Cerebral edema in newborns. Causes and symptoms of cerebral edema

Cerebral edema in children is quite common. birth trauma. This anomaly may well be asymptomatic and without obvious signs, and the consequences can be the most dire.

Cerebral edema in newborns is a rather complex and unfortunately common problem in modern pediatrics. Treatment is usually long-term and very complex. Sometimes required surgery. The consequences can be serious.

The presence of cerebral edema in children requires a thorough examination using modern technologies(CT, MRI) and long-term observation by both a neurologist and a pediatrician.

Main reasons and types

Edema can occur due to a number of congenital and acquired diseases, as well as as a result of birth trauma. Hypoxia of the newborn, meningitis, abscesses, tumors, encephalitis, are common reasons swelling of the head in small children and infants. In infants, there is an increase in the volume of intracerebral fluid, general weakness, tearfulness, as well as a whole range of neurological symptoms.

Cerebral edema can be divided into two types:

Regional

It is also called local edema. This is a specific area of ​​the brain that is affected by a pathological process or formation. Pathology and swelling are located in the tissues of the brain itself, for example, when a tumor occurs, a cyst forms, as well as an abscess or hematoma.

Common

It affects the entire brain; it is also called generalized. The development of this type of edema occurs with traumatic brain injury, birth asphyxia of the newborn, drowning or intoxication.

Symptoms

Swelling and enlargement intracranial pressure leads to infringement of the medulla oblongata, which is responsible for thermoregulation, breathing, and work cardiovascular system. All this can be disrupted and not work correctly. The consequences of this are terrible - sudden death child.

Symptoms of head edema in young children are associated with increased intracranial pressure. The consequences of compression of the brain will be fainting, loss of consciousness, and convulsions. Newborns may experience a constant excited state, non-stop and high-pitched crying, enlargement or swelling of the fontanelle, vomiting, fever, and convulsions.

Diagnosis of edema

Diagnosis of this condition can be divided into two methods: general medical and instrumental.

General medical

This method includes general examination child's doctor, complete neurological examination, assessment of behavioral reactions, assessment of psychomotor function.

Instrumental

These are electroencephalography, echoencephalography, neuroophthalmoscopy, and studies using radioactive isotopes. TO this method diagnostics can be attributed computed tomography, nuclear magnetic resonance imaging and neurosonography in newborns and children up to one year old.

Principles of treatment

Swelling of the head, as in small children, is an emergency condition, the consequences can be adverse. The sooner his treatment begins, the greater the chances for favorable and get well soon. It is important to remember that when treating head edema in children, the cause of its occurrence should be eliminated.

Edema should be treated with several groups of drugs. The main ones are: osmotic diuretics (Lasix, furosemide, mannitol), hormonal drugs(glucocorticosteroids).

Treatment must be carried out by a competent doctor, the effectiveness of treatment must be constantly assessed, the dosage of drugs and the method of their administration must be adjusted.

Consequences of cerebral edema

The effects of edema in young children and newborns may be different or even absent. This depends on the age of the child, the severity of the disease, and on correct and timely treatment.

One of the consequences in infants, as well as children under one year old, can be a significant increase in head circumference due to the opening of the fontanel.

Some other consequences may include developmental delay in the child, hyperactivity and absent-mindedness, cerebral palsy, epileptic seizures, as well as periventricular edema and leukomalacia.

Periventicular leukomalacia is necrosis of part of the brain. This condition most often occurs in premature babies as a result of immaturity of the mechanisms of self-regulation of cerebral blood flow and inadequacy of cerebral circulation. This condition causes hypoxia premature newborn, as a result of which, there is a delay and accumulation of fluid in the brain, that is, edema.

There is no effective treatment for leukomalacia due to its irreversibility. Sometimes it is possible to maintain the condition of a premature newborn baby until the moment when his body is able to control all the processes occurring in it. Since this happens, in particular, with premature babies, the possibility of prolonging pregnancy and preventing premature birth should be considered.

If such an anomaly occurs, all functions of the premature baby’s body should be adequately monitored, while preventing attacks of apnea and fluctuations. blood pressure. The consequences of underestimating the child's condition will be irreparable. Hypoxia or oxygen starvation brain.

It must be remembered that by contacting a specialist in a timely manner, you can prevent many adverse consequences. And if you notice any symptoms of cerebral edema in your child, you should immediately consult a doctor. Since only he is able to provide qualified assistance and prescribe the necessary treatment.

Pregnant mothers should follow a daily routine, take healthy foods rich in vitamins and try to maintain pregnancy until certain period in order to avoid in the future possible consequences and complications of premature babies.

Smirnova Olga Leonidovna

Neuropathologist, education: First Moscow State University medical university named after I.M. Sechenov. Work experience 20 years.

Articles written

Newbornsare increasingly suffering from diseases such asedemabrain. The problem is getting worse every yearcommonand dangerous.Edemabrain innewbornsdifficultamenabletreatment, and most often requires surgery to eliminate it. And interference with a child’s brain activity is no less dangerous than the disease itself. Signsedemabrainbabyeasy to identify, which means medical care will be provided in a timely manner, which significantly increases the chances of a favorable outcome.

Brain edema in newborns is most often a consequence of trauma during childbirth. But, in addition to this, swelling in the brain of babies can provoke:

• abscesses;
• any shape;
• encephalitis;
• tumor of any etiology.

Any of these reasons can provoke swelling of the brain and its lobes in a newborn. Doctors divide the disease into 2 main forms:

1. Regional when cerebral edema in children is localized in a specific part of the brain. The cause is a hematoma, or tumor.
2. Common when the entire brain is swollen. The causes of such edema are asphyxia during childbirth, drowning or severe intoxication.

Brain edema in such a child provokes an increase in intracranial and blood pressure. Afterwards, the medulla oblongata of the brain, which is responsible for body temperature, respiratory and cardiac functions, is pinched.

Important! Failure in any small system baby leads to death if medical assistance is not provided in time.

Clinical picture

Brain edema in children can be determined even without being a medical specialist. With swelling of brain cells, the disease will be defined by the following symptoms:

• lethargy, irritability due to light and sounds, even quiet ones, crying - all these are signs that swelling has provoked an increase in intracranial pressure;
• failure in respiratory and cardiac activity, the consequences of which can be death or disability;
• organ failure;
• convulsions;
• rapid pallor of the skin;
• fainting.

Important! The situation is worst for premature babies, the consequences of such swelling they can not only provoke a significant disruption of brain activity, but also cause the death of the baby.

Parents who strictly monitor their baby will instantly see changes in his condition. little child, especially a newborn, never cries just like that. At this age, the reason for his crying is health problems. Therefore, you should not ignore him and complain about his bad behavior. If he screams, there is a reason, and if any of the symptoms of brain swelling are added to the crying, then you cannot hesitate. Time is ticking now, so call urgently ambulance to save your child.

Diagnostics

Brain problems, the symptoms of which were listed above, using several methods:

1. To identify and confirm signs of cerebral edema, the child will be examined by a neurologist who will check reflex and reaction characteristics.
2. Research using and.
3. A neurosonograph and a nain ophthalmoscope will help determine the occurrence of pathology and its location.

Most often used integrated approach in diagnostics so that the diagnosis is accurate. After all, the slightest mistake can cost a small patient his life and health. A premature baby is examined more thoroughly, because many of his organs have not really developed, which means that the chances of recovery are less. The occurrence of such a pathology in him can be provoked by any factor, it all depends on the current state of his health.

Therapy

It is very difficult to combat cerebral edema in children. Depending on the final assessment of his condition and the severity of the disease, special therapy will be prescribed. Due to the wide range of damage that can be caused to brain activity, treatment will be highly individualized. The consequence of late application for medical care There may be not only disability for the baby, but also death. It doesn’t matter whether a premature or full-term baby is diagnosed with an illness, doctors have one goal - to find what caused the swelling and its development, and to eliminate it as quickly as possible.

Medicines are prescribed in combination to not only remove a number of symptoms characteristic of edema, but also its very cause. Therapy is based on:

• osmotic diuretics such as Furosemide or Lasix;
• hormones;
• muscle relaxants, which will help eliminate the convulsive condition;
• corticosteroids. They will relieve swelling and stop the spread of edema throughout the brain;
• . They will help, without which brain activity will not return to normal;
• drugs to relieve specific symptoms.

In such a situation, therapy will be selected strictly individually. The child is admitted to the hospital department intensive care, where the child’s condition is monitored minute by minute. When the child’s condition improves, examinations move to an hourly schedule. Brain parameters are strictly monitored to prevent new development of pathology. Sometimes children do not tolerate specific medications well, so the doctor will choose more suitable analogues. All measures in therapy will be aimed not only at eliminating the damage caused by the tumor, but also at the recovery of the baby.

What does this mean for the baby?

If swelling occurs in the baby’s brain, no doctor can immediately give an accurate prognosis of the outcome of the disease. Increased attention will be paid to the manifestations of edema and its symptoms, and only after therapy has begun will the doctor be able to give the baby’s parents a more accurate prognosis. Sometimes the consequences of the disease can be frightening, and some babies tolerate it without any consequences at all. Depending on how quickly the parents responded to dangerous symptoms, brought the child to the hospital, where he was started correct treatment, the forecast will depend.

Most often the most frequent complications after such an illness they become:

1. The growth of the child's head is disproportionate to the body, which is caused by the expansion of the fontanel, which is influenced by high intracranial pressure.
2. A child's development may be abnormal, both physically and mentally. If the outcome of treatment is favorable, a baby at the age of one should catch up with his healthy peers in development, but only if the brain is slightly damaged. Otherwise, the baby’s retardation will be obvious, and the child will be assigned a disability group depending on his individual indicators.
3. Hyperactivity or, conversely, complete absent-mindedness of the baby.
4. Cerebral palsy.
5. Periventricular edema is recognized as the most dangerous consequence disease, because its consequence most often is periventricular leukomalacia. With it, brain cells die faster. Most often this problem is diagnosed in babies who were born ahead of schedule, due to the fact that their brain blood supply system does not yet function normally, and all the mechanisms of self-regulation of this process are undeveloped, and leukomalacia occurs. Often because of this, which without other reasons stimulates swelling of the brain tissue.
6. A disruption in the child’s physiological functionality is an equally complex consequence of cerebral swelling. With it, the child cannot bend or straighten his limbs normally. There is a problem with independently holding the head. Often even the sucking reflex disappears. Therefore, such children are often diagnosed with cerebral palsy.
7. Death. This is the saddest prognosis for such an illness, which most often occurs due to the fact that parents did not seek medical help in time, or it was provided incorrectly. Death can also occur in cases where the child received extensive injuries during childbirth.

Nowadays, immediately after birth, many children are diagnosed withedemabrain, but these situations are not always critical. At the first manifestation of symptoms of this pathology, you should immediately notify your doctor. After all, the sooner the problem is identified and treatment is started, the greater the chance that yourchildwill transferherwithout consequences. Only from the attention of parents and pediatricians tochilddepends on his health and long years of life without disability or other health problems.

The body of a newborn child is quite weak and unprotected. He is prone to developing a variety of pathological conditions under conditions that would go unnoticed in an adult. One of these conditions is cerebral edema - this is not a rare pathology in newborns.

Why does swelling develop?

Brain edema in a newborn can occur for various reasons:

• congenital infectious diseases- rubella, cytomegalovirus infection,
• TORCH complex infections;
• when entwined with the umbilical cord;
• Rh conflict leading to hemolytic disease;
• birth trauma of the skull.

The causative factor damages the substance of the brain - directly or indirectly. Brain cells respond to this by hyperproduction of fluid - they increase in size. At further action damaging factor, fluid accumulates not only in the cells, but also in intercellular substance- cerebral edema intensifies.

Since the brain is located in a closed space, it cannot expand indefinitely. Signs of compression of the brain begin to develop. The last stage In case of cerebral edema in a child, the trunk becomes wedged into the foramen magnum. Without emergency assistance this leads to death due to impairment of vital functions.

Symptoms of pathology

Brain edema in children develops gradually. Therefore, unfavorable signs can be detected in advance:

• the child becomes lethargic, moves little, does not take the breast or bottle well;
• he gradually appears headache- the newborn reacts to this with sharp cries;
• upon examination, you can detect bulging fontanelles on the skull;
• limbs are in a state of hypertonicity - fists are clenched, hands are pressed to the chest,
• the toes are tucked, and the legs themselves are bent at the knee and hip joints;
• you can notice the dilation of the pupils;
• the child goes from lethargic to hyperactive and screams shrilly;
• there is an increase in body temperature.

As cerebral edema progresses, the child develops convulsions, instability of breathing and blood circulation is noted, and increasing compression of the brain substance leads to impaired consciousness up to coma.

Diagnosis and treatment of pathological conditions

Cerebral edema in an infant can be diagnosed based on:

• medical history data that will suggest the cause of this condition;
  inspection data;
• ultrasound examination of the brain through the fontanelles;
• radiography of the skull;

Diagnosis must be carried out in a short time in order to begin treatment as early as possible. Relief of this condition involves placing the child in an intensive care unit. Initial measures should be aimed at eliminating the cause, if possible.

In parallel with etiotropic treatment, intensive pathogenetic and symptomatic therapy. It includes the use of the following groups of drugs:

1. Diuretics - Diacarb (eliminates overproduction of fluid by brain cells), furosemide (removes excess fluid from the body).
2. Glucocorticoids to eliminate edema (Dexamethasone).
3. Anticonvulsants (Seduxen).
4. Sedatives - aimed at correcting psychomotor agitation. Relanium can be used in pediatric practice.
5. Correction of circulatory and respiratory disorders - ceraxon, digoxin, dopamine.
6. To improve metabolism - ATP, ascorbic acid, B vitamins.

All these means are aimed at eliminating life-threatening conditions. After stabilizing the child’s condition, medications are prescribed aimed at restoring brain cells, impaired body functions, and preventing complications:

• neuroprotectors - restore the integrity of brain cells (Cerebrolysin, Actovegin);
• nootropics - improve cerebral circulation(Cavinton, Vinpocetine);
• means for improving microcirculation - restore tissue damaged during hypoxia (Pentoxifylline, Trental).

Forecast and consequences

At early diagnosis and complete treatment of cerebral edema in infants, the prognosis for life is favorable. However, such severe damage as cerebral edema, in most cases, leaves consequences:

• formation ;
• decreased mental abilities;
• mental disorder;
• motor dysfunction;
• disappearance of previously acquired speech skills;
• extinction of grasping and sucking reflexes;
• muscle hypertonicity;
• strabismus;
• lethal outcome.

This is why timely and correct diagnosis this condition in children.

Every parent wants their child to be healthy and happy. But, unfortunately, desire alone is not enough, and the influence of certain aggressive factors and a combination of circumstances leads to the development of diseases of varying complexity in children of various ages. And all kinds of diseases are diagnosed even in very young children, including those who have just been born. Just such dangerous and at the same time common disorders include cerebral edema in newborns, the consequences, causes and treatment of which will be discussed further in a little more detail.

By cerebral edema we mean an increase in the size of this organ due to the accumulation of fluid in the space between the cells. Similar condition in fact it is worth considering how secondary symptom damage, it can be either local or diffuse.

Why does cerebral edema occur in newborns, what are the reasons for this?

A fairly common cause of edema is birth trauma to the brain of newborns. This condition can also be caused by traumatic brain injury and oncological diseases, sometimes it is caused by a stroke, and sometimes hypertension.

Also, the causes of cerebral edema in newborns include hypoxia (oxygen starvation of the brain), meningitis and encephalitis. Another possible factor causing this disorder is hydrocephalus of the brain.

Doctors note that a predisposing phenomenon to the development of cerebral edema in newborns is both toscosis during pregnancy and the woman’s illnesses, which can cause fetal hypoxia.

Symptoms of cerebral edema in newborns

Symptoms of cerebral edema in newborns may initially be mild. An increase in intracranial pressure leads to the baby becoming lethargic. The child can sleep for a long time. There is swelling optic nerve(congestive optic nerve nipple). Also, the baby is often bothered by headaches, and the progression of edema causes convulsions and noticeable deterioration general condition.

Cerebral edema in newborns is manifested by a number of visual symptoms. Among them are stiffness of the neck muscles, swelling of the fontanel, and dilation of the pupils. In addition, muscle hypertonicity, increased body temperature (classified as hyperthermia), and possible convulsions are observed. Pathological processes cause tachycardia and fluctuations in blood pressure, and the child often cries loudly and strongly, which is defined by experts as a cerebral cry.

Brain edema can be complicated by neuroinfection, metabolic disorders in the body and the occurrence of neurotoxicosis.

It is worth noting that the specific manifestations of the disease are often subtle, so parents need to be especially attentive to the baby’s condition and, at the slightest suspicion of any abnormalities, consult a doctor. To diagnose cerebral edema in newborns, doctors use a number of additional techniques: MRI, CT, angiography, spinal tap etc.

How is cerebral edema corrected in newborns? What treatment is effective?

It is worth noting that cerebral edema in newborns is emergency, requiring close attention and adequate timely correction. Timely treatment allows for recovery and prevention unpleasant consequences for the baby's health.

Treatment of cerebral edema in newborns is aimed at correcting the root cause of this disorder and optimizing oxygen metabolism in brain cells. In most cases, with such a violation, the baby is under the device artificial ventilation lungs. In order to maintain optimal pressure and to prevent infections, a number of drugs are infused.

Drug treatment cerebral edema in a newborn involves the use of osmodiuretics and saluretics, which effectively remove excess fluid from the body. Corticosteroid drugs are also used - drugs that inhibit the occurrence of swelling. Another drug of choice is often muscle relaxants; they are able to relieve seizures and focal symptoms.

Drug treatment cerebral edema in newborns includes the use of drugs that optimize blood circulation in the blood vessels of the brain. Another medication that is often used is angioprotectors.

Body temperature is almost never reduced artificially.

Consequences

At timely diagnosis And adequate therapy Neonatal cerebral edema is quite treatable. Children who have suffered such a disease should be registered with a pediatrician.

Sometimes cerebral edema during the newborn stage leads to a decrease in the baby’s intellectual abilities in the future. A similar consequence occurs due to the death of cells in the cortical structures. The more they are damaged, the greater the degree of decline in mental abilities.

The child’s physiological functions may also be impaired. Most often, such a consequence is manifested by a violation of the extensor functions of the limbs; the baby may have difficulty holding his head, in addition, sucking and/or grasping reflexes may be impaired.

In some cases, cerebral edema in newborns provokes the development of cerebral palsy or epilepsy. A fatal outcome is also possible - if help for the child was untimely, or if there are primary extensive brain lesions.

Folk recipes

Traditional treatment will not help in any way to cope with cerebral edema in newborns. But the herbs correct use will contribute to the successful correction of the consequences of such a violation. So good for your health nervous system baby has a positive effect on baths with sedative plants. You can connect medicinal plant calendula, mint and oregano (in equal parts). Brew one hundred and fifty grams of the resulting raw material with three liters of boiling water and leave to steep until it cools. Pour the strained infusion into a ten-liter bath. The duration of this procedure is ten minutes. Do it three times a week, in a course of five to seven times.

No one knows exactly what can cause a brain tumor in newborns. The development of the disease begins in young cells when their normal maturation is disrupted. Mature cells never form a tumor. What prevents cells from going through the normal maturation pathway? Experts point only to possible factors, which can indirectly provoke the development of the disease:

ionizing radiation, which is used for diagnostics (can leave its “trace” for a future illness even during pregnancy); vinyl chloride, or more precisely, its evaporation (most children’s toys are now made from this material); electromagnetic fields from technology, including - from mobile phones; birth injuries to the head; heredity (the risk of developing brain cancer in a child increases if there have already been cases of this disease in the family).

Some gene diseases also increase the risk of developing a brain tumor, including:

von Recklinghausen syndrome (neurofibromatosis of the NF1 or NF2 genes); Turco's syndrome (abnormalities in the APC gene); Gorlin's disease (basal cell nevus syndrome of the PTCH gene); Li-Fraumeni syndrome (abnormalities in the TP53 gene).

In 40% of cases, these diseases are a provoking factor in the development of brain tumors in newborns.

Parents should also remember that children’s DNA does not change in the womb, but rather in the body itself. early age(during the neonatal period). This can also be caused by environment, and the state of the child’s health, and even his emotional background.

Symptoms

The insidiousness of the disease lies in the long asymptomatic diseases. External signs are absent while the tumor grows. Severe symptoms appear when the tumor has reached a certain size.

The absence of symptoms of the disease in newborns is associated with structural features of the central nervous system (CNS) and skull. In recently born children, the sutures of the skull and cerebral ventricles tend to stretch, and the brain cisterns and subarachnoid fissures tend to increase in size. Often even with ultrasound diagnostics brain, specialists may not pay attention to neoplasms.

What symptoms should parents be alert to:

an increase in the size of the skull; a non-healing main fontanel, which is tense, its pulsation is barely visible; divergence of the sutures of the skull; the appearance of digital impressions; thinning of the calvarium.

In addition to hydrocephalic symptoms, there are also hypertensive ones:

vomiting; partial hearing loss (the child does not respond to sounds); strabismus; unusual position of the head; headache (because of it the baby can cry for a long time); convulsions.

Diagnosis of a brain tumor in newborns

Diagnosis of the disease in newborns begins with a medical history. A huge role is influenced by how the pregnancy proceeded, whether there were threats of its termination, and what kind of life the pregnant woman led. Childbirth also plays an important role.

The next stage in diagnosing the disease is studying physiological conditions child. There are many factors considered here:

the shape and circumference of the child’s head at birth (as a rule, these indicators are much higher than average); the child’s weight gain during pregnancy and after childbirth.

The following studies help confirm the diagnosis:

X-ray of the skull (you can see from it that there are calcium deposits in the skull, which indicates the disease); electro- and echoencephalography (records how changes electrical activity brain every minute); fundus examination; transcranial Dopplerography (ultrasound of blood flow, shows how blood circulates through the vessels inside the skull); computer or magnetic resonance imaging (the most the right way find out about the presence of even the smallest neoplasm).

Complications

Neurological complications can result from both the neoplasm itself and the treatment of the disease. Why is brain cancer dangerous? Some young patients subsequently experience a slow reaction, lack of initiative, lack of concentration, bad memory and delay intellectual development. However, modern medicine can correct these “ side effects» illness and treatment and return the child to normal life.

Despite the complexity of the disease, statistics show positive results. Brain tumors are completely cured in 85% of cases. Parents whose babies have been diagnosed with this should know: during the neonatal period, cancer is much easier to tolerate and treatable than similar diseases in adults.

After surgical intervention And radiation therapy children go into long-term remission and then are completely cured.

Treatment

What can you do

Parents, remember that the more attentive you are to your children and their health, the more less chance start the disease. If you pay attention to your child's behavior in time, he will physical development, and contact specialists, treatment of a brain tumor in newborns will be easier.

If something begins to bother you in your baby’s behavior, you should contact a neurologist.

What does a doctor do

After the diagnosis is confirmed, oncologists prescribe treatment. It depends on the age of the child, his condition, the course of the disease and the location of the tumor. In newborns and children in the first year of life, brain tumors can only be removed through surgery.

If the tumor is located in vital places of the brain, then you can get rid of it with the help of radiation therapy, which is aimed at destroying the tumor.

Prevention

Despite the fact that experts cannot pinpoint the exact reasons for the development of the disease in infants, the child’s mother can prevent DNA failure and further development of brain cancer. You must do this at the stage of planning and carrying a pregnancy. It’s not for nothing that obstetricians and gynecologists talk about correct mode sleep and wakefulness, emotional peace, balanced diet. If you lead correct image life, give up possible bad habits- this can save your baby from cancer.