as a result of severe head trauma or intracranial hemorrhage. It is characterized by a very rapid onset after the initial injury and extremely high intracranial pressure, which can be fatal. The main cause of acute intracranial hypertension is swelling of the brain or intracranial hemorrhage in the subarachnoid space that surrounds the brain.
Chronic intracranial hypertension in children is a neurological disorder in which high cerebrospinal fluid pressure typically occurs and remains elevated for an extended period of time. It may occur without an identifiable cause (idiopathic ICH) or be caused by an identifiable cause, such as an underlying disease or disorder, a reaction to a drug, injury, or a blood clot in the cerebral venous sinus (secondary intracranial hypertension). Often this disease remains for life and causes not only physical and emotional disorders, but also requires financial investment in treatment.

Chronic intracranial hypertension can cause both rapid and gradual changes in vision. Vision loss and blindness due to chronic hypertension are usually associated with swelling of the optic nerve, which is caused by high cerebrospinal fluid pressure on the nerve and the vessels supplying it.

In addition, people with this disorder often suffer from severe headaches. The most common form is chronic headaches, which typically do not respond to pain medications.

Anyone can develop chronic intracranial hypertension, regardless of age, gender, ethnicity, race, or body size. While the chronic form of intracranial hypertension is usually not fatal, current treatments for the disorder can lead to serious, sometimes life-threatening complications.

Researchers are seeking to determine the mechanism underlying chronic intracranial hypertension. Although no one is sure why this happens, some researchers believe the answer may involve a blockage (obstruction) in the flow of cerebrospinal fluid through pathways leaving the brain.

Reviews

Ekaterina, 26 years old I am grateful to the chance that brought me together with a knowledgeable doctor. At the age of two months, my daughter was diagnosed with symptoms of intracranial pressure. I cannot describe the horror that I experienced. The baby cried constantly and did not sleep well. The doctor advised not to rush into treatment, take more walks with the child, and breastfeed. Within six months the symptoms disappeared. Elizaveta, 36 years old This was my second birth, but it was difficult - my son was born entwined in the umbilical cord. The worst thing is that symptoms of intracranial pressure appeared. To clarify the diagnosis, a puncture was prescribed, but I did not allow the child to undergo a puncture. We conducted an ultrasound examination and decided not to prescribe medications for now. Gradually, the signs of ICP disappeared. Valentina, 38 years old My son’s first symptoms of intracranial pressure appeared in adolescence after an injury during sports activities. Severe headaches began, irritation appeared, and poor sleep. The neurologist advised me to take up swimming instead of wrestling and prescribed me to take medications. It took a long time to be treated, but the condition improved. Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient. Found an error in the text? Select it, press Ctrl + Enter and we will fix everything! Did you like the article? Tell friends:

How to identify neurological pathology in a baby

High cranial pressure in a child can be determined by the following signs:

the large fontanel is noticeably enlarged and has begun to bulge (in normal condition the fontanel should be slightly sunken);
the seams of the skull are coming apart;
a pronounced venous network has formed on the head;
Hands and chin constantly tremble;
gagging;
the child experiences constant lethargy, practically no weight gain, and physical and mental development is getting worse every day;
The baby behaves very restlessly and cries frequently and monotonously.

Treatment with folk remedies for ICP and prevention

To prevent an increase in blood pressure in children susceptible to the disease, it is necessary not to wean the baby off the breast for as long as possible, provide sufficient fresh air, surround the child with care and positive emotions, and also practice moderate physical activity.

You can relieve your baby’s headache in a simple and safe way: during an attack, wipe your ears with cool water. To improve sleep at night, warm lavender oil is gently rubbed into the temporal area.

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Despite the fact that with congenital increased ICP, the indicators almost always return to normal within six months, diagnosis of the brain and prevention of increased ICP must be carried out regularly at intervals of 1-2 years.

Computed tomography and magnetic resonance therapy

These two diagnostic procedures are prescribed only in exceptional cases. It is easier to detect intracranial pressure in an 8-year-old child than in an infant.

In the latter case, you cannot do without administering a sleeping pill, since you cannot move to get accurate results.

Despite the significant difference in price, after each procedure you receive high-quality images in different projections. The only difference between these methods is the research technique.

If, after carrying out alternative diagnostic measures, it is not possible to find out whether the child has a disease such as intracranial pressure, a CT or MRI is prescribed.

Clinical manifestations

Increased intracranial pressure in a young child can remain compensated for quite a long time due to anatomical features - softness and pliability of the bones, the presence of a fontanel and elastic sutures on the skull.

This explains the rather long subclinical course of the disease. The most striking form is congenital hydrocephalus, which is associated with occlusion (blockage) of the cerebrospinal fluid pathways in the brain. This disease occurs with a frequency of 1:4000 children and is usually recognized soon after birth. The following are typical signs of intracranial pressure in a child with hydrocephalus:

a significant increase in head circumference for age – an increase of more than 1 cm every month or more than 12 cm per year;
violation of the proportions between the circumference of the head and chest - in newborns the chest is narrower than the head, by 4 months in a healthy baby their sizes are comparable, by the year the chest circumference should exceed the head circumference;
overhang of the brain part of the skull over the facial part;
expansion of the saphenous veins on the head;
divergence of the seams between the fontanels and bones on the skull;
tension and bulging of the large fontanel.

With a rapid increase in symptoms, intracranial pressure in a child with congenital hydrocephalus can be fatal. Children with severe disease rarely survive to school age without treatment; death occurs from progressive dystrophy and generalized damage to internal organs.

In addition to the general symptoms listed above, children of any age may experience other signs of ICH, for example:

headache of a bursting nature, which occurs at night closer to the morning and gradually passes by the middle of the day;
vomiting that does not bring relief - often accompanies headaches, in young children the equivalent
are frequent regurgitation delayed from feeding;
disorders of consciousness up to complete loss;
behavioral disorder - anxiety, unreasonable crying in sleep;
periodic seizures;
hearing and vision disorders (“flashes”, double vision);
delay in neuropsychic development indicators of varying degrees;
detection of swelling of the optic discs during fundus examination at an ophthalmologist's appointment.

The combination of these symptoms may be suspicious for the presence of a pathology such as high intracranial pressure in a child. Each of these signs alone does not indicate an increase in ICP. To make a diagnosis, only a set of symptoms is taken into account, the cause of their appearance is determined, and complaints are analyzed.

If the parents have no complaints about the baby’s behavior, and the doctor discovers an increase in head circumference of 2 cm per month instead of 1 cm, this is not a reason to panic and immediate treatment.

https://youtu.be/KHqWhk2cGmk

Main directions of treatment

Treatment of intracranial pressure in infants can have several directions:

elimination of excessive volume of cerebrospinal fluid;
replenishment of this fluid in the skull;
eliminating the causes;
improvement of the symptomatic picture.

The choice of a specific therapeutic method will directly depend on the identified causes of ICP.

If the doctor, after receiving the results, said that the problem is the presence of a malignant tumor (or there are anatomical abnormalities), then surgery will be considered.

If the baby suffers due to the development of hypoxia, then special medications are prescribed that reduce discomfort and normalize the process of cerebrospinal fluid circulation.

The most commonly used treatment methods are:

surgical intervention in particularly severe cases;
prescription of medications that reduce ICP;
a course of taking vitamins that improve blood circulation in the brain;
sedatives;
physiotherapeutic procedures, massage, homeopathy.

Infants should constantly feel emotional contact with their mother. Frequent walks outside, breastfeeding and regular sleep are also recommended.

Medicines

Don't be afraid of drug treatment. Experienced doctors know how to treat increased intracranial pressure in a child. The sooner therapy begins, the faster positive results will appear.

Taking into account the child's health, treatment is prescribed using age-appropriate drugs. The therapeutic course is determined only by the doctor, who takes into account the nature and degree of neglect of the disease. Self-medication of pathology in a baby is excluded, since the risk of harm is high.

Often, a remedy such as magnesia is prescribed for the treatment of intracranial pressure in infants. The injections calm the nervous system and also reduce emotional arousal. An overdose of the drug is extremely dangerous. Since there is a risk of depression of the respiratory center, therapy is carried out under the strictest medical supervision.

The disadvantages of magnesium treatment include pain during injection. The poor condition of the baby may be accompanied by anxiety due to a sore bottom.

If there is a need to get rid of excess cerebrospinal fluid, then Glycerol may be prescribed. Under the influence of the drug, not only the amount of cerebrospinal fluid decreases, but also the ICP decreases. With the help of this drug it is only possible to relieve symptoms and alleviate the condition, while there is no effect on the underlying cause.

Compared to similar drugs, the effect of the drug occurs later, but is much more stable. A number of unpleasant consequences include the risk of an allergic reaction and problems with stool.

Intracranial pressure in infants often increases for natural reasons (for example, during periods of weather change, after overexcitation, during crying and abdominal pain). All this is considered temporary, so you should not immediately resort to using medications. It’s better to give your baby a massage or give him the opportunity to swim in the bath.

Diagnosis and treatment of ICP

But to confirm an increase in ICP, measurement of this indicator is required. It can only be accurately determined during a spinal puncture, when cerebrospinal fluid flows out of the needle under pressure. This technique is rarely used, so ICP is determined only by indirect signs. To determine ICP and its consequences, a complete and detailed examination of the child is carried out using modern diagnostic methods.

First of all, an examination by a neurologist and identification of indirect signs of high blood pressure, which we described above, are indicated.

In addition, the doctor will pay attention to deviations in reflexes, muscle tone and the condition of the sutures and fontanelles on the child’s head. An examination of the fundus by an ophthalmologist will complement the clinical picture.

In the presence of ICP, the veins in the fundus of the eye become dilated and full of blood, but the arteries are in spasm, and the optic disc may be swollen.

In children with open fontanelles, one of the methods of indirect diagnosis is NSG of the brain, identifying the expansion of the interhemispheric fissure and an increase in the volume of the ventricles of the brain, their deformation or displacement of brain structures to one side, especially against the background of space-occupying formations. The method is absolutely harmless and can be performed as many times as required. However, the diagnosis of intracranial hypertension is not made only based on NSG data; this is an indirect method for identifying the problem.

In a child older than one year, with closed fontanelles, an MRI of the brain will help confirm the diagnosis.

The choice of treatment tactics depends on the degree of damage to brain structures and the severity of the increase in pressure. Complex therapy includes normalization of the regimen, walks in the air, and moderate physical activity. When there is a pronounced increase in blood pressure, diuretics are used - diacarb or triampur, as well as drugs to normalize the functioning of brain tissue, sedatives, glycine and many others. Physiotherapy is indicated. In the presence of space-occupying formations, only surgery can help eliminate ICP, and in case of hydrocephalus, shunting with drainage of excess fluid into the body cavity through catheters.

A severe and pronounced increase in ICP, left without treatment, can result in epileptic activity, visual impairment, mental disorders and strokes for the child. In addition, consciousness, brain and cardiac activity, breathing may be impaired, and paralysis may occur. But this only happens with a pronounced increase in pressure, which happens very rarely.

Photo - Lori's photo bank

What can cause an increase in ICP?

First of all, the cause may be space-occupying formations of the cranial cavity - benign or malignant tumors. They occupy a certain space in the skull, which is limited by the bones, so the fluid is forced to shrink (there is nowhere for it to be displaced) and the pressure increases. Due to excessive fluid pressure on brain tissue, it becomes deformed and changed. This leads to severe neurological symptoms.

Inflammation of the spinal cord (meningitis) or brain (encephalitis), in which swelling of the brain occurs and its volume increases; accordingly, less space remains for fluid and its pressure increases. If this is a purulent process, then the properties of the cerebrospinal fluid also change, it becomes viscous, flows worse through the narrow ducts in the area of the cerebrospinal fluid circulatory system.

An increase in ICP may result from toxic cerebral edema and the development of hydrocephalus (increased production of cerebrospinal fluid or disruption of its outflow). At the same time, the production of cerebrospinal fluid continues, the outflow of fluid and its absorption are disrupted, which leads to the accumulation of excess fluid in the closed cavity of the skull. Her blood pressure naturally rises.

Head injury leading to swelling of the brain and a decrease in the volume of the cerebrospinal fluid space, which increases fluid pressure. The pressure can increase especially strongly in the presence of a hematoma (rupture of a vessel with leakage of blood, which occupies a certain volume of the cranial cavity, displacing cerebrospinal fluid).

Brain edema can occur as a result of intrauterine infection, birth trauma or acute fetal hypoxia during childbirth; in addition, too early fusion of the skull bones can lead to increased intracranial pressure, which is why the head cannot fully grow in accordance with the growth of the brain. Due to the growth of the brain, the volume for fluid remains less and less, its pressure increases.

Surgical interventions

Using surgical methods, it is possible to eliminate the cause that provoked the development of increased pressure in the skull, for example, to remove a tumor, hematoma or cyst.

In children with severe hydrocephalus, shunting is used - this is the creation of artificial pathways for the outflow of excess fluid.
The endoscopic method of installing shunts and performing ventricular plastic surgery is considered a promising direction. In inoperable cases, children undergo palliative operations to relieve suffering, such as spinal taps and ventricular punctures.
In case of severe head injuries with signs of displacement of brain structures and impaired consciousness in children, decompression craniotomy is considered justified to prevent the increase in intracranial hypertension.

Increased intracranial pressure is a symptom that accompanies some dangerous and serious diseases. The prognosis will depend on the cause of the development of the pathology, the severity of the disease, the timeliness of treatment and the individual characteristics of the body.

https://youtu.be/KJuctlOFqMo

Causes of brain diseases

The main cause of increased ICP in children is hydrocephalus, which occurs due to increased production of cerebrospinal fluid. Excess cerebrospinal fluid collects in different parts of the head, causing problems with the patency and absorption of cerebrospinal fluid.

Hydrocephalus often begins to appear before childbirth. It will be possible to detect signs of this disease only after the baby is born. If you treat a newborn in a timely manner, he can be saved from the disease . Sometimes blood pressure increases slowly for the following reasons:

Genetic and chronic disorders that provoke congenital neurological pathologies.
Birth too early before the cerebral cortex has formed.
Difficult pregnancy, accompanied by various diseases.
Intrauterine infection.
Birth injuries of the baby.

Treatment for elevated ICP in infants

Treatment consists of eliminating the causes of impaired circulation of intracranial fluid. Medicines are prescribed only when the diagnosis is completely certain. Products that are safe for infants are selected. Doses are selected individually.

To reduce intracranial pressure, infants are prescribed diuretics (furosemide), drugs to reduce the production of intracranial fluid, such as Diacarb or Triampur. Nootropic drugs (piracetam, Cavinton) are used in treatment. They improve blood circulation in the brain and speed up metabolism. Improving brain nutrition helps restore its normal functioning.

Neuroprotective drugs (glycine) are prescribed. They are needed to strengthen the nervous system.

Children are also given sedatives to help regulate sleep. It is recommended to walk a lot with the baby and do special gymnastics with him. Swimming has a beneficial effect on a child's psyche.

In case of extreme necessity, surgical treatment is performed, for example, removal of a brain tumor or elimination of an anatomical defect. For hydrocephalus, brain shunting is performed - surgical restoration of blood flow in its vessels (elimination of ischemia).

In special cases, fluid is drained from the skull using a catheter inserted into it or excess cerebrospinal fluid is diverted into the abdominal cavity.

After treatment, the baby must be periodically re-examined, especially carefully monitoring its development, paying attention to the slightest deviations

It is important to remember that treatment must be timely and should only be prescribed by a qualified specialist. You cannot rely on folk remedies and home methods of self-medication

You cannot rely on folk remedies and home methods of self-medication.

August 1, 2019 Olga Piskunova

Methods for diagnosing ICP in infants

A neurologist who suspects that a child has increased ICP prescribes an examination so that assumptions about the causes of the pathology can be clarified, as well as the pressure of intracranial fluid on the brain can be measured. The mother and child are referred to an ophthalmologist, who, after examining the baby’s fundus, will be able to notice signs of increased ICP (dilated retinal veins, swelling of the optic nerve). After this, it becomes clear that further, more detailed examination is necessary.

A fairly informative research method is neurosonography (ultrasound of the brain). The resulting image clearly shows characteristic changes in the size of the ventricles of the brain, as well as its other structures. For children whose fontanelle has not yet become overgrown, an ultrasound probe is applied to the crown of the head.

Using the Doppler ultrasound method, circulatory disturbances that cause increased ICP are detected in the vessels of the neck and brain.

Another technique using ultrasound is used - echoencephalography. 2 sensors are moved across the surface of the head. This produces a two-dimensional image of the brain.

Ultrasound examinations are absolutely painless and safe. They do not provide accurate ICP readings, but with a high probability it is possible to confirm the presence of pathology in the brain. In the most difficult cases, computed tomography methods are used.

Extremely rarely, only when absolutely necessary, ICP is measured by inserting a special needle with a sensor into the spinal canal or into the ventricles of the brain.

Signs and Symptoms of ICP Problems in Infants

Unfortunately, a newborn baby is not yet able to tell us what is bothering him. That is why we need to be extremely attentive to more than obvious physiological and behavioral signals on his part.

The following symptoms in an infant indicate intracranial pressure:

refusal of the mother's breast;
incessant, constant crying;
frequent turning of the head to the sides;
restless sleep, hyperexcitability;
excessive regurgitation, vomiting, nausea;
tremor;
uncontrolled movements of the eyeballs;
increased crying during sudden weather changes;
passivity and lethargy;
periodic visual disturbances;
very rapid head growth;
general retardation in development: the child walks, speaks, crawls, holds his head later;
lack of weight gain;
constant throwing of the head back;
protrusion of the eyes.

Signs of intracranial pressure in infants:

prominent large forehead;
the subcutaneous venous network on the head is visible;
a strip of white sclera is visible between the upper eyelid and the iris of the eye (when the baby looks down);
swollen fontanel (normally, it is sunken, slightly convex);
divergence of the skull bones;
strabismus (most often on the inside);
disproportionately large head.

Based on the above signs and symptoms, it is possible to promptly identify increased or decreased intracranial pressure in a child.

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Severe symptoms

Perhaps the main sign indicating this illness is the child’s restless behavior. The baby cannot sleep, cries constantly and even refuses to eat. Even water makes him sick.

In children aged several months, external symptoms of increased ICP can be noticed and identified.

They manifest themselves in changes in the child’s body parameters:

the head is not proportionately large;
the frontal part is enlarged;
fontanel with signs of swelling;
veins appear on the head;
eyeballs are too downward;
the baby has problems gaining weight and has a slow reaction time;
some developmental deviations are observed;
sometimes frequent regurgitation also indicates increased ICP.

As the child develops, the symptoms become more clear and pronounced. Having learned to speak, the baby himself will be able to say that he is experiencing pain, and it will become easier for parents to understand what kind of condition the child has.

To a pediatric neurologist

If there is a suspicion of increased intracranial pressure in infants, the pediatrician will definitely suggest a consultation with a specialist doctor. After examining the fontanel, checking the tone, measuring the circumference of the head, the specialist will give a direction for the following diagnostic procedures:

Neurosonography.

This method is used if the large fontanel is not yet closed. Using ultrasound, you can evaluate each ventricle, examine the structure of the brain and determine its echogenicity. To understand whether the pathology is progressing or not, it is necessary to repeat the procedure over time.

Dopplerography.

This is an informative diagnostic procedure, the results of which can be used to understand whether there is blockage of blood vessels, what the degree of pathology is and the parameters of blood flow intensity.

Computer or magnetic resonance imaging.

They make it possible to obtain a complete picture of the pathology and a description of its course. Prerequisite: the baby must be motionless. If without such a procedure it is impossible to make an accurate diagnosis, then anesthesia must be administered. Tomography is prescribed extremely rarely for infants, and if ICP is very dangerous for the baby.

Echoencephalography.

The most famous diagnostic method. Already outdated, since more accurate results can be obtained after other modern procedures.

Manifestations of ICP in infants

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For increased ICP in infants, attacks of crying and restlessness are typical, especially pronounced in the evening. During the day, the baby can be relatively calm, but in the evening and at night there may be attacks of loud and incessant crying, because of which the child cannot calm down or fall asleep. This occurs due to the peculiarities in the structure of the venous collectors and liquor ducts of infants. In the evening and at night, babies spend a longer time in a horizontal position, while the outflow of blood through the veins becomes more difficult, and the veins inside the skull and around the brain become overfilled with blood, which leads to an increase in the production of cerebrospinal fluid. An increase in the volume of cerebrospinal fluid leads to even greater stagnation of blood in the veins, which provokes an increase in intracranial pressure. Such changes provoke headaches, which cause problems with falling asleep, sleep disturbances with frequent awakenings.

Characteristics of increased ICP include copious and frequent regurgitation, as well as vomiting, the urge to vomit against the background of crying or anxiety.

Also typical are enlarged head sizes, disproportionate growth with divergence of the sutures and bulging of the fontanelles, an increase in the size of the forehead and cranium. This is due to the accumulation of fluid in the cranial cavity and its pressure on the meninges and bones of the skull. In order to reduce pressure, a compensatory increase in head circumference occurs - hydrocephalus is formed. As the size of the head increases, the venous network under the skin on the head becomes more pronounced. This occurs due to stretching of the skin and its thinning with stagnation of blood in the area of the venous plexuses, their overflow and expansion of the subcutaneous venous network. Such veins are more noticeable in the thickness of the skin.

Graefe's symptom may be detected - a disturbance in the area of the oculomotor nerves with uncontrolled downward deviations of the eyes, due to which a white stripe of the protein membrane is detected between the upper eyelid and the iris of the eye (this symptom is also called the “setting sun”).

Children may refuse feedings, since sucking physiologically increases intracranial pressure and increases the intensity of headaches. With poor feeding, children begin to gain weight worse, lose weight, their development is disrupted, and a lag in physical and psycho-emotional development occurs. Mental development disorders are associated with both nutritional deficiencies and the effects of ICP on brain tissue.

Normal pressure readings

The normal functioning of the central nervous system will be difficult if the cerebrospinal fluid circulates poorly and is retained in places. Liquor is located in the brain cisterns or ventricles, which are necessary for accumulation. Hydrocephalic syndrome occurs when too much of this fluid collects around the brain .

Liquor circulates normally between the meninges surrounding the organ. They are divided into 3 types: hard, cobweb, soft. Microscopic gaps are needed so that the cerebrospinal fluid circulates better between such membranes. Normal values of intracranial pressure are clearly defined.

In newborns, the normal value is 2-6 mmHg. Art. Infants are distinguished by a mark of 3-7 mm. Normal values change as a person ages. Increased ICP leads to the appearance of persistent hypertension syndrome.