Benign intracranial hypertension in children

Intracranial hypertension in children is a rare phenomenon. It directly affects the cranium and is a broad concept when the pressure inside the skull rises due to an increase in the amount of cerebrospinal fluid or blood. The condition is observed with brain tumors and other formations inside the skull. All of them put additional pressure on the brain tissue, which is why the characteristic symptoms occur.

The pressure inside the skull in a child can increase due to several reasons. But any manifestation of intracranial hypertension requires emergency care.

Description of pathology

For a newborn child who has just been born, there are already many indicators that allow you to assess his condition. A set of constants describes the functionality of the brain and the degree of its development. One of them reflects the ratio of the volume of the skull to the amount of fluid inside it, which is a constant value for children and adults.

In clinical practice, benign intracranial hypertension in children has the following picture:

• The child is not able to suck, or the sucking reflex is significantly reduced.
• Abnormal growth of the head circumference, which does not correspond to the age and size of the child's body.
• The sutures of the skull or fontanelles are in tension or protrude
  , there is no pulsation in them.
• The venous network of the head is visible to the naked eye, especially if the hair growth is not intense.
• The child is characterized by high muscle tone, there may be clonic convulsions.
• The disease is characterized by the so-called “setting sun” symptom, which covers differential diagnosis: when looking down, the baby’s sclera is visible.
• Often, parents are alarmed by the piercing cry of a child for no reason. The scream can be paroxysmal and end with vomiting.

All symptoms speak of irritation of the brain by some pathological process.

Etiology of the disease

A detailed study of such a problem in newborns made it possible to establish many etiological causes. The brain and spinal cord is a single system, so the amount of cerebrospinal fluid and its condition directly determines the pressure in the cranium.

Pathological conditions are observed in several cases:

• Cerebrospinal fluid is produced in excess.
• Liquor is produced in the optimal amount, but its absorption is difficult.
• The outflow of cerebrospinal fluid along the excretory pathways is disturbed due to discirculation.

There are reasons that are reflected in these pathologies:

• Brain injuries during childbirth, with concussions and bruises.
• Infectious process in the tissues of the brain - meningitis, encephalitis.
• Consequences of poisoning, exposure to toxins or radiation.
• Intrauterine malformations of the nervous system.
• Underdevelopment of the vascular network, anomalies of the arteries or veins of the brain.
• In the cranium there is a tumor process of various localization and degree of progression.

Such conditions can occur not only in newborns, but in any age group.

No one is immune from domestic injuries, infections and other processes, and children are the most vulnerable.

There are some causes of intracranial hypertension that are unique to infants:

• Complicated pregnancy, all types of gestosis in the mother.
• All degrees of prematurity, postmaturity of the fetus, artificial induction of labor.
• Intrauterine infections of the fetus, hypoxia.
• Congenital malformations of the brain or stem.

Rapid diagnosis and therapy

Increased pressure in the skull requires rapid diagnostic measures and emergency care.

The presence of symptoms of brain irritation requires examination not only by a pediatrician, but also by a narrower specialist - a neurologist, who is able to accurately determine the causes of the pathology and prescribe the most effective treatment.

Advanced diagnostics usually include:

1. Detailed history taking, observation of the child at the time of feeding, sleep and wakefulness. Examination of the mother for latent infections of the intranatal and postnatal period, taking biological samples of breast milk.
2. The fine structure of the bones of the skull in children makes it possible to perform an ultrasound of the brain, which is extremely informative. Fontanelles do allow you to determine the volume of the ventricles, the increase of which is the main etiology of ICP.
3. Echoencephalography is somewhat outdated, but has not lost its informativeness. It "sheds light" on the blood supply to the head and vascular pathology.
4. Sometimes they resort to a study that is unsafe for children - MRI. Tomography is able to reflect the most hidden intracranial problems.

Treatment of pathology

Establishing the cause of intracranial hypertension requires emergency therapeutic care.

Benign treatment of pathology can be corrected by drug treatment. Usually it consists in a physiotherapeutic effect, massage and drugs that normalize the volume and exchange of cerebrospinal fluid.

When intracranial hypertension is diagnosed, the risk of surgery is high. It is not always possible for CSF to be eliminated from the body on its own, so it needs to be helped with a shunt. There are cases when a child is given such a device for an unlimited period, and sometimes for life.

With timely assistance, a history of intracranial hypertension in the anamnesis may not affect the health of a growing organism in the future. Children quickly recover, do not lag behind their peers, develop perfectly in personal and creative terms. The continued presence of a shunt in the brain necessitates some care to avoid head injury. Otherwise, these children are no different from others.