Enlarged cerebellum in a newborn. Causes and symptoms of dilation of the ventricles of the brain. Dimensions and contours of the cerebral ventricles

To understand why the ventricles of the brain are enlarged, you need to know the anatomical side of the problem. The ventricles located in the medulla small baby, are represented by a variety of cavity formations necessary for the preservation of cerebrospinal fluid.

The capacitive structure of the brain for liquor storage is considered lateral ventricles. In terms of size, they are larger than all the others. The left ventricular formation of the brain is the first, and located on the right edge is the second.

The third ventricular element is closely interconnected with the two located laterally due to the hole located between the column of the fornix and the anterior thalamic ending, connecting the third ventricular element with the lateral ones (interventricular). The corpus callosum has sides, and these cavity formations in the form of ventricles are localized on the sides, just below this body. The composition of the lateral ventricles is presented in the form of anterior, posterior, inferior horns, as well as the body.

The fourth ventricular component is very important and is located near the cerebellum and medulla oblongata. Similar to a diamond shape, which is why it is called a diamond-shaped fossa in which the canal is located spinal cord with the channel where there is a communication of the fourth ventricular component with the aqueduct.

It is worth noting that if there is a 5th ventricle located in the medullary region at ultrasound diagnostics during pregnancy, this is normal.

Together with the accumulation function of the ventricles, the secreting function of spinal cerebrospinal fluid is performed. IN in good condition this fluid drains into the area of the subarachnoid space, but sometimes this process is disrupted; various ventricles located in the brain region of the helpless infant are dilated. This indicates an impaired outflow of cerebrospinal fluid from the ventricular zone, and a hydrocephalic condition develops.

What does this mean

There is no need to panic if some of the ventricles located in the brain region of a helpless baby are dilated. After all, dilatation of some ventricles located in the brain region is not always pathological. A slight enlargement of any ventricle located in the area of the baby’s brain is due to physiology due to the baby’s large head.

Enlargement of the ventricles of the brain in newborns is not uncommon until one year of age. In this situation, it is necessary to find out not only how dilated some of the ventricles located in the brain zone of a small baby are, but also to measure the entire liquor apparatus.

An excess of cerebrospinal fluid is considered the main root cause of what actually causes this expansion of the ventricles of the brain. The cerebrospinal fluid does not flow due to an obstruction in the place where it leaves, which results in dilatation of the existing ventricular system located in the medullary region.

Dilation occurs in those babies who were born prematurely. When dilatation of some lateral ventricles located in the area of the brain in newborns, or their asymmetry, is suspected, they need to be measured and a qualitative parameter established. This is what happens when the existing lateral ventricles of the human brain are expanded, and what this means is already clear. Conditions when many ventricles are dilated require careful description.

Ventriculomegalic state

With it, the cavity system of the ventricular apparatus is enlarged, which will result in dysfunction of the central nervous system.

Ventriculomegalic types

Depending on the severity, the pathology occurs in mild degree, medium and heavy; location determines the following types:

lateral, in which there is a pronounced enlargement of some ventricles in small child, such as rear and side;
another type, where the pathology is located in the area near the visual thalamus and frontal region;
V next case the focus affects the cerebellar region with oblong section brain.

What are the causes of the pathology

The main root cause of possible pathology in newborns is considered to be a chromosomal abnormality in pregnant women. Other circumstances that determine why certain ventricles of the brain zone in a small child are enlarged include infectious diseases, physical trauma, hydrocephalic obstruction, hemorrhagic manifestations, and complicated heredity.

Symptoms of the disease

Dilated certain ventricles of the brain in a small child are the root cause of the Down, Turner, and Edwards syndrome conditions. In addition, enlarged certain ventricles of the brain area in a small infant affect cardiac activity, brain structures and the musculoskeletal system.

Diagnostic measures

This condition in children is diagnosed using an ultrasound examination of the head.

How is it treated

In a condition where the lateral ventricles of the child’s brain are dilated, the main thing is to prevent complicated conditions in the body. Diuretics are prescribed vitamin preparations, antihypoxants. Additional methods Treatments for this condition are massage procedures with special physical therapy. To prevent complicated conditions, potassium-sparing agents are used.

Hydrocephalic-hypertensive syndrome

Another course of the disease cannot be excluded, in which enlarged ventricular medullary components are observed in newborns - hydrocephalic hypertension syndrome.

With it, cerebrospinal fluid is overproduced, accumulating under the meninges and the ventricular system of the brain. Occurs this pathology rarely, requires diagnostic confirmation. This syndrome is classified according to age indicator child.

Causes

The root causes are divided into those that existed before birth and those that have already been acquired. Congenital occur due to:

complicated course of a woman’s condition during which she is pregnant, complicated childbirth;
intrauterine cerebral hypoxia, trauma during childbirth, developmental anomalies;
early labor;
intrapartum trauma with hemorrhage into the subarachnoid space;
intrauterine infectious pathology;
brain abnormality;
prolonged labor;
a long period between the breaking of amniotic fluid and the expulsion of the fetus;
maternal chronic pathology.

Acquired root causes include:

neoplasms of oncological or inflammatory nature;
foreign body located in the brain;
condition after a skull fracture with penetration of bone fragments into the brain;
infectious pathology;
cause of unknown etiology.

All the root causes of this syndrome lead to the development of dilation of the ventricles of the brain in infants.

Manifestation of pathology

The clinical syndrome manifests itself:

high intracranial pressure;
increased volume of fluid in the ventricular system.

The symptoms boil down to:

baby refuses to feed breast milk, whiny, capricious for no apparent reason;
he has a decrease in activity in muscle fibers;
reflexive activity is poorly expressed: poor grasping and swallowing;
burps frequently;
there is strabismus;
iridescent upon examination eye shell half-covered by the lower eyelid;
the sutures of the skull diverge ─ this also indicates that there is an increase in some of the lateral ventricles of the child’s brain area;
tension with bulging fontanelles shows that the ventricles of the brain are dilated in the child;
month after month the head circumference increases, this too important sign the fact that some of the lateral ventricles of the brain are slightly expanded in infants;
the fundus shows what visual discs edematous, also an indicator that dilatation of the lateral ventricles located in the brain region of a small baby is occurring.

These manifestations indicate that the ventricular system of an enlarged brain in a small child, or the fifth ventricle of the brain, is enlarged; serious consequences are possible. Older children age category sometimes acquire this syndrome immediately after being ill infectious pathology or damage to the skull and brain.

A characteristic feature of this problem is considered to be morning pain in the area of the head, of a compressive or bursting nature, localized in the temporal and frontal zone, with the manifestation of nausea with vomiting.

The complaint, in which a certain ventricle of a region of the brain in a small child is enlarged, is the inability to raise the eyes upward with the head down. This is often accompanied by a feeling of dizziness. With observed paroxysm skin pale, lethargic, lack of activity. The child is irritated by bright lights and loud sound effects. Based on this, it is already possible to assume that the left ventricle of the child’s brain is enlarged.

Due to high muscle tone in the legs, the child walks on his toes, he has severe squint, he is very sleepy, and his psychomotor development is slow. This is what enlarged ventricles of a diseased brain lead to in a small child of 3 years old.

Diagnostic measures

Highly accurate diagnosis of hydrocephalic syndrome with hypertension, to find out whether the cerebral ventricle is really enlarged in an infant, is not easy. Using the latest diagnostic methods, it is impossible to establish an accurate diagnosis, in which the syndrome leads to the development of a slight dilatation of the ventricular system of a small area of the child’s brain, or the 3rd ventricle located in the area of the brain is expanded, or dilation of the left ventricle located in the area may occur. brain in a child.

The diagnostic parameters of a newborn are the circumference of the head region and the activity of reflexes. Other diagnostics include:

ophthalmological examination of the fundus;
neurosonographic examination in order to see how enlarged the ventricle of a certain part of the brain is in a newborn;
Carrying out a computed tomography examination and MRI will help to accurately determine that this may be a slight dilatation of the lateral ventricles of the brain in a child;
lumbar puncture study, which determines the degree of pressure of the cerebrospinal fluid. This method is accurate and reliable.

Therapeutic measures

Neurological and neurosurgical specialists are required to treat this disease. Patients are constantly monitored by doctors, otherwise the enlarged ventricles of the child’s brain will bring serious consequences.

Until six months of age, when dilatation of the left lateral ventricle of the brain is observed in newborns, treatment is outpatient. The main treatment is:

diuretics together with drugs that reduce the reproduction of cerebrospinal fluid;
nootropic group of drugs that improves cerebral circulation;
sedatives;
special gymnastic exercises with massage.

Therapeutic measures for the syndrome, in which an enlargement of the left ventricle of the brain is detected in newborns, are long-term, lasting more than 1 month.

Older children age group They are treated for hydrocephalic syndrome, depending on the pathogenesis, depending on the root cause of the pathology. When the syndrome arose due to infectious disease, prescribe drugs against bacteria or viruses. In case of cranial trauma or oncology it is indicated surgical intervention. If left untreated, the enlarged ventricular system of the brain in newborns will cause serious consequences.

Complicated conditions

The manifestation of hydrocephalic syndrome with hypertension causes complicated conditions in the body, in which the child will have the following consequences:

psychomotor development of the baby is slow;
will become completely or partially blind;
auditory dysfunction, possibly completely deaf;
may fall into a coma;
completely or partially paralyzed;
the fontanel bulges abnormally;
epileptic seizures are manifested;
involuntarily urinates, performs an act of defecation;
may die.

This is what the increased condition of the ventricular elements of the brain in newborns will lead to, what the possible consequences are, if treatment is not performed on time.

In the infancy period, the prognosis is most favorable due to the frequency arterial type pressure and intracranial pressure, which come to normal levels over time the older the baby gets. In the older age category of children, the prognosis is unfavorable, depending on the root cause of this syndrome and the characteristics of treatment.

Ultrasonography allows you to study the work and structure internal organs. By reflecting the waves, the finished data is sent to the monitor. Ultrasound of the brain in infants is a mandatory preventive examination procedure. Thanks to the data obtained, it is possible to judge the structure of the brain and its functioning. vascular system. The examination is carried out quickly and painlessly and does not pose any danger to the child..

NSG (neurosonography) allows you to determine disturbances in the functioning and structure of all brain structures, as well as evaluate the functioning of the central nervous system.

NSG is carried out through the fontanel, which is located between the unfused bones of the skull. Thanks to this, the result will be accurate and correct. The fontanel is soft to the touch, pulsation is palpable. Normally it should be at the level of the surface of the head. Swelling indicates health problems.

The NSG procedure does not require additional preparation - it is enough to free the child’s head from the cap. The result is not affected in any way by the child’s condition, even if he cries, is capricious, or calmly examines the situation. The procedure is also carried out when the child is sleeping.

What is the reason for this study?

Ultrasound is a mandatory scheduled procedure every month. In other cases, indications for performing NSG before the first month of life are the following cases:

NSG is mandatory in one month in the following cases:

children who were born by caesarean section;
irregular head shape;
conduct research to monitor the condition;
with developmental disorders such as torticollis, strabismus, paralysis;

For children older than one month, NSG is performed for the following indications:

evaluate the effectiveness of treatment for injuries or neurological diseases of the brain;
after infectious diseases (encephalitis, meningitis);
genetic and gene disorders;
head injury.

In some cases, an MRI of the brain is indicated, which is performed under anesthesia.

Interpretation of the results obtained during the survey

The results will depend on many factors - due date, birth weight. The norm for all children of different months of life is the following parameters.

All parts of the brain should be symmetrical in size and homogeneous in composition.
The furrows and convolutions have clear contours.
There is no fluid in the interhemispheric fissure, and its dimensions do not exceed 3 mm.
The choroid plexuses of the ventricles are hyperechoic and homogeneous.
The normal size of the lateral ventricles is: anterior horns - up to 4 mm, occipital horns - 15 mm, body - up to 4 mm. The third and fourth ventricle – up to 4 mm.
The norm for a large tank is up to 10 mm.
There should be no seals, cysts or neoplasms.
The membranes of the brain are unchanged.
The normal size of the subarachnoid space does not exceed 3 mm. If it is greater, and an increase in temperature and frequent regurgitation are observed, then a disease such as meningitis can be suspected. If there are no associated symptoms, all other examinations are normal, perhaps this phenomenon is temporary.

The ventricular cavity should not be enlarged. Their increase indicates diseases such as hydrocephalus and rickets. During hydrocephalus, the child has a large head and swollen fontanel. This disorder causes frequent headaches, mental and physical underdevelopment.

The contents of the lateral ventricles (right and left) is cerebrospinal fluid. With the help of special holes they are connected to the third ventricle. There is also a fourth ventricle, which is located between the cerebellum and medulla oblongata.

The connection occurs in the lateral ventricles cerebrospinal fluid, after which it moves into the subarachnoid space. If such an outflow is disrupted for some reason, hydrocephalus occurs.

Asymmetry of the lateral ventricles (dilatation) is observed when the amount of fluid increases. The disease can be diagnosed in children who were born prematurely, since their lateral ventricles are larger.

If asymmetry of the lateral ventricles is detected on the NSG, the size is measured and the quantitative and qualitative characteristics are determined.

The main reasons due to which the ventricular cavity expands include hydrocephalus, trauma to the skull and brain, damage to the central nervous system and other malformations of newborns.

A septum pellucida cyst is usually detected at birth. The transparent septum is a thin plate consisting of brain tissue. Between these plates there is a cavity resembling a gap. A septum pellucida cyst is a cavity filled with fluid. The cavity accumulates and begins to compress neighboring tissues and vessels.

A cyst of the septum pellucidum is detected on NSG in almost all premature infants. After some time it may disappear. If a septum pellucida cyst was detected immediately after birth, then in most cases a special drug therapy not prescribed.

If a cyst of the transparent septum occurs due to injury, inflammation or an infectious disease, immediate treatment is required. May occur associated symptoms(head pain, visual and hearing impairment).

During NSG, which is carried out every month after detection of a disorder, the dynamics of the development and growth of the cyst of the transparent septum are determined. Depending on the growth rate and the cause of the cyst, it will depend further treatment. Basically, drugs are prescribed that free up this brain cavity.

If any violations were discovered during the NSG, a decision may be made to medically disqualify all vaccinations. Vaccinations can worsen the condition, so after the examination you should visit a neurologist.

A neurologist interprets and clarifies the diagnosis. Only he can prescribe the correct treatment and observe the development of the disease over time. He will also prevent possible complications and prevent other disorders.

The human brain is a complex and amazing structure, all the mysteries of which scientists have not yet unraveled. One of the most interesting mechanisms of the functioning of the nervous system remains the process of formation and circulation of cerebrospinal fluid (CSF), which is carried out using the 3rd ventricle of the brain.

3rd ventricle of the brain: anatomy and physiology

The third ventricle of the brain is a thin slit-like cavity bounded by the visual thalamus and located in the diencephalon. The inside of the third ventricle of the brain is lined soft shell, branched choroid plexus and filled with cerebrospinal fluid.

The physiological significance of the 3rd ventricle is very great. It ensures unimpeded flow of cerebrospinal fluid from the lateral ventricles into the subarachnoid space for washing the brain and spinal cord. Simply put, it ensures the circulation of cerebrospinal fluid, which is necessary for:

regulation of intracranial pressure;
mechanical protection of the brain from damage and injury;
transporting substances from the brain to the spinal cord and vice versa;
protecting the brain from infection.

3rd ventricle of the brain: normal in children and adults

A normally functioning liquor system is an uninterrupted and harmonious process. But if even a small “breakdown” occurs in the processes of formation and circulation of cerebrospinal fluid, this will certainly affect the condition of the child or adult.

The 3rd ventricle of the brain is especially important in this regard, the norm of which is indicated below:

Newborns -3-5 mm.
Children 1-3 months -3-5 mm.
Children 3 months - 6 years -3-6 mm.
Adults -4-6 mm.

Common diseases of the third ventricle of the brain

Most often, the problem of impaired outflow of cerebrospinal fluid occurs in children - newborns and babies up to one year old. One of the most common diseases at this age is ICH () and its complication – hydrocephalus.

During pregnancy future mom undergoes mandatory fetal ultrasound, which makes it possible to identify birth defects development of the child’s central nervous system is still early stages. If during the examination the doctor notes that the 3rd ventricle of the brain is dilated, additional diagnostic tests and careful medical supervision will be needed.

If the cavity of the 3rd ventricle in the fetus becomes more and more dilated, in the future such a baby may require bypass surgery to restore the normal outflow of cerebrospinal fluid.

Also, all babies born at the age of two months (earlier if indicated) undergo mandatory medical checkup a neurologist who may suspect dilatation of the 3rd ventricle and the presence of ICH. Such children are sent for a special examination of brain structures (neurosonogathia).

What is NSG?

Neurosonography is a special type of ultrasound examination of the brain. It can be performed on infants because they have a small physiological opening in the skull - the fontanel.

Using a special sensor, the doctor receives an image of all the internal structures of the brain, determines their size and location. If the 3rd ventricle is dilated in the NSG, more detailed tests are performed - computed tomography (CT) or magnetic resonance imaging (MRI) to obtain a more accurate picture of the disease and confirm the diagnosis.

Which doctors should you contact when diagnosing ICH?

If the 3rd ventricle of the baby’s brain is slightly dilated and the mother has no serious complaints, regular monitoring by a local pediatrician is sufficient. Consultation with a neurologist and neurosurgeon is necessary if there is significant dilatation of the ventricles on ultrasound or symptoms of ICH:

the child began to suck the breast worse;
the fontanel is tense, protruding above the surface of the skull;
the saphenous veins of the scalp are dilated;
Graefe's symptom - a section of white sclera between the iris and eyelid when looking down;
loud, sharp cry;
vomit;
divergence of the sutures of the skull;
rapid increase in head size.

Doctors determine further tactics for treating a baby with: conservative means prescribing vascular medications, massage, physiotherapy; surgical – performing an operation. After therapy, children quickly recover, the activity of the nervous system is restored.

Colloid cyst of the 3rd ventricle is a disease common among adults 20-40 years old. It is characterized by the appearance of a benign round formation in the cavity of the 3rd ventricle, not prone to rapid growth and metastasis.

The colloid cyst itself does not pose any danger to human health. Problems start when she reaches large sizes and prevents the outflow of cerebrospinal fluid. In this case, the patient experiences neurological symptoms associated with increased intracranial pressure:

severe headache;
vomit;
visual impairment;
convulsions.

Diagnosis, treatment colloid cyst The third ventricle is jointly dealt with by a neurologist and a neurosurgeon. If the size of the formation is pronounced, determined on CT or surgery cysts. After the operation, the normal flow of cerebrospinal fluid is quickly restored, and all symptoms of the disease disappear.

Summing up

Thus, the third ventricle is important element liquor system, diseases of which can lead to serious consequences. Attentive attention to health and timely consultation with doctors will help you quickly and permanently cope with the disease.

Katya Emelyanova, Woman, 24 years old

Hello! Help me figure it out, please. The child was born at 41 weeks, natural birth, 8/9 on the apgar scale, weight 4000g, height 56cm, ob/gr 35/34/37cm. 1 tight coil around the neck. NSG at 1 month: oblique size in front of the horns side of the ventricles on the right 3.5 mm on the left 3.5 mm third ventricle 3 mm interhemispheric fissure 2 mm fluid level 1 mm the rest without features At 3 months they diagnose delayed motor development, tone on the right and presumably torticollis. hydrocephalus is questionable. We completed a massage course, the child began to hold his head confidently and became more mobile. We went back for an NSG to rule out hydrocephalus. Results of NSG at 4 months: oblique size in front of the horns side of the ventricles on the right 4 mm on the left 4 mm third ventricle 3.9 mm interhemispheric fissure 3 mm fluid level 3 mm the rest without any peculiarities The neurologist prescribed us injections of ubequinone composite and the vascular drug cenarisin, it seems, 1/6 each Now I can no longer find the appointment sheet. and glycine morning and evening. + after 2 months a course of massage. We did all this. Now the child is 8 months old. At 6 months he sat up on his own, at 7 months he stood up on his own. Crawling confidently. He babbles a lot. He sleeps about 14 hours a day and sleeps well at night. NSG at 7 months: oblique size in front of the horns side of the ventricles on the right 5mm on the left 5mm third ventricle 3.8 mm interhemispheric fissure - 0 fluid level - 0 the rest without any features The neurologist who was observed said, “You still have ventriculomegaly, but many people live with it all their lives they live nothing terrible and your indicators are not so terrible" - this is the first question, please explain. I read that this is enough terrible diagnosis for a child and may threaten mental retardation, I very worried. How can I help my child, how long will it take to do NSG again? The doctor didn't tell me anything. She only told me to give Ubekhinon composite 5 more injections. And before the New Year, a massage. Question 2 - we still haven’t had DPT, there was a medical withdrawal, now the neurologist has allowed us to get vaccinated, outlined the preparation and prescribed the drug VINPOCETINE 1/4 2 times a day for 7 days before and after the vaccination. Is it possible for a child at this age and with our diagnosis? And how does this affect the vaccination? The fact is that we have a doctor’s appointment in the clinic for 5 minutes and I simply don’t have time to ask all the questions that interest me, if you explain it to me, I will be very grateful to you! Thank you very much!

Hello. According to the NHS, there are excellent positive dynamics. The ventricles are slightly enlarged, this is not scary and will not affect the child’s development in any way. There may be headaches in the future, but there may not be any. good product, suitable for children from birth (do not look at the instructions). It is prescribed to prevent the amount of fluid in the ventricles from increasing. Sincerely, Alla Vasilievna

Consultation with a neurologist on the topic “Size of the ventricles of the brain” is given for informational purposes only. Based on the results of the consultation received, please consult a doctor, including to identify possible contraindications.

About the consultant

Details

Pediatrician, children's neurologist. Associate Professor of the Department of Pediatrics, Candidate medical sciences, doctor of the highest category.

She graduated from the St. Petersburg State Pediatric University, then residency and postgraduate studies in pediatrics at St. Petersburg State Medical University named after Academician I.P. Pavlov. She completed professional retraining in child neurology at St. Petersburg State Pedagogical University. In 1995 she defended her dissertation for the scientific degree candidate of medical sciences.

General medical experience over 30 years.

Professional interests: perinatal damage to the central nervous system in children of the first year of life, consequences of PP of the central nervous system in children older than one year of age, speech disorders, vegetative-vascular dystonia syndrome, headaches, neuroses (tics, stuttering) and neurotic conditions, enuresis, ADHD (attention deficit hyperactivity disorder), impaired school performance.

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 liquor collectors are located on both sides 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 are specific values. These indicators are shown in the table.

To assess normal indicators, the definition of all structural elements lateral ventricles. 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 intracranial hypertension in a child with this state usually does 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 The child has.

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.

Fetal hypoxia

Traumatic brain injuries or falls

Pathological birth

Infection bacterial infections during pregnancy

Oncological formations and cysts that are located in the brain

Infectious diseases

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 when pronounced violations The first adverse manifestations of the disease begin to appear. 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 talk about mild flow. When headache, dizziness, and other symptoms indicating high intracranial hypertension appear, the disease becomes moderately severe. If general state the child is severely impaired and requires treatment in inpatient conditions, 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 further development 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 babies have 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 allows us 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.

Ultrasonography

CT scan

Magnetic resonance imaging

Fundus examination

Neurosonography

Treatment

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.

For elimination 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 excitement.

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

Multivitamin complexes. Used to compensate for all essential 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.

This article will be relevant for parents whose children have been diagnosed with ventricular enlargement

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:

Lateral;
Third;
Fourth.

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, according to right side- second. Both ventricles work with the third ventricle.

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

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.
A distinct manifestation of veins on the forehead, the cause is 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 in, after which the change in the size of the cerebrospinal fluid is monitored.

TO the following types diagnostic activities 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 20-25 minutes. Since this task is almost impossible for a baby, doctors have to put the child into artificial sleep. At the same time, this procedure is carried out

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 brain system baby. For example, for large babies this is the norm.

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

Falling into a coma;
Development of complete or partial blindness;
Deafness;
Death.

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.

Video

Conclusion

Dilatation in newborns should not be considered an anomaly in the development of the baby. It is rare that serious medical assistance is required. 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.

Why is an ultrasound of the baby's brain performed?

The discovery of the ability of ultrasound to reflect differently from structures of different densities was made 200 years ago, but in pediatrics this diagnostic method has become in demand since the mid-20th century.

Ultrasonic waves are produced using piezoelectric crystals. Sound vibrations with a frequency of 0.5 - 15 MHz tend to penetrate soft cloth, encountering structures with different acoustic characteristics.

Sometimes the sound is reflected as an echo, hence another name for the procedure - echography. While inferior to cutting-edge techniques, ultrasound has its advantages:

Does not harm tissues, the fetus, chromosomes, has no contraindications or side effects;
Doesn't need special training, administering anesthesia for examination;
Available at a very early age;
Doesn't take much time;
A simple procedure can be repeated more than once;
It is tolerated by children without problems.

Why is an ultrasound of the brain performed on infants? Research using the properties of sound vibrations is one of the most informative ways to study the structure of an infant’s brain, on which both the effectiveness and timing of treatment completely depend.

Neurosonography

Brain research to identify the limits of midbrain structures, displacements, additional cavities brain, dilation of the ventricles, blood flow speed and changes in the vessels supplying the brain using ultrasound is called neurosonography (NSG).

The method helps diagnose a tumor, brain abscess, intracranial hemorrhage, underdevelopment, dropsy and cerebral edema, complications from intrauterine infections.

By examining vessels and blood flow speed using ultrasound, it is possible to identify an area of ischemia (lack of blood circulation), infarction (cell damage due to weak blood flow).

For infants, ultrasound plays a special role, since the fontanelles ─ areas free from the bones of the skull ─ remain on the baby’s head for up to 1-1.5 years.

Without craniotomy at this age, one can easily penetrate these “windows” to examine information about the functioning of the brain.

The size of the fontanel also determines the possibilities for studying areas of the brain.

Simple and available method makes it possible to use neurosonography in mass screening examinations of infants for early definition pathologies in brain function. In some maternity hospitals, the procedure is performed on all newborns, but this method has not yet become mandatory.

Premature babies, as well as those born in difficult conditions, are referred to ultrasound by neurologists. Why do infants undergo a brain ultrasound, you can learn from Dr. Komarovsky.

Preparation for the NSG

Access to examine the baby's head is possible only through the fontanel - a membrane between the bones of the skull, with the help of which the fetus, moving along the birth canal, adapts to the anatomical features of the mother's body. As intracranial pressure increases, excessive volume is released through the fontanelles.

In a full-term baby, by the time of birth, most of the fontanels are overgrown with hard tissues; only the largest one can be determined by touch - normally soft, pulsating, located at the level of the skull bones, sometimes even small.

In the first three months, while the fontanelles are available, NSG is performed. The interpretation of the results is not affected by the child’s condition: whether he is sleeping or awake, crying or calm.

There is one limitation for Doppler ultrasound, which examines the blood vessels of the brain: the procedure is carried out 1.5 hours after eating. In other cases, no special preparation is needed. Where to do an ultrasound of the brain in a baby ?

You can check the address with your pediatrician, call or use the 24-hour electronic appointment form with a doctor on the medical institution’s website.

Read here. How do seizures manifest in infants?

Indications for NSG

The birth of a baby before the 36th week of pregnancy;
Birth weight ─ up to 2kg 800g;
Degree of difficulty of childbirth ─ 7/7 points or less on the Apgar scale ─ (possible damage to the central nervous system with developmental defects: ear shape, number of fingers);
Hernia (protruding part of the brain with a membrane);
Lack of cry at birth;
Transfer due to birth trauma to intensive care;
Prolonged or rapid labor;
Intrauterine infection;
Absence labor activity after the water breaks with a conflicting Rh factor;
During an ultrasound examination of a pregnant woman, brain pathology in the fetus was visible;
1 month after cesarean section;
Use of auxiliary instruments during childbirth (forceps, vacuum extractor, etc.);
Non-standard head shape;
Birth injury;
For strabismus, convulsions, torticollis, paresis, paralysis.

If the baby’s capricious behavior, constant regurgitation, tearfulness, if no pathology is found in other organs, an ultrasound of the head is prescribed. The effectiveness of treatment of meningitis, encephalitis, genetic disorders, head injuries are monitored by ultrasound.

Hemorrhage, cysts, ischemia, hydrocephalus, and intracerebral abscess are also diagnosed by ultrasound.

How does the procedure work?

An ultrasound is performed through the fontanelles; if it is necessary to study the structure of the posterior cranial cavity, then through the back of the head. When laying the baby on the couch, a sensor lubricated with a conductor gel is installed on the temples (if there are still springs) and in the area of the large spring.

Sometimes the back of the head is also examined.

By adjusting the position of the sensor, the doctor examines the structures of the brain.

Children do not feel pain, the study lasts no more than 10 minutes.

An echography image is projected on the display screen. Thick fabrics are highlighted in light tones, loose ones – in darker tones.

Typically, sonometry of 12 brain parameters is performed. The measurements are compared with standards, and the specialist gives an opinion on whether the ultrasound scan of the baby’s brain is normal.

This is not a diagnosis yet, just a diagnostic tool for a neurologist. In case of serious deviations, clarifying studies are carried out (MRI, CT).

Interpretation of NSG results

The norms for ultrasound of a baby are determined by the timing of his birth. But there are also mandatory criteria for deciphering an ultrasound of the brain in an infant:

Symmetrical arrangement of all brain structures;
All convolutions are clearly visible;
The cerebral ventricles and cisterns are homogeneous in structure;
The thalamus and subcortical nuclei have moderate echogenicity;
Anterior horn of the lateral ventricle ─ 1-2 mm in length;
Body of the lateral ventricle ─ 4 mm in depth;
The interhemispheric fissure (up to 2 mm in width) does not contain fluid;
The choroid plexuses are hyperechoic;
3rd ventricle ─ 2-4mm;
Large tank ─ 3-6mm;
Without displacement of stem structures.

After the study, the doctor deciphers and describes the results. For this he has 12 normative criteria.

He evaluates the size and contours of the ventricles (this helps to diagnose rickets, hydrocephalus and other pathologies). Then the condition of large vessels is studied (this helps to identify cysts and hemorrhages).

Dimensions and contours of the cerebral ventricles

Normally, the ventricles are cavities filled with cerebrospinal fluid. Enlargement of the ventricle may indicate hydrocephalus, an accumulation of cerebrospinal fluid in the skull.

The disease can be congenital or acquired. The cause of development may be intrauterine infection, defects in fetal development, or hemorrhage.

Children with this diagnosis are characterized by an increased head size, large fontanels and a convex forehead.

Enlargement of the subarachnoid space

This zone, filled with cerebrospinal fluid, is located between the soft and arachnoid membranes. Normally the width should be a few millimeters. If this area enlarges, you can think of inflammation of the membranes after injury or infection.

Cysts in the choroid plexuses

These neoplasms are visible on ultrasound even during pregnancy. They can develop in infants and children of the second year of life. Cysts also occur in adults.

Subependymal cysts are located near the ventricular wall and develop after hypoxia and minor hemorrhage. On brain activity they do not affect and do not require treatment.
Arachnoid cysts are located in arachnoid membrane. Critical sizes ─ from 3 cm. They already put pressure on the brain, causing epilepsy. Such a cyst does not resolve on its own.

Hemorrhages in the brain centers

Pathology occurs due to intrauterine infection, conflicting blood rhesus, and oxygen deficiency. birth injuries, blood clotting disorders. Occurs more often in premature infants.

Such hemorrhages come in four degrees of complexity. With this diagnosis, observation by a neurologist is mandatory, since the consequences of self-medication are very dangerous.

Ischemia

Oxygen deficiency during ischemia can lead to damage to nerve cells. Occurs after premature birth when the lungs are not sufficiently developed by the time the baby is born.

Damage to nerve cells is accompanied by softening of the brain, which provokes disturbances in the development of the baby.

Meningitis

When the brain becomes infected, its membranes thicken and become inflamed. The disease requires immediate treatment.

Tumors

Volumetric neoplasms in the cranium are rare, which makes it all the more important to be under constant supervision of a neurologist.

If there are a significant number of “finds”, it is worth consulting with a doctor about prescribing vitamin D for your baby, which promotes rapid overgrowth of the fontanelles. This is not useful if there is increased intracranial pressure.

Consultations in such cases require time limits or complete failure from vaccinations. For closed springs, transcranial ultrasound is performed, which is less informative than NSG.

MRI can give a clearer picture of the disease, but is mandatory general anesthesia for a baby is not always justified. The price of an ultrasound scan of the brain in an infant can range from 1300 to 3800 rubles. The cost depends on the region where the examination is carried out: for Moscow it is 1,600 rubles. and above, ultrasound of the brain in infants in St. Petersburg ─ from 1000 rubles.

Conclusion

On thematic forums, parents are satisfied with the conditions of the examination. The only thing that scares them is the conclusions of sonologists.

But timely diagnosis significantly increases the chances of recovery, because the brain of an infant in the first year of life is immature, and the body’s capabilities at this age are great.

Parents need to study the list of indications in order to understand that inexplicable crying, whims, shuddering, convulsions are harmless “little things” that indicate a pathology that is difficult to identify with age and no less difficult to treat.

More information

Examination of the newborn's brain is mandatory procedure, allowing to identify various pathologies nervous system in the first days of life. However, it should be remembered that an increase in the size of the lateral ventricles of the brain does not always indicate serious neurological disorders.

The human central nervous system is very complex. Its most important centers are the brain and spinal cord. Any pathology and deviations from the norm can cause the development of a number of neurological disorders, so examination of the brain and spinal cord in newborns must be done in the first days of life.

Ultrasound of the brain is mandatory in the following cases:

complicated childbirth;
birth injury;
fetal hypoxia;
prematurity;
presence of infections in the mother.

Also, a brain examination in newborns is indicated in the case of a low Apgar score (less than 7 points) and in case of changes in the fontanel.

If there are indications for an ultrasound scan of the brain, it is performed immediately after the birth of the baby; a repeat examination is indicated upon reaching one month of age.

There is a table describing brain norms for newborns. So, if during the initial ultrasound there is a discrepancy with the norm of the ventricles of the brain in children, the norm in the table is presented for different ages- additional examinations are carried out.

Dimensions of the lateral ventricles

If an ultrasound showed enlarged lateral ventricles in a child under one year old, this is not necessarily a pathology. For many children, their normal size may be slightly larger than normal, especially if the child has a large skull.

Control of brain development in a child is important here. The examination must be repeated regularly. If there is a tendency towards a further increase in the size of the ventricles, only then can we talk about pathology.

These organs serve as an intermediate “storage” for cerebrospinal fluid. With a significant increase in their size, the outflow of cerebrospinal fluid in a child is disrupted, and the intracranial pressure and there is a risk of developing hydrocephalus.

What does the expansion indicate?

Ultrasound of the brain is mandatory for children born. Enlargement and asymmetry of the lateral ventricles may indicate the presence of the following pathologies in a child:

hydrocephalus;
traumatic brain injury;
cyst;
pathologies of central nervous system development.

If there is an increase in a premature baby, expectant management is chosen. The examination must be carried out regularly to determine trends in changes in the size of the ventricles and the condition of the brain.

In most cases, deviation from the norm does not mean pathology. In premature infants, enlargement and asymmetry of the ventricles are associated with features of brain development. This problem goes away on its own without treatment when the child begins to catch up with his peers in weight.

It is not uncommon for premature babies to be born with a septum pellucida cyst. Such a cyst is a small, regular-shaped neoplasm filled with fluid. The cyst compresses neighboring tissues and vessels, which can cause problems metabolic processes brain.

As a rule, in 90% of cases the cyst goes away on its own without treatment and does not cause any neurological disorders in the child.

Treatment is necessary if the cyst was not diagnosed at birth, but was obtained as a result past illness or injury. In such cases, its size quickly increases and provokes the accumulation of cerebrospinal fluid, which can lead to the development of a number of disorders.

How and when is diagnosis carried out?

Regular ultrasound examination brain is prescribed in the first month of the baby’s life, if there is alarming symptoms, for example, weak reflexes or causeless restlessness of the child.

If pathology is present, the examination in children under one year of age is repeated every three months.

Deviation from the norm at this age does not always require treatment. A wait-and-see approach is required and regular examinations to determine the dynamics of changes in the state of brain tissue. Often, enlarged ventricles are temporary and quickly return to normal without any treatment.

In case of complicated childbirth, ultrasound is performed in the first hours of life. In all other cases, a neurologist may refer you for examination if the child exhibits the following symptoms:

head too big;
weakening of reflexes;
anxiety;
fontanelle injuries;
strabismus;
elevated body temperature.

Also, diagnosis of the state of the brain is carried out in cases of suspected cerebral palsy, rickets and a number of other congenital disorders.

How is an ultrasound done on babies?

Ultrasound examination methods are the safest and do not cause negative influence on the newborn's body.

No special preparations are required for the examination. The child should be fed and not feel discomfort. Since newborn children most They spend time sleeping; there is no need to wake up the baby for examination. An ultrasound does not cause discomfort, so the child will not wake up unless specifically awakened.

The child is placed on a special couch, a small amount of special gel is applied to the fontanel area and the diagnosis begins. The procedure does not last long and does not cause any discomfort.

Decoding the results

The results of the examination are examined by a neurologist. Do not worry ahead of time if the results obtained show minor deviations from the norm. In addition to the size of the lateral ventricles, an important characteristic is their structure and symmetry. The doctor’s task is to assess not only the sizes, but also their compliance with the characteristics of the child’s body.

Dental granuloma is an inflammation of the tissue near the tooth root. The treatment is carried out by a dentist, an additional decoction is used