Hydrocephalus is an excessive accumulation of cerebrospinal fluid in the ventricular system and causes an increase in intracerebroventricular pressure, which is a common clinical condition.
I. Causes of hydrocephalus in newborns
There are many causes of hydrocephalus in newborns, as follows.
1, congenital malformations: such as stenosis of the midbrain aqueduct, diaphragm formation or atresia, cerebrovascular malformation, spina bifida, etc.
2, infection: fetal intrauterine infection, resulting in septic meningitis or tuberculous meningitis, which is not treated in time.
3, hemorrhage: intracranial hemorrhage caused by fibroplasia can cause hydrocephalus.
4, tumors: intracranial tumors can block any part of the cerebrospinal fluid circulation, more often seen near the fourth ventricle.
5, trauma: such as traumatic subarachnoid hemorrhage, cerebellar contusions, arachnoid fibrous degeneration, etc.
6, other: such as genetic, metabolic diseases, severe vitamin deficiencies in the perinatal and neonatal periods, etc.
Second, how to determine neonatal hydrocephalus
Neonatal hydrocephalus can be judged clinically by its symptoms and related examinations. In general, infants with hydrocephalus may have vomiting and other symptoms, while children with severe hydrocephalus may have dilated scalp veins and sunset-shaped eyes, with typical hydrocephalus symptoms such as large head and small face, strabismus, tremor and backward development. Once the above symptoms are found, the following tests can be completed to clarify the diagnosis.
1.Physical examination: gradual growth of head circumference, separation of cranial sutures, enlargement and bulging of the forehead, etc. can be seen.
2. cranial transillumination test: the whole skull of children with hydrocephalus is translucent, and those who are translucent only at the top of the forehead are often subdural hematomas or hydrocele.
3, cranial ultrasound examination: midline waves are not displaced, commonly enlarged ventricular waves.
4.Cranial X-ray: cranial cavity enlargement, asymmetric head to face ratio, thin skull, separation of cranial sutures, enlarged fontanelle, deepening of the pterygoid saddle and other changes can be seen.
5.CT or MRI of the head: to clarify the presence or absence of hydrocephalus, the degree of hydrocephalus, the site of obstruction, periventricular edema, etc.
Treatment of neonatal hydrocephalus
The treatment methods of neonatal hydrocephalus include surgery and symptomatic treatment with drugs, as follows.
1, etiological treatment: such as catheter stenosis feasible dilatation or placement, the system of median foramen adhesion feasible adhesion release, incision molding, etc..
2, ventricular shunt: including intracranial and extracranial shunts, currently commonly used methods include ventricular-abdominal shunt, ventricular-atrial shunt and ventricular-subarachnoid shunt, three extracranial shunts. Among them, ventriculo-peritoneal shunt is the preferred method.
3, drug symptomatic treatment: dehydration, lowering cranial pressure available mannitol, furosemide, human albumin, etc.; reduce cerebrospinal fluid production can be treated with acetazolamide, digoxin, dexamethasone.
Prevention of neonatal hydrocephalus
The prevention of neonatal hydrocephalus is as follows.
1, strengthen prenatal early diagnosis.
2.Promote knowledge of eugenics and reduce the number of births.
3, safe delivery, to prevent asphyxia, birth injuries.