High intracranial pressure in a child

Intracranial pressure due to fluid volume (CSF) in the ventricles of the brain, venous sinuses, in the space under the arachnoid membrane. It protects brain tissue from bumps, acting as a layer that provides power structures, creates the necessary conditions for an adequate blood supply.

Increased intracranial pressure in a child is caused by imbalance between production of CSF and its flow, creating mechanical obstruction to outflow. Accordingly, the reason for the decrease may be leakage of cerebrospinal fluid out at traumatic damages of a skull or an artificial medical intervention (puncture, brain surgery).

When measuring mercury manometer as the norm for the child's age is taken 2 mm Hg. article (adult to 15). This pressure child enough to offset the unfavorable external conditions.

Neurologists believe that prescribing the right treatment, it is necessary to consider the relationship between the volume of brain tissue and fluid: if in connection with the swelling of the brain increases, compensatory decreases production of CSF, increasing the absorption. Against this background, the intracranial pressure may remain normal with good adaptation.

This explains why most children who suffer from deficiencies in the immune system. In the case of depletion of compensatory mechanisms, even a small increase in the volume of tissue causes a high pressure inside the skull.

What causes contribute to increased pressure inside the skull?

The easiest way to explain possible causes:

• the excess production of CSF;
• insufficient suction;
• mechanical obstacle to patency of the outflow pathways.

Clinical manifestations in children up to years

As a rule, kids under one year not yet overgrown fontanelles. This creates a "reserve" space for growth of the substance of the brain, but also compensates for possible swelling and expansion. Signs of decompensation may include:

• Increased anxiety, the cry of a child should pay attention to the fact that the day and hands in a vertical position, the child calms down. Night in a horizontal position for CSF is hampered that fills the veins of the brain, increases the reset liquorous system and the internal pressure.
• Violation of falling asleep, poor sleep surface — occur for the same reason.
• Profuse vomiting after eating, possible vomiting — associated with stimulation of the centers of the medulla oblongata. A sign cannot be considered mainly because causes can include overfeeding, swallowing of air.
• At a monthly inspection of the baby, the pediatrician notes rapid increase in the size of the baby's head, especially the frontal lobes, bulging out of the fontanelles, suture between the skull bones. Itindicates excessive accumulation of fluid in the ventricles and the sinuses, hydrocephalus.
• Under the scalp you can clearly see the dilated veins. They are filled with stagnant blood.
• Eyeballs seem to be bulging out of their sockets. Sight is deflected downwards, the eyelids are not fully closed, the visible gap above the upper edge of the iris. Symptom it is named after the author who described it — Graefe. Is associated with compression of the oculomotor nerve.
• Food refusal and delay of weight gain — the process of sucking causes an increase in pressure and pain of the baby, so he can't eat.
• Physical and mental development are violated. The child is unable to master the movement, to sit independently, does not respond to games, speech.

Clinic older children

At an older age and adolescence children can describe their suffering, to answer the questions of the doctor. The most frequent manifestations:

• headaches night, in the morning;
• poor sleep;
• fatigue;
• pain in the eye sockets, double vision, flashes, momentary loss of vision;
• constant nausea, possible vomiting, but no relief comes;
• inability to concentrate;
• poor memorization;
• irritability, tearfulness.

Students as affecting academic performance, ability to do the schoolwork.

How to examine a child?

The most accurate result is to measure intracranial pressure through a spinal (lumbar) puncture. The method is applicable only in stationary conditions. In the children's clinic, doctors use indirect signs, symptoms, story of parents and child, the results of the inspection.

Read more about performing a lumbar puncture and evaluation of cerebrospinal fluid read in this article.

Children grudnichkovye age determine the level of intracranial pressure by pulsation of the fontanel at the crown of the monitor Ladd.

In neurosurgical hospitals when required constant monitoring in intensive care unit used bedside monitors. Thus in a skull of a patient inserts a catheter with a balloon on the end. The pressure is recorded and transmitted to the measuring device and the computer.