Expansion of the anterior horns in a child consequences. Normal and abnormalities of the brain on an ultrasound scan of a baby

The first is the left lateral ventricle, the second is the right. Through the Monroe (interventricular) foramina, the left and right lateral ventricles communicate with the third ventricle. They are located symmetrically on either side of the midline, just below the corpus callosum. Each lateral ventricle consists of an anterior frontal horn, a central part (body), a posterior occipital part, and an inferior temporal horn.

Causes of dilatation of the lateral ventricles. Diagnostics.

Dilation, or expansion of the lateral ventricles, occurs due to the production of a large amount of cerebrospinal fluid, as a result of which it does not have time to be excreted normally, or due to the occurrence of obstacles to the exit of the cerebrospinal fluid. This disease most often occurs in premature babies due to the fact that the size of their lateral ventricles is much larger than in children born at term.

When diagnosing hydrocephalus, the size of the lateral ventricles is determined by their quantitative and qualitative characteristics. There are a sufficient number of special techniques for this. In this case, the immediate depth of the lateral ventricles is measured, as well as the size of the cavity of the transparent septum located in the third ventricle.

Normally, the depth of the ventricles ranges from 1 to 4 mm. When these indicators increase by more than 4 mm, as a result of which their lateral curvature disappears and the shape becomes rounded, they speak of the beginning of expansion of the lateral ventricles.

Dilatation of the lateral ventricles is not considered a pathology, but a symptom of some disease. It is this reason that specialists have to diagnose.

Diseases in which dilatation of the lateral ventricles occurs.

Excessive accumulation of cerebrospinal fluid most often occurs as a result of a condition such as hydrocephalus. It is considered a fairly serious brain pathology. In this case, the process of cerebrospinal fluid absorption is disrupted, as a result of which it accumulates in the lateral ventricles, which leads to their dilatation.

Excess cerebrospinal fluid appears with lesions of the central nervous system. In this case, the ventricles dilate due to the slow release of cerebrospinal fluid.

Disturbance in the normal circulation of cerebrospinal fluid occurs due to the occurrence of neoplasms in the form of tumors or cysts, as well as as a result of traumatic brain injuries, inflammatory processes and hemorrhages in the brain.

A common cause of dilatation is a congenital defect of the Sylvian aqueduct. It occurs in 30% of cases of hydrocephalus. Hydrocephalus can also be caused by an aneurysm of the vein of Galen and a subdural hematoma of the posterior cranial fossa.

Arnold-Chiari syndrome causes communicating hydrocephalus. In this case, a displacement of the brain stem and cerebellum occurs. This condition can also be caused by cytomegaly or toxoplasmosis.

Other causes of dilatation of the lateral ventricles.

Dilatation of the lateral ventricles can cause brain defects. At the same time, despite the fact that they do not affect the child’s health, observation by a specialist is still necessary.

Most often, dilatation of the lateral ventricles, not caused by serious diseases, does not lead to serious consequences. It can be a consequence of rickets, and also appear as a result of the specific structure of the skull.

Dilatation and asymmetry of the lateral ventricles is detected by ultrasound examination of the brain. If in doubt, a repeat ultrasound scan is scheduled after a certain period of time.

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Enlargement of the ventricles of the brain in newborns

Before answering the question why the ventricles of a child’s brain are enlarged, you should have an idea of what these ventricles are.

The cerebral ventricles are a whole system of interconnected cavities in the brain, necessary for the deposition of cerebrospinal fluid (CSF).

What are they?

Lateral ventricles. They are the same containers in the brain intended for depositing cerebrospinal fluid. In size, the lateral ventricles are superior to all others. The ventricle located on the left side is designated as the first, and the one located on the right is designated the second. Both lateral ventricles communicate with the third ventricle using special (Monroy) foramina. The location of these ventricles is on the lateral sides, slightly below the corpus callosum. The lateral ventricles contain the anterior, posterior, inferior horns and body.

Fourth ventricle. It is a very important formation of the brain, and is located between the medulla oblongata and the cerebellum. In terms of its structure, the fourth ventricle looks like a rhombus, but many associate its shape with the shape of a tent with a roof and bottom. The very bottom of the fourth ventricle has a diamond shape, which is why it is called the rhomboid fossa. This anatomical formation contains the spinal canal, as well as the canal connecting the fourth ventricle with the aqueduct.

In addition to the storage function, the cerebral ventricles also perform a formative function, namely the formation of cerebrospinal fluid. Normally, the synthesized cerebrospinal fluid should exit into the subarachnoid space, but there are situations when this process fails. If the body's normal flow of cerebrospinal fluid from the ventricles is disrupted, the condition is called hydrocephalus.

What does ventricular dilatation mean in a child?

You should not always panic if such a condition occurs. An increase in the size of the ventricles of the brain in a child does not always signal the presence of a pathological process. This process may be physiologically determined, and it only means that the child simply has a large head size. Enlargement of the ventricles of the brain is not uncommon in children under the first year of life. In this case, it is imperative to establish the sizes of not only all ventricles, but also the remaining liquor systems.

Excessive accumulation of cerebrospinal fluid is the basis of why the ventricles of the brain may be enlarged in an infant or young child. Disruption of the outflow of cerebrospinal fluid can be caused by a certain obstacle in the way of its exit.

A condition such as enlargement of the ventricles of the brain in a child is most often observed in children born prematurely. This is due to the fact that in such children the sizes of the lateral ventricles are comparatively larger than in children born according to their term. If there is a suspicion of enlargement or asymmetry of the lateral ventricles, it is necessary to measure them and determine their qualitative characteristics. Let us consider in more detail the conditions in which an increase in the size of the ventricles of the brain in children is possible.

Ventriculomegaly

This pathology means an enlargement of the cavities of the cerebral ventricles, as a result of which a number of disorders of the functions of the central nervous system develop. Most often, this pathology affects the lateral ventricles of the brain.

Types of ventriculomegaly

According to severity, this disease can be divided into severe, moderate and mild forms. Depending on the location of the pathological process, ventriculomegaly is divided into the following types:

Side shape. With this form, the lateral and posterior ventricle enlarges.
Type No. 4. Affects the area of the cerebellum and medulla oblongata.
Type No. 3. The pathological process is localized in the area between the visual hillocks and the frontal part.

Why does it occur

The main reason for the development of this process is chromosome abnormalities in the body of a pregnant woman. Secondary causes of the development of the disease include all kinds of infections.

Main symptoms

Such a complex pathology can cause the child to develop Turner and Down syndromes. Moreover, ventriculomegaly affects the structure of the brain and heart.

Diagnostics

Pathological enlargement of the ventricles of the brain is determined using ultrasound diagnostics of the brain.

Treatment

The key point in the treatment of this pathology is the maximum prevention of the development of possible complications from organs and systems. First of all, drug therapy is carried out, which includes taking diuretics, vitamin preparations and antihypoxants. Additional methods include massage and special therapeutic exercises. To prevent the development of serious neurological complications, it is recommended to take drugs that retain potassium ions in the child’s body.

We also cannot exclude another possible pathology in which the ventricles of the brain in an infant will be enlarged, namely hypertensive-hydrocephalic syndrome (HHS).

What is

This syndrome refers to a condition characterized by excessive production of cerebrospinal fluid, which tends to accumulate under the membranes of the brain and in its ventricles. In terms of frequency of occurrence, hypertensive-hydrocephalic syndrome is a rather rare pathology and requires serious justification.

What is it like?

This pathology is classified according to the age of the children, and the HGS of newborn children and older children are distinguished.

Why does it occur

All causes of the appearance of HGS can be divided into congenital and acquired. Congenital causes include:

Complicated course of pregnancy followed by complicated childbirth.
Damage to the child’s brain due to intrauterine oxygen deprivation, developmental defects and birth trauma.
Childbirth before the due date.
Intrapartum trauma followed by hemorrhage into the subarachnoid space.
Any intrauterine infections.
Anomalies of brain development.
Late birth.
A long period of time between the rupture of amniotic fluid and the expulsion of the fetus.
Some chronic diseases of the mother.

Acquired causes of HGS include:

Any tumor formations of the brain (cysts, hematomas, abscesses).
Presence of a foreign body in the brain.
Fractures of the cranial bones with subsequent penetration of bone particles into the brain.
Infectious diseases.
Unknown cause of HGS.

How does the disease manifest itself?

The clinical picture of hypertensive-hydrocephalic syndrome is based on the following factors:

Increased intracranial pressure (hypertension).
An increase in the amount of cerebrospinal fluid in the ventricles of the brain (hydrocephalus).

In newborns, HGS can be suspected by a number of the following signs:

The child refuses breastfeeding, cries and is capricious for no particular reason.
Overall muscle tone decreases.
Shaking (tremor) of the upper and lower extremities often develops.
All innate reflexes, such as swallowing and grasping, are sharply reduced.
There is frequent regurgitation.
Strabismus develops.
During a medical examination, a child may have a rising sun symptom, when the child's iris is half covered by the lower eyelid.
There is a divergence of the cranial sutures, in particular the sagittal one.
The fontanelles are tense and bulging.
Every month there is a pathological increase in head circumference.
During fundus examination, swelling of the optic discs is clearly visible.

In older children, the manifestation of HGS symptoms develops immediately after an infectious process or traumatic brain injury.

The most characteristic sign of enlargement of the ventricles of the brain in a child and the development of the HGS is the appearance of a headache, which most often appears in the morning. Constant nausea and vomiting are also typical. The headache is of a pressing or bursting nature, and is localized in the temples or forehead.

Often such children complain about the inability to raise their eyes up and at the same time lower their heads down. Cases of dizziness are also common. During characteristic attacks, the child’s skin becomes pale, general weakness and reluctance to do anything appear. Loud sounds and bright lights are strong irritants for such children.

Due to increased tone in the muscles of the lower extremities, such children can walk on their toes, they develop strabismus, there is increased drowsiness and slower psychomotor development.

How to diagnose

In general, it is quite difficult to accurately diagnose hypertensive-hydrocephalic syndrome, and to understand whether the cerebral ventricle is really enlarged in a newborn. Not always, even the latest diagnostic methods allow this diagnosis to be made with 100% accuracy. In children in the neonatal period, the main diagnostic criteria are head circumference and reflex control. Other diagnostic measures include:

Assess the condition of the vascular network of the fundus for edema, hemorrhage or spasm.
Carrying out neurosonography to determine the size of the ventricles of the brain.
MRI and computed tomography of the brain.
Lumbar puncture to determine cerebrospinal fluid pressure. This method is the most reliable.

Treatment Options

The treatment of this pathology should be carried out by a neuropathologist together with a neurosurgeon. Children with this syndrome should be under constant medical supervision to avoid possible complications and worsening of the condition. In newborns up to six months, enlargement of the ventricles of the brain and the HPA is treated on an outpatient basis. The main therapeutic measures include:

Taking diuretics (diuretics), as well as medications that reduce the production of cerebrospinal fluid (Diacarb).
Inclusion of nootropic drugs in therapy. This group of drugs improves blood supply to the brain.
Taking sedatives.
Special gymnastics and massage.

Treatment of infants is long-term and serious. Sometimes this takes several months.

In older children, treatment of HGS is pathogenetic in nature, and the selection of therapy is carried out according to the cause that caused this syndrome. If the disease occurs after an infection, then the therapy must include the use of antibacterial or antiviral drugs.

If the cause of HGS is a traumatic brain injury or a tumor process, then surgical intervention cannot be ruled out.

Possible complications

A condition such as hypertensive-hydrocephalic syndrome can cause a number of complications from various organs and systems. Such complications include:

Delayed psychomotor development.
Complete or partial blindness.
Persistent hearing impairment up to deafness.
Development of coma.
Complete or partial paralysis.
Abnormal bulging of the fontanel.
Development of epilepsy attacks.
Incontinence of feces and urine.
Fatal outcome.

The prognosis for children during infancy is considered to be most favorable. This is due to periodic increases in blood and intracranial pressure, which return to normal with age. For older children, the prognosis is less favorable, and depends solely on the cause that led to the development of HGS, as well as the approach to treatment.

Moderate expansion of the lateral ventricles of the brain in a child

They made our third NSG. Conclusion - No gross violations were identified. Moderate dilation of the anterior horns of the lateral ventricles. In words, the uzistka said that there is an expansion of the external liquor spaces, but at the upper limit of the norm. In conclusion, she did not write this. The second NSG was in November, its conclusion was the expansion of external liquor spaces. Moderate expansion of the anterior horns of the lateral ventricles. The first NSG was in August, everything was fine there. In general, there are no positive dynamics. I read on the Internet that such conditions cannot be treated with massages and physiotherapy; medications are needed.

Good afternoon We are 1 month old. Yesterday we had a medical examination. I was very upset, I don’t know what to do. They did an ultrasound Neurosonography, in the conclusion they wrote: Echo signs of dilatation of the lateral ventricles, 3 ventricles. The resistance index in PMA is moderately reduced. We gained little weight in a month. Born on 3920, discharged from the maternity hospital at 3500. Yesterday we weighed 4150. During the ultrasound, the child cried, can the baby’s crying have an effect? Or the baby's weight? The neurologist did not prescribe treatment (only give Elkar, 3 drops, 3 times a day and supplement with formula).

Let's define the terms. Hydrocephalus is a dynamic process of dilatation of the ventricles with a certain clinical picture, if there are no complaints or neurological disorders for a long time, but according to the NSG the sizes of the ventricles do not fit into the normative indicators - this is ventriculomegaly. Isolated ventriculomegaly - changes are detected only on the side of the lateral ventricles without pathological changes on the part of the brain parenchyma. Let's decide on the sizes. Ventriculomegaly is diagnosed in a child when the size of the lateral ventricles is more than 10 mm! Values up to 10 mm are the norm! Ventriculomegaly is divided into three degrees: mild.

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Dilatation of the lateral ventricles of the brain in a newborn child

This article will be relevant for parents whose children have been diagnosed with enlarged ventricles of the child’s brain.

The ventricles are a system of anastomizing cavities that communicate with the spinal cord canal.

The human brain contains structures that contain cerebrospinal fluid (CSF). These structures are the largest in the ventricular system.

They can be divided into the following types:

The lateral ventricles are designed to store cerebrospinal fluid. Compared to the third and fourth, they are the largest among them. On the left side there is a ventricle, which can be called the first, on the right side - the second. Both ventricles work with the third ventricle.

The ventricle, called the fourth, is one of the most important formations. The fourth ventricle contains the spinal canal. It appears to be diamond-shaped.

An increase in the size of the ventricles is a consequence of a violation of the cerebrospinal fluid (CSF).

Causes of dilatation

In medicine, enlargement of the ventricles is called ventriculomegaly. For whatever reason, dilation occurs, the greatest danger lies in their asymmetry. Symmetrical ventriculomegaly can be either normal or a sign of hydrocephalus.

If the size of the cerebral ventricles in newborns is disproportionate, increased, i.e. If their asymmetry is observed, this most likely indicates a volumetric formation.

The reasons why a child’s indicators are dilated can be congenital or acquired.

Congenital defects include complications such as:
Intrauterine hypoxia (oxygen starvation) of the child; Complication of pregnancy and childbirth;
Premature birth of a child;
Disturbed development of the central nervous system.

It is also worth taking into account hemorrhages, which in turn causes compression of the ventricle, resulting in its asymmetry.

Acquired pathologies include:

This disease, like hydrocephalus, leads to an increase in cerebrospinal fluid, although it does not appear immediately and the cerebrospinal fluid cavities may not increase for a long time. Only after a sharp rise in intracranial pressure do the sizes begin to expand.

An example of ventricular dilatation can be a disease such as rickets or appear due to an irregular shape of the skull. The normal depth of the ventricles is from 1 to 4 mm. An increase in these indicators indicates their expansion.

Manifestations of dilatation

When intracranial pressure increases, a child exhibits the following symptoms:

Decreased appetite of the child; it often happens that the child refuses breastfeeding.
Muscle tone is reduced.
Tremors of the upper and lower extremities appear.
Clear manifestation of veins on the forehead, the cause is obstructed outflow from the cranial cavity.
The child's swallowing and grasping abilities are reduced.
High likelihood of developing strabismus.
Disproportionality of the head.
Frequent regurgitation due to increased cerebrospinal fluid pressure.

A characteristic sign of ventricular enlargement and the development of hypertensive-hydrocephalic syndrome (HHS) manifests itself in a headache that begins in the morning on the left or right. Often the baby feels sick and vomits.

The child often complains of the inability to raise his eyes and lower his head, dizziness and weakness appear, and the skin begins to turn pale.

Diagnostic methods

It is very difficult to determine whether a baby’s ventricle is enlarged. Diagnostics does not provide a 100% guarantee that the diagnosis can be determined, even using the latest methods.

Closing of the fontanelles occurs within a period of 1-2 years, after which changes in the size of the cerebrospinal fluid of the brain are monitored.

The following types of diagnostics include the following:

Magnetic resonance imaging. It identifies problems in the soft tissue structures of the child’s brain quite well.
The condition of the fundus is assessed for the presence of edema or hemorrhage.
Neurosonography. It is carried out to determine the size of the ventricles (both left and right).
Lumbar puncture.
CT scan.

The problem with diagnosing a newborn using MRI is that the baby needs to lie quietly for about a minute. Since this task is almost impossible for a baby, doctors have to put the child into artificial sleep. However, there are serious contraindications for this procedure.

Therefore, most often, computed tomography is used to diagnose the size of the ventricles of the brain. At the same time, the quality of diagnosis is slightly lower than using MRI.

A violation is considered if the ventricles of the brain have a norm different from 1 to 4 mm.

Treatment

Enlarged ventricles are not always a reason to sound the alarm. When the ventricles of the brain are enlarged, this may be a case of individual and physiological development of the baby’s brain system. For example, for large babies this is the norm.

Treatment is carried out if it has been possible to prove through research that the infant’s liquor pressure is increased.

This disease is treated by a neuropathologist and neurosurgeon. The child is under constant medical supervision to avoid deterioration of the baby’s condition.

Treatment is carried out in the following ways:

Taking diuretics. Medicines that reduce the production of cerebrospinal fluid are also prescribed.
Drugs are prescribed to improve blood supply to the brain.
Calming (sedative) drugs.

Also, in the treatment of this disease the following will be ineffective: acupuncture, herbal treatment, homeopathy, therapy with vitamins.

First of all, in the treatment of dilation of the lateral ventricles in a child is to prevent the development of possible complications in the child.

Possible consequences of HGS

The condition of hypertensive-hydrocephalic syndrome often causes a number of serious complications, these include:

Ventricular enlargement in newborns, as a diagnosis, has a higher chance of a favorable outcome than in older children, due to increased arterial and intracranial pressure, which returns to normal as they grow older.

The expansion of the lateral ventricles of the brain has adverse consequences and primarily depends on the cause of the development of the HGS.

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Conclusion

Dilatation in newborns should not be considered an anomaly in the development of the baby. It is rare that this disease requires serious medical assistance. A complete and final diagnosis, which will be established by a qualified specialist - a neurologist, will reflect the complete picture of the disease.

Therefore, observation and consultation with a specialist are necessary so that your child does not suffer any complications.

Enlarged lateral ventricles of the brain in a child

What should you do if the doctor reports on an ultrasound that your child has enlarged ventricles of the brain? If the baby feels normal and there are no abnormalities in neuropsychic development, the specialist may suggest simply regularly visiting a neurologist to monitor the little patient’s condition. With a pronounced clinical picture of brain damage, pronounced neurological symptoms and a significant deviation in the size of the ventricles from the norm, treatment is necessary, which is prescribed by a neurologist.

Normal cerebral ventricles in a newborn

Normally, a person has four ventricles in the head: two lateral, they are located symmetrically, the third and fourth, located in the middle. The third is conventionally anterior, the fourth is posterior. The fourth ventricle passes through the cisterna magna, connecting to the central canal (spinal cord).

Why are doctors concerned about enlarged ventricles of the brain? The main function of the lateral structures is the production of cerebrospinal fluid and regulation of the volume of cerebrospinal fluid. A large release of fluid and a violation of its excretion provokes disruption of brain function.

The depth of the third ventricle should normally not exceed 5 mm, the fourth ventricle – 4 mm. If the lateral ventricles of the brain are considered, the norm for a newborn is calculated as follows:

Anterior horns – from 2 mm to 4 mm.
Occipital horns – from 10 mm to 15 mm.
Lateral bodies - no deeper than 4 mm.

The standard depth for a large tank is 3-6 mm. All brain structures should grow gradually, the size of the ventricles should be linearly consistent with the size of the skull.

Causes of enlarged ventricles of the brain

It is believed that changes in ventricular structures in infants are genetically determined. Pathological changes in the brain develop due to chromosomal abnormalities that occur in pregnant women. There are other factors that provoke asymmetry of the ventricles and excessive enlargement of parts of the brain:

Diseases of infectious etiology that a woman suffered during pregnancy.
Sepsis, intrauterine infections.
Entry of a foreign body into the brain structures.
Pathological course of pregnancy caused by chronic diseases of the mother.
Premature birth.
Intrauterine fetal hypoxia: insufficient blood supply to the placenta, increased placental blood flow, umbilical cord varicose veins.
Long waterless period.
Rapid birth.
Birth trauma: strangulation by the umbilical cord, deformation of the skull bones.

Experts also note that the ventricles of the brain in newborns may become enlarged due to the occurrence of hydrocephalus of unknown etiology. Congenital causes that provoke expansion of the ventricles of the head include the growth of neoplasms: cysts, benign and malignant tumors, hematomas.

A traumatic brain injury received by a child during childbirth, cerebral hemorrhage, ischemic or hemorrhagic stroke can also cause enlargement of the ventricles of the baby’s brain.

Clinical manifestations of ventricular dilatation

The ventricles not only store cerebrospinal fluid, they also secrete cerebrospinal fluid into the subarachnoid space. An increase in fluid secretion and a deterioration in its outflow leads to the fact that the ventricles stretch and enlarge.

An increase in the ventricular structures of the brain (dilatation, ventriculomegaly) may be a normal variant if a symmetrical expansion of the lateral ventricles is detected. If there is asymmetry of the lateral structures, the horns of only one of the ventricles are enlarged, this is a sign of the development of a pathological process.

Not only the lateral ventricles of the brain can become pathologically enlarged; the normal production and excretion of cerebrospinal fluid may be disrupted in the third or fourth. There are three types of ventriculomegaly:

Lateral: enlargement of the left or right part of the ventricular structures, expansion of the posterior ventricle.
Cerebellar: the medulla oblongata and cerebellar region are affected.
When pathological release of cerebrospinal fluid occurs between the visual tuberosities, in the frontal part of the head.

The disease can occur in mild, moderate, severe form. In this case, not only an expansion of the cavities of the ventricles of the brain is noted, but also a disruption in the functioning of the child’s central nervous system.

There is normal symmetrical oversizing of the lateral ventricular structures when the child is large, has a large head or an unusual skull shape.

Symptoms of the disease in an infant

Since the outflow of cerebrospinal fluid is impaired, it remains in large quantities in the head, while the intracranial pressure in the newborn increases, and swelling of the tissues, gray matter, and cerebral cortex increases. Due to pressure on the brain, blood supply is disrupted and the functioning of the nervous system deteriorates.

If the growth of the horns of the ventricles of the brain is accompanied by hydrocephalus, the child’s skull bones move apart, the fontanel bulges and tenses, the frontal part of the head can significantly exceed the facial part in size, and a network of veins protrudes on the forehead.

When the ventricle of the brain is enlarged in a newborn or pathological asymmetry of the lateral ventricles is noted, the child experiences the following neurological symptoms:

Impaired tendon reflex, increased muscle tone.
Visual impairment: inability to focus, squint, constantly downturned pupils.
Trembling of limbs.
Walking on tiptoe.
Low manifestation of basic reflexes: swallowing, sucking, grasping.
Apathy, lethargy, drowsiness.
Irritability, loudness, capriciousness.
Poor sleep, jumping up in sleep.
Poor appetite.

One of the most striking symptoms is frequent regurgitation, sometimes vomiting. Normally, a child should burp only after feeding - no more than two tablespoons at a time. Due to the fact that when intracranial pressure increases (it is provoked by excessive accumulation of cerebrospinal fluid in the cavity of the cranium), the vomiting center in the fourth ventricle at the bottom of the rhomboid fossa is irritated, the frequency of regurgitation in a newborn increases significantly (more than twice after feeding and later).

The acute, rapid development of the disease provokes severe headaches, which is why the child constantly screams loudly and monotonously (brain scream).

Diagnostic methods

For the first time, a doctor can pay attention to deviations in the size of brain structures from the norm during an intrauterine ultrasound examination of the fetus. If the head size does not return to normal, a repeat ultrasound is performed after the baby is born.

Enlargement of the ventricles of the brain in newborns is diagnosed after neurosonography - ultrasound performed through the skin of an undeveloped fontanel. This study can be carried out until the child’s skull bones have completely fused.

If the disease develops chronically, the doctor may pay attention to the fact that the ventricles of the brain are larger than normal when examining the child with an ultrasound scan at three months of age. To clarify the diagnosis, it is recommended to undergo additional examination:

Ophthalmological examination - helps to identify swelling of the eye discs, indicating increased intracranial pressure, hydrocephalus.
Magnetic resonance imaging can be used to monitor the growth of the cerebral ventricles after the bones of the child’s skull have fused. MRI is a long procedure, the time spent under the machine is minutes. In order for the child to lie motionless for such a long time, he is immersed in medicated sleep.
When undergoing a CT scan, you do not need to remain motionless for a long time. Therefore, this type of study is suitable for children for whom anesthesia is contraindicated. Using CT and MRI, you can obtain accurate images of the brain, determine how much the size of the ventricular system deviates from the norm, and whether there are neoplasms or hemorrhages in the medulla.

It is recommended to undergo an ultrasound of the brain for children in the first month of life if pregnancy or childbirth was accompanied by complications. If the ventricles are enlarged but there are no neurological symptoms, it is recommended to be re-examined after three months.

Treatment

When a child has enlarged ventricles of the brain, only a neurologist or neurosurgeon can prescribe the necessary treatment.

Drug therapy

Enlargement or asymmetry of ventricular structures does not always require treatment. If the child develops correctly, eats and sleeps well, it is considered that enlargement of the ventricular horns is an acceptable deviation from the norm.

If pronounced neurological symptoms occur, the baby is prescribed special medications:

Diuretics (Diacarb, Furosemide) - to reduce cerebral edema, speed up urination, and normalize fluid excretion from the body.
Potassium preparations (Panangin, Asparkam) - to replenish potassium deficiency, which occurs during accelerated work of the urinary tract.
Vitamins (Multitabs, B6, D3, Magne B6) - to prevent rickets and accelerate regeneration processes in the body of a newborn.
Nootropic drugs (Cavinton, Vinpocetine, Noofen, Ecephabol, Cerebrolysin) - to normalize cerebral circulation, strengthen blood vessels, improve microcirculation in brain tissue.
Sedative medications (Glycine) – help reduce nervous symptoms: tearfulness, moodiness, irritability; stabilize the process of falling asleep, normalize sleep.

If the provoking factors that caused the pathological growth of the ventricles of the brain are identified, they are also eliminated: viral and infectious diseases are treated. If the cause of the pathology is brain damage or the growth of a tumor, surgical intervention is performed: the cyst is excised, the cancerous tumor is removed.

When enlarged ventricles of the brain are diagnosed in a child, treatment takes a long period of time. Newborns need to undergo massage courses and constantly perform physical therapy exercises to restore muscle tone and prevent atrophy.

Possible consequences and complications

Probably due to the wide availability of information and the opportunity to consult with other parents, an unhealthy trend has been observed recently. Parents refuse to treat their children for hydrocephalus; they attribute constant crying to capriciousness and stubbornness, and lethargy to character traits. People are frightened by serious medications and contraindications, and they decide that the disease will go away on its own.

But asymmetry of the ventricles of the brain, their significant increase can lead to serious consequences:

Delayed mental, physical, mental development.
Loss of vision: complete or partial.
Hearing loss.
Paralysis of limbs, complete immobilization.
Pathological head growth.
Inability to regulate bowel movements and urination.
Epileptic seizures.
Frequent loss of consciousness.
Comatose state.
Lethal outcome.

It’s good if the doctor notes a slight deviation from the norm during the ultrasound and suggests only observing the patient. This is possible if there are no symptoms of the disease: the child is calm, eats well, sleeps, and develops normally.

A diagnosis of “Dilation of the lateral ventricles of the brain in a child” has been made, but you doubt the professionalism of the doctor, and do not want to give your newborn medications in vain? Contact several independent specialists and get a complete examination. Do not refuse treatment, since the actions of the parents determine how fulfilling the child’s life will be.

All information on the site is provided for informational purposes only and cannot replace consultation with your attending physician.

In the first days after birth, not only a huge number of tests are taken from the child, vaccinations are given, many medical procedures are performed, but an ultrasound of the brain is also performed. Doctors need to know the state of the brain, whether all its parts are properly developed, since the subsequent life and health of a person depends on this.

For newborns, the procedure is carried out through the fontanelles, which are non-ossified areas of the baby's skull with a thin, membrane-like structure. There are several fontanelle spots on the baby's head. Their goal is to help the child during childbirth, allowing the head to adapt to the anatomical features of the birth canal. After birth, the fontanelles tighten, and only one remains, through which the brain is mainly examined.

The main purpose of an ultrasound is to make sure that there are no possible abnormalities and that all indicators are normal, but, unfortunately, this is not always the case. A difficult pregnancy, difficulties during childbirth, genetic abnormalities, etc. can disrupt the development of the newborn’s brain. The same reasons can also cause an increase in the lateral ventricles of the brain in children, which has recently been often diagnosed by doctors.

What are the ventricles of the brain?

In the human brain there are special structures containing cerebrospinal fluid, i.e. cerebrospinal fluid. Their main purpose is the production and circulation of cerebrospinal fluid. There are several types of ventricles: lateral, third and fourth.
The largest are the lateral ones, resembling the letter C. The left lateral ventricle is considered the first, the right - the second. The lateral ventricles communicate with the third, which contains subcortical autonomic centers. The unpaired or fourth ventricle of the brain resembles a diamond or pyramid in shape.

Being in fact a remnant of the brain bladder, this ventricle is an extension of the central canal of the spinal cord. All ventricles communicate with each other through holes and channels, which ensures the movement of cerebrospinal fluid and its subsequent outflow.

Reasons for expansion

Unfortunately, expansion of the ventricles of the brain negatively affects the child’s nervous system, development and health. Modern diagnostic methods, in particular computer or magnetic resonance imaging, allow us to assess the situation and condition of the baby and diagnose problems.

Often, infants are found both expansion and asymmetry lateral ventricles of the brain. The objective reason for this is increased secretion and impaired patency of the cerebrospinal fluid. It turns out that the cerebrospinal fluid is simply not able to leave the brain canals in a timely manner. Most experts consider dilation of the lateral ventricles in newborns to be a symptom of a specific disease. This may be (impaired circulation and absorption of cerebrospinal fluid), tumors and neoplasms in the brain, traumatic brain injury, etc.

Enlargement of the ventricles of the brain in a newborn may not be a manifestation of some disease, but a consequence of a developmental defect. For example, expansion of the cephalic ventricles may be a consequence of, or may occur due to the unusual shape of the skull. Doctors also consider chromosomal abnormalities in the mother's body, infection or virus entering the placenta during pregnancy, a hereditary factor, complicated or early birth, hypoxia and some others as reasons.

What to do and how to treat?

Expansion of the ventricles of the brain in a newborn is not always a reason for panic. Their increase does not always indicate a serious pathology, but may be the cause of the individual and physiological development of the child. For example, in large children this is rather the norm.

Today, every fifth child under the age of one year has enlarged ventricles of the brain. If a defect is detected, not only the size of the ventricles will be determined, but also all other systems associated with the transportation and secretion of cerebrospinal fluid. When prescribing the necessary course of treatment, the neurologist will rely both on the numbers and indications of the examination, and on general symptoms. For example, an increase of several millimeters in one ventricle in the absence of pathologies and symptoms of other brain structures does not require drug therapy.

In case of more serious deviations, the doctor prescribes treatment with diuretics, antihypoxic vitamin preparations. Some experts recommend massage and special therapeutic exercises to help drain cerebrospinal fluid. The primary task in treating enlarged ventricles of the brain is to prevent the development of possible complications in the child’s body and nervous system.

In any case, the treatment of such pathology should be carried out by a neurologist and a neurosurgeon. Newborns with enlarged lateral ventricles are under close and regular medical supervision. Babies under six months are often treated on an outpatient basis, sometimes for several months.

As a small conclusion

Enlargement of the ventricles of the brain in newborns is not considered an acute developmental abnormality. A child rarely needs serious treatment, but the final, complete diagnosis and treatment plan must be established by a qualified neurologist, who, naturally, will take into account the indications and general manifestations of neurological abnormalities. Therefore, constant monitoring and consultation with a doctor are vital. Our advice to parents is to contact a good neurologist and, of course, do not panic under any circumstances.

Normal cerebral ventricles in a newborn

Anterior horns – from 2 mm to 4 mm.
Occipital horns – from 10 mm to 15 mm.
Lateral bodies - no deeper than 4 mm.

The standard depth for a large tank is 3-6 mm. All brain structures should grow gradually, the size of the ventricles should be linearly consistent with the size of the skull.

Causes of enlarged ventricles of the brain

Diseases of infectious etiology that a woman suffered during pregnancy.
Sepsis, intrauterine infections.
Entry of a foreign body into the brain structures.
Pathological course of pregnancy caused by chronic diseases of the mother.
Premature birth.
Intrauterine fetal hypoxia: insufficient blood supply to the placenta, increased placental blood flow, umbilical cord varicose veins.
Long waterless period.
Rapid birth.
Birth trauma: strangulation by the umbilical cord, deformation of the skull bones.

A traumatic brain injury received by a child during childbirth, cerebral hemorrhage, ischemic or hemorrhagic stroke can also cause enlargement of the ventricles of the baby’s brain.

Clinical manifestations of ventricular dilatation

An increase in the ventricular structures of the brain (dilatation, ventriculomegaly) may be a normal variant if a symmetrical expansion of the lateral ventricles is detected. If there is asymmetry of the lateral structures, the horns of only one of the ventricles are enlarged, this is a sign of the development of a pathological process.

Lateral: enlargement of the left or right part of the ventricular structures, expansion of the posterior ventricle.
Cerebellar: the medulla oblongata and cerebellar region are affected.
When pathological release of cerebrospinal fluid occurs between the visual tuberosities, in the frontal part of the head.

There is normal symmetrical oversizing of the lateral ventricular structures when the child is large, has a large head or an unusual skull shape.

Symptoms of the disease in an infant

When the ventricle of the brain is enlarged in a newborn or pathological asymmetry of the lateral ventricles is noted, the child experiences the following neurological symptoms:

Impaired tendon reflex, increased muscle tone.
Visual impairment: inability to focus, squint, constantly downturned pupils.
Trembling of limbs.
Walking on tiptoe.
Low manifestation of basic reflexes: swallowing, sucking, grasping.
Apathy, lethargy, drowsiness.
Irritability, loudness, capriciousness.
Poor sleep, jumping up in sleep.
Poor appetite.

The acute, rapid development of the disease provokes severe headaches, which is why the child constantly screams loudly and monotonously (brain scream).

Diagnostic methods

Ophthalmological examination - helps to identify swelling of the eye discs, indicating increased intracranial pressure, hydrocephalus.
Magnetic resonance imaging can be used to monitor the growth of the cerebral ventricles after the bones of the child’s skull have fused. MRI is a long procedure, the time spent under the machine is 20-40 minutes. In order for the child to lie motionless for such a long time, he is immersed in medicated sleep.
When undergoing a CT scan, you do not need to remain motionless for a long time. Therefore, this type of study is suitable for children for whom anesthesia is contraindicated. Using CT and MRI, you can obtain accurate images of the brain, determine how much the size of the ventricular system deviates from the norm, and whether there are neoplasms or hemorrhages in the medulla.

When a child has enlarged ventricles of the brain, only a neurologist or neurosurgeon can prescribe the necessary treatment.

Drug therapy

If pronounced neurological symptoms occur, the baby is prescribed special medications:

Diuretics (Diacarb, Furosemide) - to reduce cerebral edema, speed up urination, and normalize fluid excretion from the body.
Potassium preparations (Panangin, Asparkam) - to replenish potassium deficiency, which occurs during accelerated work of the urinary tract.
Vitamins (Multitabs, B6, D3, Magne B6) - to prevent rickets and accelerate regeneration processes in the body of a newborn.
Nootropic drugs (Cavinton, Vinpocetine, Noofen, Ecephabol, Cerebrolysin) - to normalize cerebral circulation, strengthen blood vessels, improve microcirculation in brain tissue.
Sedative medications (Glycine) – help reduce nervous symptoms: tearfulness, moodiness, irritability; stabilize the process of falling asleep, normalize sleep.

Possible consequences and complications

But asymmetry of the ventricles of the brain, their significant increase can lead to serious consequences:

Delayed mental, physical, mental development.
Loss of vision: complete or partial.
Hearing loss.
Paralysis of limbs, complete immobilization.
Pathological head growth.
Inability to regulate bowel movements and urination.
Epileptic seizures.
Frequent loss of consciousness.
Comatose state.
Lethal outcome.

In the first hours after birth, the child is under the supervision of neonatologists, who monitor his physiological condition and perform the necessary examinations of the body. In this case, health assessment is carried out in stages, starting from the first minute of life, and ends before discharge.

The most thorough examination is carried out on the first day and consists of a standard procedure for monitoring the activity and appearance of the newborn. If the doctor suspects congenital malformations, then it is possible to use an ultrasound examination, which can reveal abnormalities in the formation of not only internal organs, but also the brain. In this case, the sizes of the ventricles are especially carefully measured, which normally should not exceed a certain value.

At this stage, the neonatologist can diagnose dilation of the ventricles of the brain in newborns. Based on the degree of pathology and the impact on the child’s life, the question will be raised about further solving this problem: for example, in case of minor deviations from the norm, observation by a neurologist and monitoring of the condition are prescribed. If the violations are serious and the symptoms are pronounced, then the child needs special treatment and observation in a hospital setting.

Ventricular system of the brain

The ventricular system consists of 4 cavities located in parts of the brain. Their main purpose is the synthesis of cerebrospinal fluid or cerebrospinal fluid, which performs a large number of tasks, but its main function is to cushion the brain matter from external influences, control intracranial pressure and stabilize metabolic processes between the blood and the brain.

The movement of cerebrospinal fluid occurs through channels connecting the common 4th ventricle and the subarachnoid space formed by the membranes of the spinal cord and brain. Moreover, its main volume is located above significant fissures and convolutions of the cortex.

The largest lateral ventricles are located equidistant from the midline below the corpus callosum. The first ventricle is considered to be the cavity located on the left side, and the second - on the right. They are C-shaped and wrap around the dorsal parts of the basal ganglia. They produce cerebrospinal fluid, which enters the third ventricle through the intergastric openings. Structurally, segments I and II of the ventricular system include the anterior (frontal) horns, body and inferior (temporal) horns.

The third ventricle is located between the visual tuberosities and has the shape of a ring. At the same time, gray matter is located in its walls, which is responsible for regulating the autonomic system. This section is connected with the midbrain aqueduct, and through the interventricular foramen, located behind the nasal commissure, with the I and II ventricles.

The most important IV ventricle is located between the cerebellum and the medulla oblongata, with the vermis and medullary velum located above it, and the medulla oblongata and pons below it. This cavity was formed from the remains of the posterior medullary vesicle and is common to the rhomboid region. At its bottom lie the nuclei of the V-XII cranial nerves. In this case, the posterior lower corner communicates with the spinal cord through the central canal, and through the upper anterior part with the aqueduct.

Sometimes, when examining a newborn, the fifth ventricle is detected, which is a feature of the structure of the brain. It is located in the anterior midline, below the corpus callosum. Usually its closure occurs by 6 months of age, but if the gap is more than 10 mm, then we are talking about a pathology of the liquorodynamic system.

If an ultrasound revealed asymmetry of the lateral ventricles in a child, the prognosis depends on the degree of pathology and the depth of damage to brain tissue, as well as the reasons that provoked the development of the disease. Thus, a significant increase interferes with normal circulation and production of cerebrospinal fluid, which entails neurological problems. But congenital asymmetry, not aggravated by outflow disorders, in most cases does not require treatment. However, such a child needs observation in order to prevent relapse of the disease and possible consequences.

The size of the ventricles is normal

A healthy newborn normally has 4 ventricles: two lateral, the third is conventionally anterior, and the fourth ventricular component, which is considered posterior. An enlargement of the lateral ventricles entails the production of a large amount of cerebrospinal fluid, which will not be able to circulate normally between the membranes of the brain and, accordingly, perform its functions of regulating metabolic processes. Therefore, when assessing the size of the ventricles of newborns, the following standards are used:

the lateral anterior horns should fall within the range of 2-4 mm;
lateral occipital horns - 10-15 mm;
body of the lateral ventricles - no deeper than 4 mm;
III ventricle - no more than 5 mm;
IV - up to 4 mm.

When examining the brain of infants up to a year and older, the use of these standards will be incorrect, since the brain matter and ventricles will grow, so the assessment is carried out using other indicators and corresponding tables.

Causes of enlarged ventricles

If the initial examination revealed that the ventricles of the brain in a newborn are slightly enlarged, then do not despair, since in most cases this condition requires only observation during the first years of life, and the prognosis is favorable.

Initially, a slight discrepancy between indicators and norms may be genetically determined and be a feature of the structure of the brain, while pathological changes occur due to a chromosomal malfunction during fetal formation.

There are a number of factors that provoke asymmetry and dilatation (enlargement) of the ventricular cavity:

infectious diseases during pregnancy (in particular, infection of the fetus with cytomelalovirus);
blood poisoning, sepsis;
complications caused by chronic maternal diseases;
premature birth;
acute hypoxia during fetal development caused by insufficient blood supply to the placenta;
varicose veins feeding the fetus;
long anhydrous period and prolonged labor;
rapid birth;
birth injuries, hypoxia caused by umbilical cord entanglement;
deformation of the cranial bones;
entry of foreign objects into the brain structures;
cysts, neoplasms of various nature;
hemorrhages;
ischemic and hemorrhagic stroke.

Also, dilation of the ventricles can be caused by cerebral hydrocele of unknown etiology and other congenital diseases.

This is what Evgeniy Komarovsky, a well-known pediatrician in the post-Soviet space and a doctor of the highest category, says about the expansion of the ventricles.

How it manifests itself

The main function of the ventricles is to secrete cerebrospinal fluid, as well as ensure its normal circulation in the subarachnoid space. If the balance of exchange and production of cerebrospinal fluid is disturbed, then stagnation is formed and, as a result, the walls of the cavities are stretched. The same slight expansion of the lateral segments may be a normal variant, but their asymmetry and enlargement of individual parts (for example, only the horn) will be a sign of the development of pathology.

Enlarged ventricles of the brain in an infant can be diagnosed with a congenital disease such as ventriculomegaly. It varies in severity:

Slight expansion of the ventricles of the brain up to 11-12 mm, with no significant symptoms. It manifests itself in the child’s behavior: he becomes more excitable and irritable.
Increasing the depth of the ventricles up to 15 mm. Most often, the pathology is accompanied by asymmetry and impaired blood supply to the affected area, which entails the appearance of seizures, an increase in head size and a lag in mental and physical development.
Ventricular dilatation up to 20 mm is characterized by irreversible changes in brain structures and is often accompanied by Down syndrome and cerebral palsy in infants.

In adulthood, an increase in ventricular volume is manifested by the following symptoms:

Gait disturbance, with the child walking “on tiptoes” or vice versa, focusing only on the heels.
The appearance of visual disorders, such as squint, insufficient focus of the gaze, as well as double images when trying to see small details.
Tremor of arms and legs.
Behavioral disorders that manifest themselves in excessive lethargy and drowsiness, while it is difficult to captivate the child with any activity.
The appearance of headaches due to increased intracranial pressure, sometimes nausea and even vomiting may occur.
Dizziness.
Frequent regurgitation, loss of appetite. Some newborns are able to refuse breastfeeding.

Consequences

Late detection of the pathology that resulted in the expansion of the ventricle of the brain in a newborn can lead to a stop in development and deterioration in physical condition.

The main symptoms of the disease most often appear in the first 6 months after birth and are expressed in persistent increased intracranial pressure. Impaired consciousness, vision, hearing loss, epileptic seizures and fits, and disorders of the peripheral nervous system may also be observed.

Lack of proper attention to the child and failure to follow the instructions of specialists can provoke the transition of the disease from a milder form to a severe one, the treatment of which is carried out only in a hospital setting and, if necessary, with the use of surgical interventions.

Diagnosis and treatment

During pregnancy, dilation of the ventricles of the fetal brain is most often detected during a routine ultrasound examination. Subsequent examinations are carried out to monitor the clinical picture of the disease, but the final diagnosis can be made only after the birth of the child and neurosonography - ultrasound of the brain through a large fontanelle that has not yet become overgrown. In this case, the pathology can develop at any age, but most often occurs in infancy.

To make a more accurate diagnosis, the baby may need a consultation and examination with an ophthalmologist, who will assess the condition of the fundus vessels, swelling of the eye discs and other manifestations of increased intracranial pressure.

After the fusion of the cranial bones, it is possible to use MRI of the brain: it will allow tracking the dilatation of the walls of the ventricles in dynamics. However, when using this method, the child will have to remain motionless for a long time, so before the procedure he is put into medicated sleep. If anesthesia is contraindicated, the examination is performed using computed tomography.

A consultation with a neurologist is also required, who will help identify developmental problems at an early stage. Depending on the degree of pathology, further treatment can be surgical or conservative medication.

If there is a significant deviation from the norm in the size of the ventricles, only surgical treatment is used; accordingly, the child should also be examined by a neurosurgeon. In this case, during the operation, foci of neoplasms or fragments of skull bones that appear as a result of traumatic brain injuries can be removed. To reduce intracranial pressure, normalize blood circulation and metabolic processes, brain shunting is used.

Conservative therapy is prescribed for slight enlargement of the ventricles and includes the use of diuretics, nootropics, sedatives and vitamin complexes. If the disorders are caused by infections, then antibiotics are prescribed. The use of therapeutic exercises will also help improve the outflow of cerebrospinal fluid and reduce its stagnation.

Forecast

If pathology in the development of the ventricles was identified in the first days after birth, then the prognosis in most cases is favorable and depends on adequate treatment and the severity of the abnormalities.

Detection of the disease and therapy in older age can be complicated due to the formation of a large number of anomalies that arise as a result of the development of pathology, its causes and influence on other body systems.

Video: Increased intracranial pressure in a child

Quite often, after birth, babies have enlarged ventricles of the brain. This condition does not always mean the presence of a disease that necessarily requires treatment.

Ventricular system of the brain

The ventricles of the brain are several interconnected collectors in which the formation and distribution of liquor fluid occurs. Liquor washes the brain and spinal cord. Normally, there is always a certain amount of cerebrospinal fluid in the ventricles.

Two large collectors of cerebrospinal fluid are located on either side of the corpus callosum. Both ventricles are connected to each other. On the left side is the first ventricle, and on the right is the second. They consist of horns and a body. The lateral ventricles are connected through a system of small holes to the 3rd ventricle.

In the distal part of the brain, between the cerebellum and the medulla oblongata, there is the 4th ventricle. It is quite large in size. The fourth ventricle is diamond-shaped. At the very bottom there is a hole called the diamond-shaped fossa.

Proper functioning of the ventricles allows cerebrospinal fluid to enter the subarachnoid space when necessary. This zone is located between the dura mater and the arachnoid membrane of the brain. This ability allows you to maintain the required volume of cerebrospinal fluid in various pathological conditions.

In newborn babies, dilatation of the lateral ventricles is often observed. In this condition, the horns of the ventricles are enlarged, and increased accumulation of fluid in the area of their bodies may also be observed. This condition often causes both left and right ventricle enlargement. In differential diagnosis, asymmetry in the area of the main brain collectors is excluded.

The size of the ventricles is normal

In infants, the ventricles are often dilated. This condition does not at all mean that the child is seriously ill. The dimensions of each ventricle have specific values. These indicators are shown in the table.

To assess normal indicators, the determination of all structural elements of the lateral ventricles is also used. The lateral cisterns should be less than 4 mm deep, the anterior horns between 2 and 4 mm, and the occipital horns between 10 and 15 mm.

Causes of enlarged ventricles

Premature babies may have dilated ventricles immediately after birth. They are located symmetrically. Symptoms of intracranial hypertension in a child with this condition usually do not occur. If only one of the horns increases slightly, then this may be evidence of the presence of pathology.

The following reasons lead to the development of ventricular enlargement:

Fetal hypoxia, anatomical defects in the structure of the placenta, development of placental insufficiency. Such conditions lead to disruption of the blood supply to the brain of the unborn child, which can cause expansion of the intracranial collectors.

Traumatic brain injuries or falls. In this case, the outflow of cerebrospinal fluid is disrupted. This condition causes water to stagnate in the ventricles, which can lead to symptoms of increased intracranial pressure.

Pathological birth. Traumatic injuries, as well as unforeseen circumstances during childbirth, can lead to disruption of the blood supply to the brain. These emergency conditions often contribute to the development of ventricular dilatation.

Infection with bacterial infections during pregnancy. Pathogenic microorganisms easily penetrate the placenta and can cause various complications in the child.

Prolonged labor. Too long a time between the rupture of amniotic fluid and the expulsion of the baby can lead to the development of intrapartum hypoxia, which causes a disruption in the outflow of cerebrospinal fluid from the dilated ventricles.

Oncological formations and cysts that are located in the brain. The growth of tumors puts excess pressure on intracerebral structures. This leads to the development of pathological expansion of the ventricles.

Foreign bodies and elements which are located in the brain.

Infectious diseases. Many bacteria and viruses easily penetrate the blood-brain barrier. This contributes to the development of numerous pathological formations in the brain.

How does it manifest?

Ventricular dilatation does not always lead to adverse symptoms. In most cases, the child does not experience any discomfort that would indicate the presence of a pathological process.

Only with pronounced disturbances do the first adverse manifestations of the disease begin to occur. These include:

Gait disturbance. Babies begin to walk on tiptoes or step on their heels.

The appearance of visual disturbances. They often manifest themselves in children in the form of squint or insufficient focusing on various objects. In some cases, a child may experience double vision, which worsens when looking at small objects.

Trembling of hands and feet.

Behavioral disorders. Babies become more lethargic and drowsy. In some cases, even apathetic. It is very difficult to captivate a child with any games or recreational activities.

Headache. It appears when intracranial pressure increases. At the height of pain, vomiting may occur.

Dizziness.

Decreased appetite. Babies in the first months of life refuse to breastfeed and eat poorly. In some cases, the baby spits up more.

Sleep disturbance. Babies may have difficulty falling asleep. Some children walk in their sleep.

The disease can vary in severity. With minimal symptoms, they speak of a mild course. When headache, dizziness, and other symptoms indicating high intracranial hypertension appear, the disease becomes moderately severe. If the child’s general condition is severely disturbed and treatment in a hospital setting is required, then the disease becomes more severe.

Consequences

Late diagnosis of pathological conditions that lead to the appearance of enlargements in the area of the ventricles of the brain can affect the further development of the child. The first persistent symptoms of ventricular dilatation are observed in babies at 6 months.

Impaired outflow of liquor fluid can lead to a persistent increase in intracranial pressure. In severe cases of the disease, this contributes to the development of disturbances of consciousness. Visual and hearing disorders lead to the development of hearing loss and weakened vision in the child. Some children experience epileptic seizures and seizures.

Diagnostics

In order to determine the exact size of the ventricles, as well as find out their depth, doctors prescribe several examination methods.

The most informative and reliable are:

Ultrasonography. Allows you to accurately describe the quantitative indicators of the ventricles, as well as calculate the ventricular index. Using ultrasound, you can estimate the volume of liquor fluid that is present in the brain collectors during the study.

CT scan. With high accuracy it allows you to describe the structure and size of all ventricles of the brain. The procedure is safe and does not cause pain in the baby.

Magnetic resonance imaging. It is used in complex diagnostic cases when establishing a diagnosis is difficult. Suitable for older children who are able to remain still throughout the examination. In young children, MRI is performed under general anesthesia.

Fundus examination.

Neurosonography.

Treatment of pathological conditions that lead to dilatation and asymmetry of the ventricles of the brain is usually carried out by a neurologist. In some cases, when the cause of the disease is space-occupying formations or the consequences of traumatic brain injuries, a neurosurgeon is involved.

To eliminate pathological symptoms, the following treatment methods are used:

Prescribing diuretics. Diuretics help reduce the manifestations of intracranial hypertension and improve the baby’s well-being. They also help normalize the formation of cerebrospinal fluid.

Nootropics. They improve brain function and also promote good blood supply to blood vessels.

Medicines with a sedative effect. Used to eliminate increased anxiety and agitation.

Potassium preparations. Positively affects urine excretion. This helps reduce the increased amount of cerebrospinal fluid in the body.

Multivitamin complexes. They are used to compensate for all the necessary microelements involved in vital processes. They also help strengthen the body and promote better resistance to disease.

Soothing and relaxing massage. Allows you to reduce muscle tone and also helps to relax the nervous system.

Physiotherapy. Helps normalize the outflow of liquor fluid and prevents its stagnation in the cerebral ventricles.

Prescribing antibacterial or antiviral drugs according to indications. They are used only in cases where the cause of the disease is viruses or bacteria. Appointed for a course appointment.

Surgery. It is used in the presence of various space-occupying formations or to remove fragments of bone tissue as a result of a skull fracture due to traumatic brain injury.

Forecast

If the condition develops in infancy and early infancy, the course of the disease is usually favorable. With appropriate treatment, all discomfort symptoms quickly disappear and do not bother the baby. High intracranial pressure is normalized.

In older children, the prognosis of the disease is somewhat different. Adverse symptoms are much more difficult to treat. A long course of the disease can lead to permanent visual and hearing impairment. If treatment was not started in a timely manner, then in most cases the child experiences persistent disorders that negatively affect his mental and mental development.

Dr. Komarovsky will talk about the expansion of the ventricles of the brain in infants and its consequences.

Immediately after birth, the baby begins an active hospital life: he is given vaccinations and undergoes many tests that allow him to assess the health of the newborn. Among them, a mandatory procedure is an ultrasound of the brain; it is important to check it for the absence of pathologies, and also to assess how developed it is, because the whole future life of the baby depends on this.

Ultrasound examination of the brain in an infant

Anatomy of the ventricular system of the brain

The structure of the human brain is heterogeneous; it consists of several parts, each of which is responsible for a specific vital function. In any healthy person, the brain consists of four ventricles, which are interconnected by vessels, channels, openings and valves.

The brain consists of the lateral ventricles, the third and fourth. The side ones also have their own numbers: the left one is designated by the first number, and the right one by the second. 3 and 4 have a different name - front and rear, respectively. The lateral ventricles have horns - anterior and posterior, and a body of the ventricles. Cerebrospinal fluid (CSF) constantly circulates around all ventricles.

A change in the size of one or all ventricles entails a deterioration in the circulation of cerebrospinal fluid. This can have serious consequences: it leads to an increase in the volume of fluid in the spinal cord and a deterioration in the functioning of the body. Asymmetrical ventricles are not normal in babies and children under one year of age.

Standard size chart

The sizes of all parts of the brain have standards for each age. Deviation from the average values is not always a pathology, however, doctors still take into account the normal values and, if values exceeding the standards are detected, they prescribe a number of additional examinations.

The norms for the size of parts of the brain in newborns and infants are presented in the table.

Why do the ventricles of a child’s brain enlarge?

The lateral ventricles may increase in size due to impaired circulation of cerebrospinal fluid. The reasons may be:

difficulty in cerebrospinal fluid drainage;
impaired adsorption of cerebrospinal fluid;
overproduction (excess formation) of cerebrospinal fluid.

In addition, dilatation (enlargement) of the lateral ventricles can lead to their asymmetry. This is a condition in which parts of the brain are unequally enlarged in size. More often, an increase in the width of the lateral ventricles occurs due to:

infections;
head injuries;
tumors;
hydrocephalus;
hematomas;
thrombosis

Hydrocephalus

The ventricles may be asymmetrical due to hemorrhage. The pathology occurs due to compression of one of the ventricles by additional blood flow. In newborns, the condition can be triggered by prolonged stay in the womb after a puncture or rupture of the bladder and development of asphyxia.

Symptoms of pathology

Asymmetry of the ventricles of the brain is accompanied by an increase in intracranial pressure, and therefore causes a wide variety of symptoms. In this regard, diagnosis can be difficult, and it is difficult to associate them with any disease. In newborns, deviations from the norm are expressed in the following manifestations:

lack of appetite;
lethargy of the limbs;
tremor;
swollen veins on the forehead, temples and back of the head due to obstruction of blood outflow;
absence of age-appropriate reactions: decreased grasping and motor reflexes;
the pupils of the eyes are directed in different directions;
irregularities of the skull;
frequent belching and nausea not associated with food intake.

A child with this diagnosis refuses to breastfeed and often spits up. Diagnostic methods

Expansion of the cerebrospinal fluid spaces of the brain in children is one of those pathologies that cannot be left to chance. To prescribe competent treatment, you must first make a diagnosis. Modern medicine knows several methods for diagnosing the condition of the brain. Radiation diagnostics is considered the most informative, but it is suitable for children after the fontanelles have become overgrown with bone tissue (more details in the article: when and how do the fontanelles overgrow in children?). Other methods include:

MRI – magnetic resonance imaging. It allows you to get a complete picture of the condition of soft tissues, including the brain, but has many contraindications. It is prescribed to small children only in extreme cases, since for a reliable result it is necessary for the patient to lie still for at least 20 minutes, which infants cannot do. There is a solution - general anesthesia, but it negatively affects the baby’s health.
An alternative to MRI is diagnosis using a computed tomography scanner - CT. It is carried out much faster and does not require anesthesia, therefore it is the most preferable way to diagnose the condition of the brain in an infant. It has a significant drawback compared to MRI - lower quality of images, especially when it comes to small shooting areas. CT scans best show hemorrhage in the interthecal spaces, so a diagnosis can be made quickly and treatment can be prescribed.
NSG, or neurosonography. The procedure allows you to estimate only the size of the ventricles, but does not provide a visual picture. The device is capable of capturing organ sizes from 1 mm, no less.
An additional diagnostic method is to assess the condition of the fundus. During the process, dilated vessels can be seen, which will indicate that the patient has increased intracranial pressure.
Cerebrospinal fluid puncture, which is performed in the lumbar spine. By analyzing the taken material, the state of the cerebrospinal fluid is assessed.

MRI of the brain allows you to correctly assess the severity of the pathology Treatment methods

Mild enlargement of the lateral ventricles is treated with medications. More serious cases, as well as if the patient is under 2 years of age, must be treated in a hospital. Older children are referred for outpatient treatment. The neurologist prescribes:

Diuretics that enhance kidney function and help eliminate excess fluid. This reduces the volume of blood in the vessels and the amount of intercellular fluid. Accordingly, cerebrospinal fluid will be produced in smaller quantities and will cease to put pressure on the ventricles, causing them to enlarge.
Nootropic agents for stimulating cerebral circulation. They are prescribed to prevent fluid from compressing the blood vessels of the brain, which can lead to death. These drugs, in combination with diuretics, help cope with hypoxia and remove excess fluid from the ventricles into the blood, and then out through the kidneys, this helps alleviate the condition of children.
Sedatives. The child may become anxious and stressed, resulting in the production of adrenaline, which increases blood pressure and constricts blood vessels. As a result, hydrocephalus progresses. Sedatives are used only as prescribed by a doctor with strict adherence to dosage.
Drugs to improve muscle tone. Due to increased intracranial pressure, it is reduced, and since the muscles cannot control the stretching of the veins, the latter swell. In addition to medications, massage and therapeutic exercises are used for this purpose. You can start doing exercises with your baby to reduce blood pressure under the supervision of a doctor; sudden movements should not be allowed.

If the cause of dilatation or asymmetry of the 3rd and 4th ventricles is an infection caused by bacteria or viruses, such as meningitis, hydrocephalus syndrome may become one of the complications. In this case, you first need to treat the underlying cause of the enlarged ventricles.

Sometimes the deviation in the size of the liquor spaces from the norm is physiological, for example, when the newborn is large. This condition does not require specific treatment; it may only require a course of massage and special physical therapy.

Official medicine does not recognize the treatment of ventricular dilatation using acupuncture, homeopathic remedies and other methods of non-traditional intervention. People who engage in such practices, instead of the expected healing, can cause irreparable harm to the child. Taking vitamins is also ineffective, but they can be prescribed as a concomitant tonic in parallel with the main course of treatment.

Complications and consequences for the child

Despite the fact that enlargement of the ventricles of the brain is not a fatal disease, it can lead to various complications. The most dangerous condition is a rupture of the wall of a vein or ventricle. This pathology leads to immediate death or coma.

Enlargement of the ventricles of the brain can have serious consequences, so a child with this diagnosis should be observed for a long time in a medical facility

An enlarged ventricle can compress the optic or auditory nerve, leading to partial or complete blindness or deafness. If the compression is due to accumulated fluid, the condition will be reversible and vision or hearing will return when the excess fluid leaves the area.

A state of prolonged ventricular dilatation can lead to an attack of epilepsy. The mechanism of seizures is currently not fully understood, but it is known that they appear in various brain lesions.

The younger the child who is diagnosed with dilatation, the greater the chance of a full recovery. Less dangerous, but still unpleasant complications include:

delayed speech development, mental and mental development;
urinary and fecal incontinence;
blindness and deafness occurring in episodes.

The first trip to the neurologist from Polya shocked me, to be honest. I ask the doctor: “How serious is this?” She answers, almost laughing: “No one leaves me without me saying anything.” As it turns out, many diagnoses are made automatically. Like, if a child, for example, is a Caesarean, here is such and such a label for you, because you are a Caesarean. Diagnoses are made that either do not exist or do not correspond to the symptoms. Here is just the information below about this.

FACTS AND MISCONCEPTIONS OF PERINATAL NEUROLOGY
neurologist S.V. Zaitsev
Key words: perinatal encephalopathy (PEP) or perinatal damage to the central nervous system (PP CNS), hypertensive-hydrocephalic syndrome (HHS); dilation of the ventricles of the brain, interhemispheric fissure and subarachnoid spaces, pseudocysts on neurosonography (), muscular dystonia syndrome (MSD), hyperexcitability syndrome, perinatal convulsions.

Child neurology is a relatively new field, but is already going through difficult times. At the moment, many doctors practicing in the field of infant neurology, as well as parents of infants with any changes in the nervous system and mental sphere, find themselves “between two fires.” On the one hand, the school of “Soviet child neurology” is excessive diagnosis and incorrect assessment of functional and physiological changes in the nervous system of a child in the first year of life, combined with long-outdated recommendations for intensive treatment with a variety of medications. On the other hand, there is often an obvious underestimation of existing psychoneurological symptoms, ignorance of general pediatrics and the fundamentals of medical psychology, some therapeutic nihilism and fear of using the potential of modern drug therapy; and as a result - lost time and missed opportunities. At the same time, unfortunately, a certain (and sometimes significant) “formality” and “automaticity” of modern medical technologies lead, at a minimum, to the development of psychological problems in the child and his family members. The concept of “norm” in neurology at the end of the 20th century was sharply narrowed; now it is intensively and not always justifiably expanding. Probably the truth is somewhere in the middle...

According to the perinatal neurology clinic of the NEVRO-MED medical center and other leading medical centers in Moscow (and probably in other places), so far, more than 80%!!! Children in their first year of life are referred by a pediatrician or neurologist from a district clinic for a consultation regarding a non-existent diagnosis - perinatal encephalopathy (PEP):
The diagnosis of “perinatal encephalopathy” (PEP) in Soviet child neurology very vaguely characterized almost any dysfunction (and even structure) of the brain in the perinatal period of a child’s life (from about 7 months of intrauterine development of the child and up to 1 month of life after childbirth), arising as a result pathologies of cerebral blood flow and oxygen deficiency.

Such a diagnosis was usually based on one or more sets of any signs (syndromes) of a probable nervous system disorder, for example, hypertensive-hydrocephalic syndrome (HHS), muscular dystonia syndrome (MDS), hyperexcitability syndrome.
After conducting an appropriate comprehensive examination: clinical examination in combination with analysis of data from additional research methods (ultrasound of the brain - neurosonography) and cerebral circulation (Dopplerography of cerebral vessels), fundus examination and other methods, the percentage of reliable diagnoses of perinatal brain damage (hypoxic, traumatic, toxic-metabolic, infectious) is reduced to 3-4% - this is more than 20 times!

The most bleak thing about these figures is not only a certain reluctance of individual doctors to use the knowledge of modern neurology and conscientious delusion, but also a clearly visible psychological (and not only) comfort in the pursuit of such “overdiagnosis.”

Hypertension-hydrocephalic syndrome (HHS): increased intracranial pressure (ICP) and hydrocephalus

Until now, the diagnosis of “intracranial hypertension” (increased intracranial pressure (ICP)) is one of the most commonly used and “favorite” medical terms among pediatric neurologists and pediatricians, which can explain almost everything! and at any age, complaints from parents.
For example, a child often cries and shudders, sleeps poorly, spits up a lot, eats poorly and gains little weight, eyes widen, walks on tiptoes, his arms and chin tremble, there are convulsions and there is a lag in psycho-speech and motor development: “it’s only his fault - increased intracranial pressure." Isn't that a convenient diagnosis?

Quite often, the main argument for parents is “heavy artillery” - data from instrumental diagnostic methods with mysterious scientific graphs and figures. Methods can be used either completely outdated and uninformative / echoencephalography (ECHO-EG) and rheoencephalography (REG) /, or examinations “from the wrong opera” (EEG), or incorrect, in isolation from clinical manifestations, subjective interpretation of normal variants during neurosonodopplerography or tomography.

Unhappy mothers of such children unwittingly, at the suggestion of doctors (or voluntarily, feeding on their own anxiety and fears), pick up the flag of “intracranial hypertension” and for a long time end up in the system of monitoring and treatment of perinatal encephalopathy.

In fact, intracranial hypertension is a very serious and quite rare neurological and neurosurgical pathology. It accompanies severe neuroinfections and brain injuries, hydrocephalus, cerebrovascular accidents, brain tumors, etc.
Hospitalization is mandatory and urgent!!!

Intracranial hypertension (if it really exists) is not difficult for attentive parents to notice: it is characterized by constant or paroxysmal headaches (usually in the morning), nausea and vomiting not associated with food. The child is often lethargic and sad, is constantly capricious, refuses to eat, he always wants to lie down and cuddle with his mother.

A very serious symptom can be strabismus or difference in pupils, and, of course, disturbances of consciousness. In infants, bulging and tension of the fontanelle, divergence of the sutures between the bones of the skull, as well as excessive growth of the head circumference are very suspicious.

Without a doubt, in such cases the child must be shown to specialists as soon as possible. Quite often, one clinical examination is enough to exclude or preliminarily diagnose this pathology. Sometimes additional research methods are required (fundus examination, neurosonodopplerography, computed tomography or magnetic resonance imaging of the brain)
Of course, expansion of the interhemispheric fissure, cerebral ventricles, subarachnoid and other spaces of the cerebrospinal fluid system on neurosonography (NSG) images or brain tomograms (CT or MRI) cannot serve as evidence of intracranial hypertension. The same applies to cerebral blood flow disorders isolated from the clinic, identified by vascular Dopplerography, and “finger impressions” on a skull x-ray.

In addition, there is no connection between intracranial hypertension and translucent vessels on the face and scalp, walking on tiptoes, trembling hands and chin, hyperexcitability, developmental disorders, poor academic performance, nosebleeds, tics, stuttering, bad behavior, etc. and so on.

That’s why, if your baby has been diagnosed with “PEP, intracranial hypertension”, based on “goggle” eyes (Graefe’s symptom, “setting sun”) and walking on tiptoes, then you shouldn’t go crazy in advance. In fact, these reactions may be characteristic of easily excitable young children. They react very emotionally to everything that surrounds them and what happens. Attentive parents will easily notice these connections.
Thus, when diagnosing PEP and increased intracranial pressure, it is naturally best to contact a specialized neurological clinic. This is the only way to be sure of the correct diagnosis and treatment.

It is absolutely unreasonable to begin treatment of this serious pathology on the recommendations of one doctor based on the above “arguments”; in addition, such unreasonable treatment is not at all safe. Just look at the diuretic drugs that are prescribed to children for a long time, which has an extremely adverse effect on the growing body, causing metabolic disorders.
There is another, no less important aspect of the problem that must be taken into account in this situation. Sometimes medications are necessary and the wrongful refusal of them, based only on the mother’s (and more often than not the father’s) own conviction that medications are harmful, can lead to serious troubles. In addition, if there really is a serious progressive increase in intracranial pressure and the development of hydrocephalus, then often incorrect drug therapy for intracranial hypertension entails the loss of a favorable moment for surgical intervention (shunt surgery) and the development of severe irreversible consequences for the child: hydrocephalus, developmental disorders, blindness , deafness, etc.

Now a few words about the equally “adored” hydrocephalus and hydrocephalic syndrome. In fact, we are talking about a progressive increase in intracranial and intracerebral spaces filled with cerebrospinal fluid (CSF) due to the existing! at that moment of intracranial hypertension. In this case, neurosonograms (NSG) or tomograms reveal dilations of the ventricles of the brain, interhemispheric fissure and other parts of the cerebrospinal fluid system that change over time. Everything depends on the severity and dynamics of the symptoms, and most importantly, on the correct assessment of the relationships between the increase in intracerebral spaces and other neural changes. This can be easily determined by a qualified neurologist. True hydrocephalus, which does require treatment, like intracranial hypertension, is relatively rare. Such children must be observed by neurologists and neurosurgeons at specialized medical centers.

Unfortunately, in ordinary life such an erroneous “diagnosis” occurs in almost every fourth or fifth baby. It turns out that some doctors often incorrectly call a stable (usually slight) increase in the ventricles and other cerebrospinal fluid spaces of the brain hydrocephalus (hydrocephalic syndrome). This does not manifest itself in any way through external signs or complaints and does not require treatment. Moreover, if the child is suspected of having hydrocephalus based on a “large” head, translucent vessels on the face and scalp, etc. – this should not cause panic among parents. The large size of the head in this case plays practically no role. However, the dynamics of head circumference growth is very important. In addition, you need to know that among modern children it is not uncommon to have so-called “tadpoles” whose heads are relatively large for their age (macrocephaly). In most of these cases, infants with large heads show signs of rickets, less often macrocephaly due to the family constitution. For example, dad or mom, or maybe grandpa has a big head, in a word, it’s a family matter and doesn’t require treatment.

Sometimes, when performing neurosonography, an ultrasound doctor finds pseudocysts in the brain - but this is not a reason to panic at all! Pseudocysts are single round tiny formations (cavities) containing cerebrospinal fluid and located in typical areas of the brain. The reasons for their appearance, as a rule, are not reliably known; they usually disappear by 8-12 months. life. It is important to know that the existence of such cysts in most children is not a risk factor for further neuropsychic development and does not require treatment. However, although quite rare, pseudocysts form at the site of subependymal hemorrhages, or are associated with perinatal cerebral ischemia or intrauterine infection. The number, size, structure and location of cysts provide specialists with very important information, taking into account which, based on a clinical examination, final conclusions are formed.
Description of NSG is not a diagnosis! and not necessarily a reason for treatment.
Most often, NSG data provide indirect and uncertain results, and are taken into account only in conjunction with the results of a clinical examination.

Once again, I remind you of the other extreme: in difficult cases, sometimes there is a clear underestimation on the part of parents (less often, doctors) of the child’s problems, which leads to a complete refusal of the necessary dynamic observation and examination, as a result of which the correct diagnosis is made late, and treatment does not lead to the desired result.
Undoubtedly, therefore, if increased intracranial pressure and hydrocephalus are suspected, diagnosis should be carried out at the highest professional level.
What is muscle tone and why is it so “loved”?

Look at your child’s medical record: is there no such diagnosis as “muscular dystonia”, “hypertension” and “hypotension”? – you probably just didn’t go with your baby to the neurologist’s clinic until he was a year old. This is, of course, a joke. However, the diagnosis of “muscular dystonia” is no less common (and perhaps more common) than hydrocephalic syndrome and increased intracranial pressure.
Changes in muscle tone can be, depending on the severity, either a variant of the norm (most often) or a serious neurological problem (this is much less common).
Briefly about external signs of changes in muscle tone.

Muscular hypotonia is characterized by a decrease in resistance to passive movements and an increase in their volume. Spontaneous and voluntary motor activity may be limited; palpation of the muscles is somewhat reminiscent of “jelly or very soft dough.” Severe muscle hypotonia can significantly affect the rate of motor development (for more details, see the chapter on movement disorders in children of the first year of life).

Muscular dystonia is characterized by a condition where muscle hypotonia alternates with hypertension, as well as a variant of disharmony and asymmetry of muscle tension in individual muscle groups (for example, more in the arms than in the legs, more on the right than on the left, etc.)
At rest, these children may experience some muscle hypotonia during passive movements. When trying to actively perform any movement, during emotional reactions, when the body changes in space, muscle tone increases sharply, pathological tonic reflexes become pronounced. Often, such disorders subsequently lead to improper development of motor skills and orthopedic problems (for example, torticollis, scoliosis).
Muscular hypertension is characterized by increased resistance to passive movements and limitation of spontaneous and voluntary motor activity. Severe muscle hypertension can also significantly affect the rate of motor development.

Violation of muscle tone (muscle tension at rest) can be limited to one limb or one muscle group (obstetric paresis of the arm, traumatic paresis of the leg) - and this is the most noticeable and very alarming sign, forcing parents to immediately consult a neurologist.
It is sometimes quite difficult for even a competent doctor to notice the difference between physiological changes and pathological symptoms in one consultation. The fact is that changes in muscle tone are not only associated with neurological disorders, but also strongly depend on the specific age period and other characteristics of the child’s condition (excited, crying, hungry, drowsy, cold, etc.). Thus, the presence of individual deviations in the characteristics of muscle tone does not always cause concern and require any treatment.
But even if functional disorders of muscle tone are confirmed, there is nothing to worry about. A good neurologist will most likely prescribe massage and physical therapy (exercises on large balls are very effective). Medicines are prescribed extremely rarely.

Hyperexcitability syndrome
(syndrome of increased neuro-reflex excitability)

Frequent crying and whims with or without cause, emotional instability and increased sensitivity to external stimuli, sleep and appetite disturbances, excessive frequent regurgitation, motor restlessness and shuddering, trembling of the chin and arms (etc.), often combined with poor growth weight and bowel dysfunction - do you recognize such a child?

All motor, sensitive and emotional reactions to external stimuli in a hyperexcitable child arise intensely and abruptly, and can fade away just as quickly. Having mastered certain motor skills, children constantly move, change positions, constantly reach for and grab objects. Children usually show a keen interest in their surroundings, but increased emotional lability often makes it difficult for them to communicate with others. They are very impressionable, emotional and vulnerable! They fall asleep extremely poorly, only with their mother, they constantly wake up and cry in their sleep. Many of them have a long-term reaction of fear when communicating with unfamiliar adults with active reactions of protest. Typically, hyperexcitability syndrome is combined with increased mental exhaustion.
The presence of such manifestations in a child is just a reason to contact a neurologist, but in no case is it a reason for parental panic, much less drug treatment.

Constant hyperexcitability is not causally specific and can most often be observed in children with temperamental characteristics (for example, the so-called choleric type of reaction).
Much less frequently, hyperexcitability can be associated and explained by perinatal pathology of the central nervous system. In addition, if a child’s behavior is suddenly disrupted unexpectedly and for a long time for virtually no apparent reason, and he or she develops hyperexcitability, the possibility of developing an adaptation disorder reaction (adaptation to external environmental conditions) due to stress cannot be ruled out. And the sooner the child is examined by specialists, the easier and faster it is possible to cope with the problem.
And, finally, most often, transient hyperexcitability is associated with pediatric problems (rickets, digestive disorders and intestinal colic, hernia, teething, etc.).
There are two extremes in the tactics of monitoring such children. Or an “explanation” of hyperexcitability using “intracranial hypertension” and intense drug treatment often using drugs with serious side effects (diacarb, phenobarbital, etc.). Or complete neglect of the problem, which can subsequently lead to the formation of persistent neurotic disorders (fears, tics, stuttering, anxiety disorders, obsessions, sleep disorders) in the child and his family members, and will require long-term psychological correction.

Of course, it is logical to assume that an adequate approach is somewhere in between...

Separately, I would like to draw the attention of parents to seizures - one of the few disorders of the nervous system that really deserves close attention and serious treatment. Epileptic seizures do not occur often in infancy, but they are sometimes severe, insidious and disguised, and immediate drug therapy is almost always necessary.
Such attacks can be hidden behind any stereotypical and repetitive episodes in the child’s behavior. Incomprehensible shudders, head nods, involuntary eye movements, “freezing,” “squeezing,” “limping,” especially with a fixed gaze and lack of response to external stimuli, should alert parents and force them to turn to specialists. Otherwise, a late diagnosis and untimely prescribed drug therapy significantly reduce the chances of treatment success.
All circumstances of the seizure episode must be accurately and completely remembered and, if possible, recorded on video for further detailed description at the consultation. If convulsions last a long time or are repeated, call “03” and urgently consult a doctor.

At an early age, the child’s condition is extremely changeable, so developmental deviations and other disorders of the nervous system can sometimes be detected only during long-term dynamic monitoring of the baby, with repeated consultations. For this purpose, specific dates for planned consultations with a pediatric neurologist in the first year of life have been determined: usually at 1, 3, 6 and 12 months. It is during these periods that most serious diseases of the nervous system of children in the first year of life can be detected (hydrocephalus, epilepsy, cerebral palsy, metabolic disorders, etc.). Thus, identifying a specific neurological pathology in the early stages of development makes it possible to begin complex therapy on time and achieve the maximum possible result.

And in conclusion, I would like to remind parents: be sensitive and attentive to your kids! First of all, it is your meaningful participation in the lives of children that is the basis for their future well-being. Do not treat them for “supposed illnesses,” but if something worries and concerns you, find the opportunity to get independent advice from a qualified specialist.

Read my blog http://ostorozhno-eda.ru/ The whole truth about what we eat.

During a pathological course of pregnancy or childbirth, dilatation may develop - this is if the paired or unpaired ventricles of the brain in an infant are enlarged. In such cases, immediate treatment is necessary. Up to a year, complete restoration of the ventricular system and the baby’s recovery are possible.

What it is

To store and collect cerebrospinal fluid, the human brain has 2 paired and 2 unpaired ventricles. Each of them contains a reservoir for cerebrospinal fluid. Features of each element of the ventricular system:

The first (left) ventricle and the second (right) ventricle. They consist of three pairs of horns and a body, connected to each other. Dilatation of the lateral ventricles is often diagnosed in newborns. Liquid accumulates in the horns or body of the cerebrospinal fluid collectors.

Third ventricle connected to the paired ones and located between their anterior and lower horns.

Fourth ventricle (rhomboid fossa) collects all the liquid from the three previous elements. From it, the fluid is distributed along the spinal or central canal.

The growth of the ventricles occurs gradually, consistent with the linear dimensions of the skull. However, in the presence of provoking factors, dilatation of the third or fourth collector for cerebrospinal fluid occurs. Sometimes an ultrasound examination of the expectant mother may indicate the presence of the 5th ventricle. This is the norm.

Ventricular system

The ventricular system is designed to store and secrete cerebrospinal fluid. When working properly, cerebrospinal fluid is collected in the tanks of its collectors from the surrounding veins. From there, the cerebrospinal fluid is distributed into the subarachnoid space.

An enlargement of one of the ventricles in an infant is not always pathological. Minor deviations in their size are due to the baby’s large head at birth. Expansion of the elements of the ventricular system is observed up to one year of age. When a pathology is detected, it is recommended to measure the entire liquor apparatus.

Disruption of the outflow from the ventricles of the brain occurs due to the appearance of an obstruction to the excretion of cerebrospiral fluid. With prolonged accumulation of fluid, an enlarged head and a hydrocephalic condition of the infant are observed. Which leads to disruption of brain function. These disorders occur with pathological or premature birth, head trauma of the newborn.

Indicators of normal sizes

The sizes of the ventricles are determined by ultrasound examination of the infant's brain. At the slightest deviation, there is a risk of cerebrospinal fluid stagnation.

Normal indicators of the elements of the ventricular system in newborns:

Lateral (first and second): 4 mm. Features of paired elements: front horns - up to 4 mm, rear horns up to 15 mm, lateral bodies 4 mm each.
Third: 5 mm.
Normal fourth ventricle measurements range from 3 to 6 mm.

Brain structures in healthy children should grow symmetrically and gradually. Indicators are calculated depending on the linear dimensions of the skull. If one of the ventricles is larger than normal, it is necessary to examine the entire liquor apparatus and make sure of the asymmetry of paired or pathological enlargement of unpaired elements.

Hydrocephalic-hypertensive syndrome

When fluid is retained in the ventricles of the brain, their volume increases and intracranial pressure increases. With hydrecephalic-hypertensive syndrome, disruption and atrophy of the hemispheres occurs.

The causes of the pathology are as follows:

Congenital hydrocephalus: fetal hypoxia, pathological childbirth, birth of a child before 35 weeks, maternal infection or virus during pregnancy, genetic pathologies of brain development.

Acquired hydrocephalus: infection, neoplasms in the ventricles, head trauma, disruption of the integrity of the bones of the skull and brain.

A newborn with this syndrome is characterized by tearfulness, impaired motor skills and a lag in physical and psycho-emotional development. There is a gradual or sudden enlargement of the head, the bones of the skull diverge, and the fontanel protrudes.

It is also necessary to pay attention to a baby who has strabismus, who often spits up, is capricious in the morning, and reacts negatively to bright lights and loud sounds.

If dilatation of the left ventricle is diagnosed in newborns up to six months, hospital treatment is possible. The child is prescribed sedatives, diuretics and nootropic drugs. Massage and gymnastic exercises are required.

Ventriculomegalic state

Enlarged and dilated ventricles affect the functioning of the central nervous system. If the changes evenly affected every element of the liquor structure, this is the norm. There are types and degrees of severity of the ventriculomegalic condition.

Based on localization, the following types of pathology are distinguished:

Enlargement of the rear or side (left, right) element.

Enlargement affecting the visual thalamus and frontal region of the brain.

Enlargement of the fourth ventricle, which affects the cerebellum and medulla oblongata.

The main causes of this congenital condition are abnormal development of the fetus due to abnormalities in the chromosomal sequence. Other factors are associated with abnormal birth, head trauma, or infections affecting the brain.

After ultrasound diagnosis of the brain in newborns, diuretic, potassium-containing and vitamin medications are prescribed. Lack of adequate treatment leads to the development of Down syndrome, Turner syndrome, and Edwards genetic mutation.

The child will not be able to live a full life, since the dilated ventricles will negatively affect the brain and heart.

Causes of dilatation

Dilatation may occur in utero or develop gradually after an abnormal birth or head injury. Even the smallest changes in the size of liquor structures can lead to serious consequences. Their increase leads to increased intracranial pressure, which provokes hydrocephalus.

The main causes of dilated paired or unpaired ventricles of the brain in infants:

Pathological pregnancy: lack of oxygen, early placental abruption.
Early labor, prolonged labor, lack of labor activity.
Head injury during childbirth, due to a fall, blow, accident.
Benign and malignant tumors in the brain that obstruct the outflow of fluid.
Cyst formation.
Foreign bodies entering the brain.
Past infectious diseases.
Subdural and subarachoid hemorrhages leading to ventricular asymmetry.

Dilatation in infants leads to diseases of the nervous system and developmental disorders. It is possible to detect pathology in the first days of the child and mother’s stay in the neonatal unit. Therefore, it is possible to prevent the development of serious complications.

Symptoms of enlargement

Manifestations of enlarged ventricles are not noticeable with minor changes. With the gradual accumulation of fluid, disturbances in the functioning of the central nervous system, heart, organs of vision and hearing are observed.

Based on the following signs, doctors may suspect dilatation in a newborn:

lack of appetite and frequent regurgitation;
tremor of the chin, arms and legs;
epileptic seizures;
motor impairment;
retardation in mental and physical development;
strabismus and other visual impairments;
pale skin;
the appearance of enlarged veins on the forehead, temples and head;
the head enlarges, the bones of the skull diverge.

If ventricular enlargement occurs at an older age, the child may complain of nausea and headache. Coordination problems, hallucinations, and memory loss are also observed. The presence of certain symptoms may depend on the degree of dilation of the cerebral ventricles and the location of the pathology.

Diagnostics

Detection of the disease includes instrumental examinations. Such diagnostic measures make it possible to accurately determine the size and depth of the ventricles and the degree of fluid accumulation in them. If there are external changes in the outline of the skull or characteristic symptoms, the doctor prescribes the following procedures:

Fundus examination to examine the condition of blood vessels and identify visual impairments.

Neurosonography to determine the size of each of the paired ventricles.

Magnetic resonance therapy for older children. Prescribed when it is difficult to diagnose a child’s condition using other methods.

Computed tomography to detect subtle changes in the size of the ventricles.

Ultrasound examination of the child’s brain to identify echo signs of ventricular dilatation. In addition to accurate measurements of cerebrospinal fluid structures, it is possible to determine the volume of accumulated cerebrospinal fluid.

Puncture of cerebrospinal fluid to determine its composition and nature.

Only after an examination can a doctor prescribe adequate treatment. If the changes are minor and symmetrical, constant monitoring of the child’s condition is prescribed. Identified cysts can resolve on their own during the first year of life.

How is an ultrasound performed on infants?

An ultrasound examination is carried out through the child’s non-overgrown fontanel. Therefore, after a year, when the bones of the skull grow together, a computed tomography or MRI is prescribed.

The procedure is carried out according to the following algorithm:

Treatment of the spring with a special gel that promotes the penetration of ultrasonic rays.
Setting up the device based on the age of the child being examined.
Brain examination and recording of results.

Based on the presented conclusion, you should not make a diagnosis yourself. After studying the results, examining the child, and recording concomitant signs of brain development disorders, treatment will be prescribed.

Interpretation of ultrasound results

The results are interpreted by the attending physician; sometimes a consultation with a neurosurgeon is required. If the examination reveals that the baby’s ventricles are dilated, but there are no pathological symptoms, it is necessary to undergo the examination again.

In addition to the size and depth of the elements of the liquor apparatus, which were mentioned above, the following indicators are provided: the interhemispheric fissure should be no more than 3 mm;
subarachnoid space about 3mm.

These measurements indicate the condition of the ventricles and the degree of dilatation. If they are greatly enlarged, there are disturbances in the structures of the brain. The lateral ventricles should not exceed 4 mm, otherwise hydrocephalus is diagnosed.

Treatment of the disease

Dilatation therapy includes medication and physical therapy.

For the treatment of enlargement of the lateral and unpaired ventricles of the brain of newborns, the following is prescribed: diuretics to reduce the production of cerebrospinal fluid; nootropics to improve blood circulation; central nervous system sedatives; gymnastics and massage of the child to improve the child’s condition and relieve muscle tone; vitamin complexes to prevent rickets.

If the enlargement of the ventricles is a consequence of an infectious disease, antibiotics and antiviral drugs are prescribed. In case of violations of the integrity of the skull and brain, surgical treatment is performed.

Consequences and complications

The consequences of an enlarged cerebral ventricle can be different. It all depends on the degree of expansion and localization of the pathology. The main complications that can occur if medical recommendations are not followed:

loss of vision and hearing;
impaired coordination, lack of physical and mental activity;
lagging behind peers;
paralysis;
constant growth of the head, deformation of the bones of the skull;
epileptic seizures and loss of consciousness;
hallucinations;
hemorrhagic shock;
paralysis;
death.

If an ultrasound reveals a slight enlargement of the ventricles, but the baby is not capricious and develops according to the norm, a repeat examination is scheduled. To avoid the development of possible complications, do not ignore doctor’s orders. Complete all necessary examinations and treat your child.