Update: October 2018
Have you had a baby? He is still so tiny, but already
�“Fallen down” terrible diagnosis – intracranial pressure? Have
infants, unfortunately, this diagnosis is not uncommon. Most
parents are aware of the existence of such a diagnosis, but when faced with
Him in reality, they do not know what to do. Many care
последствия intracranial pressure у детей. For all your questions
There are answers in our article.
What is increased intracranial pressure?
To understand what it is, let’s look at some
аспектах анатомии черепа и головного the brain. The brain is surrounded
several shells, between the two of them, in the subarachnoid
space there is cerebrospinal fluid. Inside the head
the brain is a system of interconnected ventricles that
also filled with cerebrospinal fluid (CSF).
it защищает головной мозг человека от травм, сотрясений, на
as much as possible. CSF pressure on structures
the brain is called intracranial pressure. Elevated
intracranial pressure is the pressure that exceeds
permissible norms and entails a number of consequences.
Всегда ли повышение intracranial pressure – это
No not always. With ordinary daily activities
intracranial pressure may increase briefly. For example,
during an act of defecation, when lifting a heavy object, when coughing,
stress, even when sucking mother’s breasts. it не несет никакой
опасности для baby. But if the increased intracranial pressure in
babies is permanent, then this requires treatment.
High intracranial pressure – diagnosis or symptom?
Повышение intracranial pressure говорит о наличии какой-то
the pathology that caused it. it симптом, при его выявлении
необходимо более детально обследовать baby, чтобы выявить
заболевание, спровоцировавшее подъем intracranial pressure.
What can cause an increase in intracranial
Diseases accompanied by this symptom:
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е опухоли головного мозга — в данном
case, additional tumor tissue is formed, which leads to
повышению давления и изменению структур головного the brain.
- Malignant brain tumors – the same mechanism
most, as with benign neoplasms of the head
- Meningitis – for any type of meningitis, head edema occurs
the brain. Purulent meningitis changes fluidity.
cerebro-spinal fluid, it becomes more viscous and its outflow
- Encephalitis – inflammation of the brain tissue leads to their
отечности, что и вызывает подъем intracranial pressure.
- Токсический отек головного the brain.
- Hydrocephalus – in this disease the outflow is disturbed
cerebro-spinal fluid through the cerebrospinal fluid pathways. Liquor Products
continues and in the absence of its normal circulation occurs
резкий подъем intracranial pressure. More on symptoms and
treatment of hydrocephalus in children.
- Genetic anomalies and defects of the cerebrospinal fluid paths – can become
cause of hydrocephalus.
- Brain injury – always brain trauma
accompanied by his swelling. There may also be a subdural hematoma in
the result of injury. it ведет к увеличению объема тканей в
- Intracerebral hemorrhage – occupying a certain place, the focus
hemorrhage squeezes brain tissue and increases liquor pressure on
ткани головного the brain.
- Cerebral edema due to acute hypoxia
fetus during pregnancy or childbirth.
- Несвоевременное сращение костей черепа у baby — при этом
the brain continues to grow, if the bones of the skull have grown together early, then
это вызывает постепенное увеличение intracranial pressure.
In 90% of cases, intracranial hypertension in infants
caused by birth trauma or pathological course
pregnancy in women – intrauterine infection, hypoxia of the fetus.
One of the leading causes is hydrocephalus.
What is the effect of intracranial pressure in babies?
difference in the clinical picture at different ages?
WITHимптомы intracranial pressure у baby очень разнообразны,
because they can be “supplemented” by symptoms characteristic of
the underlying disease that caused the rise of intracranial
Признаки intracranial pressure у baby делятся на две
groups depending on age. The difference arises because
younger children (up to about a year) have “springs” – places
where the bones of the skull have not yet grown together, and in children after a year, as
the rule �”Springs” anymore. Consider in detail what is shown
increased intracranial pressure.
Symptoms in young children
- Anxiety, strong crying
A characteristic of elevated intracranial
pressure is that during the day the child may be
relatively calm, and in the evening and at night the baby cries loudly, not
may calm down, the behavior becomes restless. Due to
This is the structure of the venous and liquor systems. In the evening and at night the child
more is in a horizontal position, venous outflow at
this slows down, the veins of the brain and skull overflow, which
increases the volume of cerebrospinal fluid. This in turn
leads to a further increase in intracranial pressure.
- Sleep disturbance, frequent waking up, difficulty falling asleep. These
symptoms are also due to the reason described in the previous
- Nausea, vomiting, frequent and abundant regurgitation
These phenomena are reflex (see the causes of regurgitation in
newborn, baby). With high intracranial pressure
there is an irritation of the centers of the medulla oblongata responsible for
vomiting, nausea. Frequent regurgitation in children are on the other
reasons (overfeeding, air ingestion during feeding),
therefore, for this symptom alone it is impossible to conclude that
pathologies accompanied by high intracranial pressure, but
it also cannot be excluded.
- Increase in head size
Disproportionate head size, increase and bulging
�”Springs”, an increase in the frontal part of the skull, the divergence of the seams
bones of the skull. All this is due to the accumulation of cerebrospinal
liquids in the cerebrospinal fluid spaces of the brain, that is
- Clearly visible venous network under the scalp
Increased intracranial pressure is accompanied by excessive
filling the venous network with blood and its stagnation. This causes
expansion of the saphenous veins, which makes them visible.
- Gref’s symptom
This is a violation of the work of the oculomotor nerves that occurs
due to birth injury, high intracranial pressure.
It manifests itself with periodic uncontrolled deviations.
eyeballs down, while between the upper edges of the iris of the eye and
the upper eyelid becomes visible to the sclera (white stripe), due to which
this symptom is also called the “symptom of the setting sun”.
- Refusal to feed
When sucking physiologically increases intracranial
pressure, in conditions of the pathological process it increases
болезненные ощущения у baby. No weight gain –
is a consequence of refusal to feed.
- Lag in physical and psycho-emotional development.
The consequence of the direct damaging effects of pathology on the head
brain and inadequate feeding.
Symptoms in older children
- Nausea, vomiting. As a result of irritation of the centers oblong
the brain. Vomiting does not bring relief, which distinguishes it from vomiting with
- Children complain of pain behind the eyeballs. It arises from
pressure of the liquor on the area behind the sockets.
- Children can talk about doubling before their eyes, the appearance
flashes and ribbons before your eyes. Arise due to irritation.
- Severe headaches, the intensity of which increases in the evening
and at night.
- Crying, irritability, restless sleep.
More details in our article – Symptoms and treatment of increased
How to measure the intracranial pressure of the child?
The only method to correlate the indicators of the norm
intracranial pressure у детей с показателями у больного baby
– spinal puncture. This method is used extremely rarely.
as it is an invasive method and in modern conditions
There are many other ways to diagnose this disease by
set of features.
What diagnostic methods should be used?
The first thing that needs to be done is an examination by a neurologist. WITH
using this method, the doctor can identify abnormalities in the reflexes,
увеличение головы и «родничков» у baby. You may notice a symptom
Grefe Mom should also tell about the features of sleep and
бодрствования baby, рассказать, не менялся ли аппетит, режим сна
An examination by an ophthalmologist can help establish this
diagnosis. With increased intracranial pressure occur
changes in the fundus, dilated veins, arteries spasm,
The optic nerve head can be swollen and bulging.
The most informative method of examination in children under one year
(while the “springs” are still open) is neurosonography. it
ультразвуковое исследование головного мозга baby. With this
the study revealed an increase in the hemispheric gap, an increase in
the size of the ventricles, maybe their deformity, the displacement of the brain
structures in some direction if there is some kind of bulk
education in the brain.
How often should neurosonography be performed on a child?
WITHогласно приказу Минздрава РФ, нейросонография должна быть
held to any child up to 6 months 3 times. First time
be sure to conduct this study in 1 month, then in 3
month, then in half a year Many believe that if at first
the study was all normal, then do not worry.
it распространенная ошибка, ведь картина постоянно меняется.
The problem may appear at any time. This must be remembered
and do not ignore the scheduled examination. If necessary, and
the presence of evidence the survey can be repeated as long as
there are “springs”.
Is it harmful to do neurosonography so often?
Not harmful. Haveльтразвук для уже родившегося baby не имеет
negative impact. And the benefits of this study are difficult.
Какие методы диагностики применяются, если у baby уже нет
In this case, in addition to the examination by a neurologist, it is recommended
computer or magnetic resonance imaging.
В чем заключается лечение повышенного intracranial pressure
The choice of tactics and methods of treatment of increased intracranial
давления у baby зависит от заболевания, вызвавшего подъем
intracranial pressure. The most common methods
- Нормализация режима сна, бодрствования, кормления baby.
- Long walks in the fresh air.
- Moderate exercise, very beneficial effect
- Назначение диуретических средств — Диакарб, Триампур
and so forth
- The appointment of drugs that improve cerebral circulation,
nootropic drugs – Piracetam, Pantogam, Cavinton,
a nicotinic acid.
- Neuroprotectors (glycine).
- Drugs with mild sedative (sedative)
- Physiotherapy procedures.
- For tumors, anatomical anomalies, use surgical
- When hydrocephalus often do ventriculo-peritoneal
shunting The shunt between the ventricles of the head
brain and abdominal cavity. Excess liquor flows through it into the abdominal
cavity where it is quickly absorbed.
Какие могут быть осложнения in children?
Without treatment, increased intracranial pressure may
lead to the following consequences:
- occurrence of epileptic syndrome
- blurred vision
- mental disorder
- strokes – hemorrhagic, ischemic
- in case of infringement of the cerebellum, there may be a disorder of consciousness,
respiratory failure, weakness in the limbs
Что следует знать родителям baby с таким диагнозом?
- WITHуществует несколько заблуждений у родителей относительно
повышенного intracranial pressure — к примеру, то, что это
incurable condition. However, with timely and adequate
лечении возможно выздоровление baby. WITHегодня широкий спектр
various drugs, as well as the possibility of surgical
treatment helps to cope with a similar pathology.
- The main thing to do is follow directions.
- Remember that with increased intracranial pressure in children,
treatment should be comprehensive, individual and take place under
контролем the doctor.
- WITHледует знать, что у грудничков внутричерепная гипертензия не
has hereditary causes, but mostly
due to the pathological course of pregnancy and childbirth.
Автор: Ревус Олеся Григорьевна врач-невролог