Intracranial pressure in children

Cranial pressure concept

What happens to the pressure in the cranium in a healthy person, how does a deviation from the norm manifest? These issues need to be understood, because an increase or decrease in such pressure is an alarming sign. Symptoms of the pathology vary, which complicates the diagnosis, but the treatment depends only on the cause of the disease.

The human brain is immersed in a special fluid called cerebrospinal fluid or cerebrospinal fluid (CSF). In the brain itself there are a kind of cavity formations - the ventricles, which can communicate with each other. The choroid plexuses of the ventricles produce cerebrospinal fluid, which is then absorbed into the blood and dissolves in it. CSF constantly moves through the ventricles and spinal canals, renewing itself over and over again. One portion is excreted into the blood, and a new portion is formed at this moment. This process does not stop. The most important functions of the cerebrospinal fluid: it protects the brain from concussions and blows against the skull bone, as well as from other mechanical injuries, nourishes it and removes decay products.

In the process of circulation, the cerebrospinal fluid presses with a certain force on the cavity of the ventricles and the spinal canal from the inside. This pressure is called intracranial pressure.

Everyone has it, this is normal, if only the pressure level does not exceed the usual indicators. Otherwise, it is customary to talk about increased intracranial pressure. Because of this, the ventricles increase in size and, in turn, press directly on the brain tissue.

Increased intracranial pressure in children

How does the intracranial pressure increase, what is the reason for this process?

The pressure inside the skull rises when cerebrospinal fluid begins to accumulate in the ventricles in large quantities. This happens if, for some reason, the movement of fluid in the ventricles is difficult or its outflow through the veins from the brain is impaired.

Another reason is the increased production of cerebrospinal fluid, which exceeds normal levels.

With a significant pressure of the cerebrospinal fluid on the brain, its blood supply is disrupted, the brain structures do not receive the oxygen and nutrients necessary for them. Stagnation of blood in the vessels of the head occurs, which can lead to cerebral edema or hemorrhage.

It should be remembered that a change in the indicators of intracranial pressure in children is not an independent disease, but a manifestation, a sign of one of the list of rather serious pathologies.

The following conditions can act as the reasons causing increased pressure on the brain structures of the child:

• Hematoma (cerebral hemorrhage) that occurs in babies during difficult labor.
• Fetal hypoxia (oxygen starvation), which took place during the intrauterine development of the child or happened to him during labor.
• Infection received by the fetus during pregnancy.
• Hydrocephalic syndrome is a disease that causes stagnation of cerebrospinal fluid due to impaired outflow.
• Congenital underdevelopment of the pathways by which the cerebrospinal fluid must be absorbed into the blood.
• The child's “fontanelle” closed early, and the child's brain is intensively developing and growing.
• Encephalitis is a disease in which tissue inside the brain becomes inflamed and swollen.
• Meningitis is a disease that causes cerebral edema, which impedes the absorption of cerebrospinal fluid due to increased viscosity.
• Tumor formations in the brain of a malignant and benign nature.

The listed reasons give an idea of ​​the increased pressure inside the skull, which lasts for a long period of time and is a characteristic symptom of the disease. But quite often, the cranial pressure can increase intermittently and for a short time. Such changes are normal in children and should not be a cause for concern.

Intracranial pressure can increase with any activity that requires special stress: the child pushes when constipated, tries to lift a heavy object, overcome an obstacle, hold his head while lying on his tummy, diligently sucks on the mother's breast. Such temporary pressure surges are also observed during infectious diseases, with a sharp change in weather conditions, intense mental activity (at school age).

Symptoms

A pathological condition can manifest itself in different ways. The main signs of an increase in pressure, as a rule, are joined by the characteristic symptoms of the primary disease. In addition, much depends on the age of the child. Symptoms and treatment for infants and schoolchildren have their own characteristics.

It makes sense to distinguish between two age categories that differ in the manifestation of increased intracranial pressure. The first group consists of children who are not yet one year old. The second is children over this age. Why is one year old a borderline? By this age (plus or minus several months), the last "fontanelle" on the baby's head usually grows. "Spring" - a part of the skull in which there are holes between the bones.

How to determine increased intracranial pressure in children under one year old? There are many symptoms, but each of them is not an unambiguous indication of a dangerous diagnosis, they can only be used to suspect the presence of a pathology in a child.

• The child cries and screams for no apparent reason for a long time, behaves restlessly, is nervous.

Frequent crying at night is a characteristic sign of pathology. It is at this time, when the baby must be in a supine position for a long time, the outflow of blood through the veins of the brain is inhibited, the blood stagnates, overflowing the vessels, and disrupts the outflow of cerebrospinal fluid. The pressure in the skull rises.

• Poor, short-term sleep in a child: he has difficulty falling asleep, constantly waking up, crying.

The explanation is the same: when the baby is lying down, the movement of blood from the head slows down.

• Under the thin skin on the baby's head, you can see a pronounced mesh of blood vessels.

This happens because when the pressure on the brain increases, the venous vessels collect a large amount of blood, which cannot drain out. As a result, the veins located under the skin become clearly defined.

• The child began to eat poorly.

The process of obtaining milk from a mother's breast is a very laborious task for a nursing baby. When he “works,” he naturally begins to grow. If the baby is healthy, this will not cause him any discomfort. But in the case of the already existing fact of an increase in pressure inside the skull above normal, the additional load makes itself felt. The baby is in pain and discomfort, so he drops his chest. As a result, you can notice a lag in weight in such a child.

• The baby is constantly spitting up, and abundantly. Vomiting attacks are common. Such symptoms indicate the possibility of developing intracranial hypertension.

But in this case, the presence of other reasons cannot be excluded, for which such a symptom is also characteristic: overeating, air entering the esophagus.

• On examination, the doctor may find that the “fontanelles” have become convex, swollen.A disproportionate increase in head volume is also often noted. Especially the forehead grows. The seams of the cranial bones begin to diverge.

The normal head volume should be less than the chest volume of the baby starting at 6 months. If this does not happen and the head is still large, this should be a warning sign. Disturbance of proportions can be seen in dynamics with regular head measurements.

• The development of the baby is inhibited, backwardness is observed both from the side of physical parameters and mental ones.
• There is a disorder of the functions of the nerves responsible for the movement of the eyeballs. This phenomenon is commonly called Gref's syndrome.

This sign can be noticed by the spontaneous lowering of the eyeballs, in the gap between the upper eyelid and the iris of the eye, a white stripe (sclera) is clearly visible. Due to the external similarity of the phenomena, this symptom is called in another way "the symptom of the setting sun."

It will also be advisable to consider the symptoms of a pathological condition in older children (after 6 years):

• frequent bouts of nausea, vomiting may occur;
• pain in the eyeballs;
• difficulty falling asleep;
• dizzy;
• doubles in the eyes;
• chronic fatigue, lethargy, apathy;
• emotions are overwhelming: aggression, tearfulness, whims for no reason;
• convulsive syndrome;
• headache in the evenings and at night;
• attention is scattered, the child has become forgetful.

Syndrome treatment

For the treatment of increased intracranial pressure in children, preventive measures, drug therapy, surgical intervention, and traditional medicine are used.

Medicines that are prescribed to a child to improve the condition:

1. A group of drugs that improve blood circulation in the brain: "Cinnarizin", "Actovegin", "Pantogam".
2. Drugs from the group of neuroprotectors, for example, "Glycine".
3. Diuretics: Triampur, Diakarb, Furosemide.
4. A group of nootropics designed to improve the blood supply to the brain: "Cavinton", "Piracetam".
5. Sedatives: Nereochel.
6. Preparations from the homeopathic group, for example, "Traumeel".
7. Multivitamins with the obligatory inclusion of Magnesium B6.

According to the indications, to eliminate the symptoms of pressure in the brain, operations are prescribed to remove tumors, bypass grafting of the cranial cavity in order to pump out excess cerebrospinal fluid.

Traditional medicine to help children

It is necessary to use traditional medicine only after consulting a doctor. Usually, in this way, they supplement the main treatment or carry out the prevention of recurrent disorders, and also help the body recover after the therapy.

Compress based on alcohol and camphor oil... Mix equal amounts of ingredients. Rub the solution into the child's head with gentle hand movements. Then put plastic wrap on top and put on a wool hat. This should be done before bedtime (afternoon or evening). After 20 daily treatments, skip 5 days, then you can continue.

Bay leaf inhalation... If the child is already 3 years old, inhalation using bay leaves can be carried out. Place 25 leaves in hot boiled water. Insist 5 minutes and inhale. Its duration must be at least 15 minutes.

Birch sap treatment... This juice normalizes the level of intracranial pressure well. You need to drink it up to 3 glasses a day, for small children - up to 1 glass. You can replace half of all the liquid you drink per day with birch sap. Drink a healthy drink for 4 months in a row.

Linden flower baths... It is useful to bathe the baby for the prevention and treatment of attacks of intracranial pressure in a bath with the addition of linden inflorescences.

Head massage. Massage gently into the scalp with flower pollen mixed with honey.

Recommendations for prevention:

• You can elevate the baby's head by lifting the bed slightly from the side of the head.
• Limit water intake.
• Monitor blood pressure, its increase can provoke an increase in intracranial pressure.
• Refuse to take vasodilators.
• Regular walks in the fresh air, ventilation of the room are necessary.
• It is advisable to breastfeed your baby for as long as possible.
• Create a calm, welcoming environment around the child.
• Observe the daily routine.
• Provide a sufficiently long and sound sleep for the child.
• Older children need to spend less time watching TV and computers.
• It is necessary to take care of moderate and regular physical activity (sports for schoolchildren, children's gymnastics for toddlers).
• Conducting massage sessions.
• We must visit the sanatorium.

Intracranial pressure in a child is a rather serious diagnosis. It is often detected in very young children. The symptoms of the manifestation of the disease should alert parents, but only a doctor is able to conduct a full examination and prescribe the correct treatment.

Careful attention to the health of your own children and taking preventive measures will help prevent the development of dangerous complications.