Cerebral edema in a newborn after childbirth. Brain edema in newborns

The terms “cerebral edema in the newborn” and “cerebral edema in young children” are still under scientific debate. The fact is that “edema,” according to medical terminology, is the pushing apart of cells and their parallel compression by edematous fluid. With this pathology, an additional increase in cells is recorded. Therefore, more accurately, such a diagnosis should sound like “edema and swelling of the brain.”

In the modern classification, this disease is characterized as a pathological process manifested by an increase in brain volume due to excessive accumulation of fluid in the cells of the brain or spinal cord (primarily glia) and the intercellular space. Edema can be local (local, perifocal) and generalized (diffuse).

You will learn about the causes of cerebral edema in newborns and young children, as well as the signs and methods of treating the disease in this material.

Cerebral edema in children, adults and newborns: causes and consequences

Cerebral edema is a very complex and inherently dangerous complication caused by one or another pathology, which manifests itself in the diffuse saturation of brain tissue with fluid from the vascular space.
This complication is quite serious and cannot be treated carelessly - edema poses a threat to human health and, if left untreated, the patient can face death.

Causes of occurrence in children and adults

Due to the fact that the human brain and its tissues are intensively supplied with blood, it is very simple to provoke a disorder in the process of blood circulation and, accordingly, lead to swelling .

In this case, a disruption in the blood flow can be caused by:

ischemic or hemorrhagic type of stroke , as well as any outpouring of blood into its ventricle or gray matter tissue;
cancerous tumorlocalized inside the skull;
metastases in the gray matter from a malignant neoplasm, regardless of its location;
trauma and fracture of the bones of the skull , which led to brain injury, as well as meningitis and intracranial post-traumatic hematoma;
head injury and intoxication, poisoning of the body - this can be not only poison, but also chemical compounds, as well as alcohol, medications;
problems with the kidneys and liver , especially when doctors have diagnosed their insufficiency and there is general intoxication of the body;
any surgical intervention in the structure of the skull , as well as the tissue of the gray matter - this can also provoke swelling of its tissues;
anasarca, which occurs against the background of heart problems, when heart failure is diagnosed, as well as anaphylactic shock as a consequence of the body’s reaction, its irritation to an allergen;

All this shows that swelling can be caused by both internal and external factors and causes. Sometimes this very serious complication can develop as a result of general negative changes and transformations in the patient’s body.

Such negative changes mostly occur at the microcirculatory level in all organs and systems of a person and his tissues. But when a doctor diagnoses swelling of another organ, this does not carry such negative consequences as swelling of the gray matter, which for the most part always ends seriously, if not fatal, for a person.

Brain dislocation

In their classification, doctors divide cerebral edema, in addition to other criteria, according to its location inside the skull.

So doctors distinguish the following types of edema, taking into account its dislocation, namely:

swelling of the brain stem is a very dangerous pathogenic condition in which vital human functions such as breathing and blood flow are disrupted, and so on;
swelling of the vascular network of the brain;
directly the swelling of the gray medulla.

If we talk about edema, which arises and develops as a result of hypoxia or the development of a benign or malignant tumor, an inflammatory process, it is worth differentiating it from perifocal type edema - here we are talking about swelling and swelling of the brain in the area of destruction of the cell structure.

It is this pathology that will develop in the event of damage to the head and gray matter due to trauma.

Cerebral edema in a newborn

Speaking about a newborn, in this case, first of all, it is worth saying that the relationship between the tissue of the gray matter and the cavity of the cranium is built in a slightly different way than the similar structure in an adult.

Such differences are due to the characteristics of a young and developing organism, as well as age-related transformations and changes in the structure and functioning of the nervous system.

If we are talking about diagnosing this pathology in a newborn, then it is characterized by its rapid development due to the imperfect ability of the child’s body to regulate the tone of blood vessels and veins, liquor dynamics and maintaining pressure inside the skull at the same, stable level.

In this case, the child can be saved by the following - the peculiarity of the connections of his skull bones, which have not yet hardened and resemble soft cartilaginous bridges, or have not yet fused and are at a certain distance from one another.

So we are talking about the large and small fontanel , and if it were not for this feature in the anatomical structure of the skull, every cry of the baby could end with compression of the gray matter and its subsequent swelling.

Speaking about the root causes of the development of edema in a newborn, these may be:

intrauterine hypoxia of any nature and genesis;
injury to the baby received during the passage of the birth canal and difficult childbirth, as well as prematurity or, conversely, postmaturity of the fetus by the woman in labor;
congenital nature and defect in the development of the entire nervous system of the newborn;
intrauterine infection of the fetus , as well as diagnosed meningitis and encephalitis caused by meningococcal infection, which develop as a result of infection of the child during childbirth or after birth;
congenital tumors and abscesses;

If we are talking about symptoms that indicate edema, then these include diagnosing the following manifestations in the baby:

constant anxiety and strong , hysterical screams for no apparent reason;
the child becomes inhibited , he exhibits a delayed reaction to light and sound, and also exhibits increased drowsiness;
if cerebral edema is suspected, the baby will refuse to take the breast during natural feeding or bottles during artificial feeding;
intense pulsation or swelling of a large fontanelle visible to the naked eye, even in a calm state of the baby;
attacks of vomiting and seizures of muscle tissue spasms;

In children, another special characteristic of cerebral edema was noted - the rapid development and increase of negative symptoms, as well as a progressive deterioration of the entire condition of the body with every minute. As statistics show, in 70-80% of cases of diagnosing cerebral edema in a child, it ends in death.

Diagnosis of pathology

Diagnosis of this disease should only be made by a doctor, based on the results of tests and examinations.

If there is a suspicion of this disease, doctors mostly prescribe the following studies:

interviewing the patient and finding out the history of the pathology - in this case, the specialist establishes and analyzes the reasons that can provoke cerebral edema;
neurological examination - at this stage, the specialist assesses the patient’s level of consciousness, studies all the symptoms that may indicate a disorder of the nervous system;
the doctor examines the patient’s fundus of the eye - this allows him to identify the condition and nature of the swelling of the optic nerves;
Biomaterial is also collected by puncture - a puncture is made in the lumbar region and thereby the level of pressure inside the skull is established;
doctors prescribe a computer or magnetic resonance imaging scan - this will allow them to assess the signs of edema, the degree of damage and the localization of the pathology;
mandatory measurement of pressure inside the skull - in this case, doctors insert a sensor into the cavity of the ventricles, which records it, taking the corresponding indicators;

Treatment of pathology

At the very beginning, it is worth emphasizing that emergency measures and therapeutic measures are aimed at the very beginning to relieve the swelling itself and reduce the pressure inside the skull, eliminate seizures and fainting, disorder, and malfunction of other organs and systems.

Dehydration course of therapy.

At this stage, excess fluid is removed from the body and brain tissue and all this is done through the use of the following medications:

diuretics , which have a sufficient diuretic effect, removing excess fluid from the body;
L-lysine escinate - it does not have a diuretic effect, but it is no less effective in removing excess fluid from tissues, relieving signs of brain swelling;
hyperosmolar solutions - they enhance the effect of diuretics and help supply the affected gray matter cells with the necessary nutritional compounds;

Improvement of brain metabolism, as well as its corresponding oxygenation.

All this can be achieved in the following ways:

artificial ventilation, as well as local hypothermia - in this case, the patient’s head is covered with a container filled with ice;
administration of medications that improve metabolic processes in the gray matter of the brain, as well as administration of drugs that strengthen blood vessels;

Elimination of root causes, as well as negative symptoms of pathology.

In this case, the doctor:

examines and corrects heart function;
eliminates signs of intoxication of the body;
reduces elevated body temperature.

To achieve this result, the following may be prescribed:

a course of antibiotics;
removal of toxins and breakdown products from the body;
surgical removal of the tumor, which reduces pressure inside the skull and reduces the likelihood of brain swelling.

Consequences of brain swelling

Speaking about the consequences that develop when diagnosing this pathology, these are:

sleep disorder and depression of the patient;
absent-mindedness and failure in the patient’s physical activity;
constant attacks of headaches;
as well as a violation in a person’s communication abilities.

Edema as a cause of death

The course and consequences of the pathology are influenced by such indicators as the effectiveness and timeliness of treatment - with swelling of the brain, the following occurs:

compression of its tissues;
violation of its structure;
disturbances in the functioning of the cardiovascular system, lungs, liver and kidneys.

Lack of oxygen in the brain cells leads to its death - paralysis of the human body and death in this case is a very common result of cerebral edema. If important parts of it are affected, there is also a high probability of death.

At the first suspicion , you should not hesitate and get examined by a doctor, who will prescribe the appropriate treatment, thereby preventing and eliminating negative symptoms and death.

21.09.2016

Source: https://mozgvtonuse.com/porazhenie/otek-golovnogo-mozga.html

Causes of birth tumor

The diagnosis of “birth tumor” implies swelling of the soft tissues in the part of the child’s body that was born first, or, in other words, where it was located in the womb before birth. For example, if the newborn was “lying” upside down, then swelling after childbirth appears on the head. If the position of the fetus was legs or butt down, then swelling may appear on the buttocks or legs. Of course, not always!

The presence of an injury such as a birth tumor is associated with several reasons, the most common of which are:

incorrect placement of the fetus in the uterus;
the so-called “narrow pelvis” in the mother;
births that occurred ahead of schedule;
births that occurred later than planned;
childbirth that lasted a long time;
weak labor activity;
lack of oxygen in the fetus during childbirth.

Statistical studies show that if a woman gives birth for the first time, then the risk of a birth tumor in this case is greater than in women who give birth to a second, third, and possibly tenth child. In these cases, if the birth took place normally, the tumors in children go away without medical intervention, sometimes even within one or two days.

Tumors in the tissues of newborns are formed due to the fact that blood and lymph are retained in them. This can happen because the baby has been resting against the hard bones of the mother’s pelvis for a long time with any part of his body. Also, quite often, due to compression, oxygen deficiency or pressure drop when a baby is born, damage to the baby’s blood vessels is possible, since they are very vulnerable at the beginning of his life.

The most common birth tumors are on the baby's head (forehead, face, occipital or parietal part of the head). However, if the baby is born with the lower half of the body, tumors in children are possible on the legs, butt or perineum. The swelling does not have a clear shape. It is soft to the touch, but quite elastic. The skin at the site of swelling may change its color to yellowish, red, or even dark red with a hint of cyanosis, depending on the severity of the hemorrhage.

Brain edema in children

Expanding headache, expressed approximately equally in all areas of the head (occipital, parietal, temporal, frontal).
Nausea, vomiting that does not bring relief.
Decreased visual acuity.
Weakness, drowsiness.
Impaired consciousness up to its complete absence - in this case, the person does not immediately answer questions (or does not answer at all), is drowsy, and may not open his eyes even with painful irritation (pressure on the supraorbital arches).
Convulsive seizures are involuntary contractions of the muscles of the arms and legs, sometimes with loss of consciousness and biting the tongue.
Breathing disorders due to compression of vital systems.

Cerebral edema is a universal response to most damaging influences. Therefore, it can be caused by many factors:

cerebrovascular accident (stroke);
traumatic brain injury (brain contusion);
brain tumors;
poisoning (for example: carbon monoxide, drugs);
severe infectious diseases (tick-borne encephalitis (a disease transmitted through the bites of ticks of the genus Ixodes and manifested by weakness in the limbs and severe intoxication), influenza (a viral disease that affects the respiratory system and manifested by severe intoxication));
surgical interventions on the brain.

LookMedBook reminds you that this material is posted for informational purposes only and does not replace medical advice!

A neurologist will help in treating the disease
Make an appointment with a neurologist

Analysis of complaints and medical history. How long ago did similar complaints appear (headache, weakness, drowsiness).
Did any event precede the appearance of these complaints: head injury;
the appearance of signs of neurological pathology (weakness in the arms and legs, facial asymmetry, slurred speech);
neurosurgical operation, poisoning (carbon monoxide).

Neurological examination: assessment of the level of consciousness (how actively the patient enters into verbal contact, whether he opens his eyes on command or to painful stimulation), as well as a search for signs of neurological disorders (weakness in the limbs, facial asymmetry, strabismus), which are of primary importance in comparison with the signs cerebral edema.
Fundus examination: with cerebral edema, swelling of the optic nerve head with blurred boundaries is observed.
Measuring intracranial pressure - for this, a special sensor is installed into the cavity of the ventricles of the brain or into its tissue to measure pressure.
Lumbar puncture: using a special needle, a puncture (puncture) is made in the subarachnoid space of the spinal cord at the lumbar level (through the skin of the back). In the case of cerebral edema, which means increased intracranial pressure, cerebrospinal fluid (cerebrospinal fluid that provides nutrition and metabolism in the brain) flows out under pressure, sometimes in a stream.
CT (computed tomography) and MRI (magnetic resonance imaging) of the head: allows you to study the structure of the brain layer by layer and determine signs of cerebral edema (reduction of the space between the brain and the bones of the skull, compression and deformation of the ventricular system).
A consultation with a pediatric neurosurgeon is also possible.

Non-surgical methods.

Dehydration - the introduction of large doses of drugs that remove fluid from the body (diuretics): hormonal drugs - improve the function of the blood-brain barrier (a special system that limits the entry of certain substances into the brain tissue), reduce the permeability of brain vessels.
Anticonvulsants - if seizures occur.

Surgical methods: decompressive craniotomy (opening the cranial cavity with the formation of a defect in the skull bones - this sharply reduces the pressure inside the cranial cavity). The disease that caused cerebral edema is also treated:

cerebrovascular accident - correction of arterial (blood) pressure, drugs that improve brain nutrition (neurotrophics), improve blood flow (antiplatelet agents);
traumatic brain injury - removal of blood accumulation, destroyed brain tissue;
brain tumors - tumor removal;
poisoning - detoxification (removal of toxin from the blood);
severe infectious diseases - antibacterial and antiviral therapy.

Dislocation syndrome - in this case, part of the brain is pinched inside the cranial cavity of relatively immobile formations (falx cerebellum, tentorium cerebellum), which leads to severe neurological disorders (complete lack of consciousness, irregular breathing rhythm, drop in arterial (blood) pressure).
Risk of death.

Prevention of the development of cerebral edema is usually untenable, since it develops secondary, against the background of other serious diseases. It makes sense to carry out the following activities:

accounting for fluid administration in patients undergoing treatment;
preventive use of hormonal drugs (improving the functions of the blood-brain barrier (a special system that limits the entry of certain substances into the brain tissue), reducing the permeability of brain vessels).

Source: https://lookmedbook.ru/disease/otek-golovnogo-mozga/children

Difference from generic tumor

On the baby’s head, a birth tumor is similar to cancer, that is, a tumor-like neoplasm. However, there are some differences between these pathologies, which are expressed in the nature and consequences:

a hematoma occupies any one cranial bone, while a tumor-like neoplasm can develop in several areas of the head;
the tumor density is higher, internal exudate does not spill during palpation, which is typical for a birth hematoma;
at the same time, hemorrhage can form not in a single place of the body, but also in other areas that the baby rested on at the moment of leaving the woman’s womb, whereas this is not typical for a tumor-like neoplasm;

There is also a similarity in the source of the pathologies, but the tumor-like neoplasm disappears faster, since hemorrhage does not occur in this case.

Why does cerebral edema occur in children?

Cerebral edema in children is a pathological condition in which excess fluid accumulates in brain cells and the intercellular space.

Thus, an increase in brain volume occurs, while intracranial pressure increases, blood circulation is disrupted, and brain cells die.

If medical care is not provided in a timely manner due to a sharp increase in intracranial pressure, the patient's death is possible. This is a serious pathology that requires careful attention.

Characteristics of cerebral edema

There are 2 types of cerebral edema - local and generalized edema. Local or regional edema is characterized by limitation to one specific area that surrounds a brain formation (tumor or hematoma). Generalized edema spreads throughout the patient's entire brain.

Edema occurs as a nonspecific reaction of the body to the influence of any damaging factors. As a result of these factors, blood circulation in the tissues is disrupted, and the brain is not sufficiently supplied with oxygen. At the same time, excess accumulation of carbon dioxide occurs in the blood.

In addition, water-electrolyte, protein and energy metabolism are disrupted. Disturbances in the acid-base balance of the blood also occur, and plasma pressure changes. As a result of the spread of cerebral edema, the underlying structures in the foramen magnum begin to be pinched.

Because of this, the regulation of breathing, cardiovascular activity and thermoregulation is disrupted.

Causes of cerebral edema

Brain edema in children does not just happen; it has its own reasons. The main causes of cerebral edema:

traumatic brain injury;
suffocation;
drowning;
intoxication;
concussion or bruise of the brain;
laryngeal stenosis in children (as a result of acute respiratory infection);
hematoma under the dura mater;
brain tumors;
other acute infectious diseases with complications;
high temperature in children (hyperthermia) due to infections, heat stroke;
serious diseases such as epilepsy, diabetes, renal and liver failure;
serious allergic reactions;
anaphylactic shock;
in newborns, umbilical cord entanglement, birth trauma to the brain, prolonged labor or severe gestosis in the mother can cause swelling of the child’s brain;
ischemic stroke disrupts blood circulation in the brain due to blockage of a vessel by a blood clot, and swelling forms in the brain;
hemorrhages in the cranial cavity due to damage to blood vessels;
sudden change in atmospheric pressure.

In addition, cerebral edema in children, as in adults, occurs after surgery on the skull. Also, in some cases, cerebral edema can be observed after operations with spinal anesthesia or during surgical interventions that were accompanied by large loss of blood.

Symptoms of cerebral edema

Depending on many factors, the symptoms of cerebral edema may vary. Local edema manifests itself as isolated symptoms, and generalized edema can slowly increase, and the number of symptoms gradually increases.

Cerebral edema most often manifests itself with the following symptoms:

general malaise and weakness, increased fatigue and drowsiness;
severe headaches and dizziness;
fainting;
nausea and vomiting;
possible visual impairment and disorientation in space;
deterioration of speech and memory;
difficulty breathing;
muscle spasms;
in infants and children under 1 year of age, the head circumference may increase and, due to the displacement of the bones, the opening of the fontanelles after their closure may occur.

The occurrence of such signs should be a reason to urgently seek medical help. Otherwise, brain swelling can lead to serious consequences. Unfortunately, with cerebral edema in newborns, diagnosing symptoms becomes more difficult.

Complications of edema

Brain swelling can cause serious consequences. Most often, the consequences of edema are severe complications in the form of impaired mental and mental activity of the child, impaired vision, hearing, impaired coordination and motor functions of the body. As a result, disability may occur, and in especially severe cases, cerebral edema can be fatal for the child.

Treatment of edema

Brain swelling is treated differently depending on the reason it was caused. In some cases, this pathology can go away on its own, without outside intervention. This happens if the swelling was caused by a sudden change in atmospheric pressure or a minor concussion. In other cases, treatment is required.

Treatment of cerebral edema should primarily be aimed at restoring access to sufficient oxygen, without which brain cells cannot survive.

There are such ways to treat cerebral edema:

drug therapy (taking drugs to reduce intracranial pressure), drugs against infections;
introduction of oxygen into the patient’s blood, which is necessary for traumatic brain injury (oxygen therapy);
hypothermia method - the effect of cold restores normal metabolism;
in the most severe cases, surgery is necessary, but this method is the most dangerous for the patient.

Source: https://medinovo.ru/otek_mozga_u_detey.html

Therapy

Cephalohematoma does not always require treatment, as it usually resolves on its own within 2–4 weeks.

If there is a large hematoma (grade II–III) or there is no tendency for it to regress, inpatient and/or surgical treatment is necessary, taking into account the following principles:

The child must be under constant supervision by doctors: a pediatric surgeon and a neonatologist; if necessary, photographs are taken for control.
Conservative treatment consists of administering hemostatic drugs (Vikasol, calcium supplements).
Indication for surgical intervention (puncture and aspiration of the hematoma) is grade III cephalohematoma.

The duration of inpatient therapy depends on the presence of complications: uncomplicated cephalohematoma is treated from a week to 10 days, complicated - more than a month. Clinical observation by a pediatric surgeon and neurologist continues for 1 year.

After hospital treatment, long-term follow-up is required

Cephalohematoma can be the result of diseases of the hemocoagulation system of an infant with a tendency to hypocoagulation (poor blood clotting), for example, hemophilia, thrombocytopenia, etc. In this case, it is initially necessary to treat the underlying disease that caused the formation of hemorrhage.

Cerebral edema in newborns - features of the development of the disease and possible complications

A health and life-threatening condition – cerebral edema in a newborn baby – is increasingly being diagnosed in babies. It is characterized by the accumulation of fluid in the brain tissue. The pathology is dangerous due to its complications; surgical intervention is often necessary to solve it.

The outcome of the disease depends on when it was diagnosed and how quickly doctors began treatment. Before starting treatment and prescribing surgery, specialists identify the cause of the pathology and assess possible risks.

What is cerebral edema and why does it occur in infants?

Essentially, cerebral edema in newborns is a process in which the accumulation of fluids in the brain tissue leads to a significant increase in its volume. In appearance, the head may not have external swelling or enlarged areas, which makes it difficult to diagnose the pathology.

In addition to the trauma received during childbirth, AGM is caused by:

intrauterine hypoxia;
asphyxia at the time of birth (due to entanglement with the umbilical cord, penetration of amniotic fluid or meconium into the respiratory tract);
presence of a tumor;
microembolism and gas embolism of cerebral vessels;
abscesses;
infections (bacterial or viral meningitis, encephalitis).

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. With further action of the damaging factor, fluid accumulates not only in the cells, but also in the intercellular substance - brain 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 of cerebral edema in a child is the wedging of the trunk into the foramen magnum. Without emergency assistance, this leads to death due to disruption of vital functions.

Symptoms and types of pathology

The accumulation of fluid in the brain tissue of a newborn provokes a rapid deterioration of his condition. Signs of the disease include:

bulging fontanelles;
increase in body temperature to critical levels;
sleep disturbance;
strong and non-stop crying;
refusal of food;
clouding of consciousness;
convulsions and seizures;
vomiting;
inadequate response to external stimuli;
pallor of the skin.

Often, signs of the disease appear in the maternity hospital; if later, parents need to seek medical help as soon as possible. To clarify the diagnosis, pediatricians conduct a visual examination and prescribe instrumental types of research:

MRI;
electroencephalography;
fundus examination.

After diagnostic measures, the type of disease is determined. Based on the localization of OGM, it is divided into local and diffuse. When localized, one area is affected, and in this case the symptoms appear gradually. Diffuse affects both the hemispheres and the brain stem itself, which entails pronounced symptoms and serious consequences.

Depending on the cause of the pathology, damage to brain structures can be:

vasogenic, provoked by the presence of tumors and embolism;
cytotoxic, formed due to asphyxia;
osmotic, which manifests itself after the penetration of amniotic fluid into the respiratory tract.

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;
gradually he develops a 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.

Possible consequences of AMS in children

Like any other disease, timely diagnosed and treated AMS in a newborn has minimal negative consequences. Therapy for this pathology is always carried out in a hospital setting and consists of the following:

Reducing swelling and removing excess fluid from the body. For this, a course of diuretics is prescribed.
Restoration of nerve cells.
Elimination of seizures, for which age-appropriate muscle relaxants are prescribed.
Improves blood circulation and brain metabolism. Nootropic drugs are best suited for this.
Prevent further enlargement of the affected areas by administering corticosteroid medications.
Restoring breathing by connecting to a ventilator (in especially severe cases).

Whatever the treatment, the consequences of an AGM will be present in the child’s future life. For example, he will be registered with a neurologist. In cases of significant developmental delays and lack of speech, you will have to be observed for a long time by a psychiatrist.

Nerve cells in the brain that die as a result of the development of the disease can significantly reduce the child’s mental abilities in the future.

How physically developed the child will be depends on the stage at which the disease was detected and what part of the brain it affected.

Particularly severe cases can provoke the development of cerebral palsy and epilepsy. Periventricular edema leads to the development of necrosis of brain tissue. There are known cases of deaths when the damage to the child’s brain was too extensive, and treatment was untimely or incomplete.

Brain swelling in infants

Brain edema in newborns is a symptom that occurs as a complication of other pathologies. The main manifestation is the accumulation of fluid in the tissues of the medulla, which leads to its enlargement.

During an external examination, swelling is noted, but the manifestations may not be visualized, which does not in any way affect the danger of the pathology, which can lead to serious consequences if left untreated.

Source: https://rptp-rd.ru/rasstrojstva/otek-mozga-u-novorozhdennyh.html

Purulent hematoma: what to do?

If the hematoma begins to fester, the child is transferred to the surgical department of the regional children's hospital, where he will have to stay for at least 1 month. Treatment in this case is always surgical. The doctor opens the wound, drains the tumor, removes pus and blood clots, and then applies a bandage with an antiseptic.

To prevent the inflammatory process and severe complications, the child is prescribed antibiotics. Usually these are penicillin drugs in the form of intramuscular injections based on amoxicillin or ampicillin. If the purulent process is accompanied by an increase in temperature, severe deterioration in health, or severe intoxication, drugs from the cephalosporin group, for example, Ceftriaxone, can be used.

The drug Ceftriaxone

Treatment with antibiotics takes 7 to 10 days. To restore immunity and prevent intestinal dysbiosis, the doctor may prescribe prebiotics, for example, Linex, but the dosage, as well as the duration of use, should only be selected by a specialist, taking into account the general condition of the baby. After discharge from the hospital, the child is registered with a pediatric surgeon and neurologist and is observed at his place of residence.

Linex for children

Cerebral edema in children: causes, symptoms and treatment

The terms “cerebral edema in the newborn” and “cerebral edema in young children” are still under scientific debate.

The fact is that “edema,” according to medical terminology, is the pushing apart of cells and their parallel compression by edematous fluid. With this pathology, an additional increase in cells is recorded.

Therefore, more accurately, such a diagnosis should sound like “edema and swelling of the brain.”

You will learn about the causes of cerebral edema in newborns and young children, as well as the signs and methods of treating the disease in this material.

Causes and symptoms of cerebral edema in newborns and young children

One of the causes of cerebral edema in children is the direct damaging effect of the pathological process on the nervous system (trauma, brain tumors, infectious lesions of the brain, spinal cord and their membranes, stroke, abscess, occlusive hydrocephalus). Also, this pathology can be secondary to somatic diseases (general infections, cardiovascular diseases, burns, diabetes, etc.). Edema is often accompanied by signs of an acute increase in ICP.

The clinical picture of cerebral edema in children includes three groups of symptoms: those caused by intracranial hypertension syndrome, focal and brainstem symptoms. Intracranial hypertension syndrome is manifested by a bursting headache, nausea, vomiting at the height of pain, and a decrease in the level of consciousness.

With long-term ICH, an X-ray of the skull can show increased digital impressions, osteoporosis of the sella wall, and when examining the fundus, swelling of the optic nipples can be noted.

They detect changes in the reaction to the environment, strabismus, the “setting sun” symptom, increased blood pressure, changes in heart rate (tachycardia, bradycardia), respiratory depression, convulsive syndrome. Possible cerebral coma.

Reliable signs of this pathology include data from magnetic resonance imaging (MRI), CT and neurosonography (for cerebral edema in newborns and children under one year old). Suspected methods include EEG, neuroophthalmoscopy, cerebral angiography, brain scanning using radioactive isotopes, pneumoencephalography.

Measures for the treatment of cerebral edema in children

Treatment of cerebral edema in a child includes the following measures:

Elimination of cerebral hypoxia. Intubation and mechanical ventilation as assessed by the Glasgow Coma Scale
Moderate hyperventilation (maintaining PaCO2 at a level of 30-35 mm Hg, Fi02 at a level that provides a saturation level of >95%, Pa0290-100 mm Hg (>70 mm Hg), low PEEP levels.
Reducing ICP : mannitol at a dose of 0.2-0.5 g/kg for 10-20 minutes. Blood plasma osmolarity should be no more than 310 mOsm/L; to maintain osmolarity, mannitol can be administered at 0.25 g/kg every 4 hours. Avoid hypoosmolarity!
Infusion therapy at a level of 70-80% of the daily physiological requirement (but blood pressure should not decrease); provided with 0.9% NaCl solution or Ringer's solution. It is necessary to maintain sodium levels at normal levels. Avoid administration of hyperosmolar solutions. Maintaining central venous pressure at a normal level.
Maintaining normoglycemia.
Maintaining blood pressure above normal (using cardiotonic drugs for these purposes - dopamine, dobutamine, norepinephrine).
Hemoglobin level > 100 g/l.
Anticonvulsant therapy: thiopental bolus 2-5 mg/kg, then 1-5 mg/kg/h intravenously. Serum level: 40-50 mcg/ml. When blood pressure decreases, norepinephrine is prescribed.
Omeprazole 1 mg/kg/day (maintaining gastric juice pH > 4.5).
Maintaining normal body temperature (paracetamol, metamizole, ibuprofen for hyperthermia, avoiding hypothermia).
Prescribing antibacterial drugs.
Prednisolone intravenously or intramuscularly at a dose of 1-3 mg/kg, dexamethasone 0.1 mg/kg (4 mg in 1 ml).
Bladder catheterization is mandatory. Maintain diuresis at a level > 1 ml/kg/h (if necessary, using diuretics - furosemide, single dose 0.5-1-2 mg/kg; micro-jet administration up to 10 mg/kg/day is possible). Fluid balance every 4-6 hours (be aware of the syndrome of inappropriate antidiuretic hormone secretion).
When performing minimal interventions accompanied by pain (sanitation of the tracheobronchial tree, etc.), adequate anesthesia or sedation (midazolam 0.1-0.2 mg/kg intravenously or fentanyl 1-5 mcg/kg) is necessary to prevent coughing , increased blood pressure.
Bicarbonate: Preferably avoided due to possible paradoxical “CNS acidosis.”
Position the patient's body with an elevated head end (30°) and eliminate other causes that disrupt the outflow from the cranial cavity (for example, catheterization of the veins of the superior vena cava basin is not recommended).

If conservative treatment of cerebral edema in newborns and young children is ineffective, decompressive craniotomy is performed by removing a bone flap in order to reduce the increased ICP due to cerebral edema.

Source: https://wdoctor.ru/pediatriya/otek-golovnogo-mozga-u-detej-prichiny-simptomy-i-lechenie.html

Consequences

No specialist can say for sure what complications a baby will have with diagnosed cerebral edema. This largely depends on the timeliness of treatment and the individual characteristics of the baby’s body. are highlighted :

disproportionate development of the body to the growth of the newborn’s head. Intracranial pressure increases, leading to expansion of the fontanelle, visually this becomes noticeable;
disturbance of mental and physical development. Subject to successful therapy and minor brain damage due to edema, at the age of 1 year the child develops fully. If the damage is severe, there will already be a visible lag, the baby will be assigned a disability group;
the manifestation of absent-mindedness or hyperactivity is individual;
cerebral palsy;
death of brain cells, occurs with periventicular edema. It is typical for premature babies. The blood supply system is not fully developed, the brain does not function fully, resulting in swelling;
violation of the physiological functionality of the child. He cannot hold his head up, bend and straighten his limbs, and the sucking reflex may not be fully developed;

In the absence of necessary treatment, death occurs.

Diagnosing cerebral edema in a newborn baby should not be a death sentence for the baby and parents. Modern medical technologies allow diagnostics. The specialist will select the necessary treatment, eliminating the pathology and reducing the risk of possible negative consequences. Parents should closely monitor the baby’s condition and if there is visible deterioration, do not delay a visit to the doctor; this will help preserve not only his health, but also his life.

Treatment of swelling

The therapeutic course consists of a set of procedures aimed at:

combating the progression of brain swelling;
eliminating the cause of swelling;
treatment of symptoms that cause complications and aggravate the patient’s well-being.

The causes of cerebral edema are eliminated:

treatment with antibiotics: cefepime, cefuroxime;
prescription of calcium channel blockers: phendiline, verapamil, nimodipine;
removal of toxins;
normalization of vascular tone;
elimination of the tumor if the patient’s condition is stable;
improving blood circulation;
drainage of cerebrospinal fluid.

When treating this pathology, it is necessary to control the cardiovascular system and body temperature, since its increase exacerbates swelling.

When cerebral edema is diagnosed, the patient must be hospitalized. He is placed in the intensive care unit, and the patient’s vital functions are supported artificially.

Only swelling that is small or caused by mountain sickness can go away on its own.

Main methods of treatment:

medicinal;
oxygen therapy;
with the help of surgery.

A complex of medications is prescribed for treatment:

Diuretics to remove excess fluid from tissues: lasix, sorbitol, furosemide, mannitol. They have a diuretic effect and are used in combination with glucose and magnesium sulfate to enhance the effect.
Decongestant drug L-lysine escinate.
Installations to increase oxygen saturation of tissues, and, if necessary, artificial ventilation.
Mexidol, contexten, actovegin, ceraxon improve metabolism.
Muscle relaxants to relieve cramps.
Glucocorticoid hormones: prednisolone, dexamethasone, cortisone, hydrocortisone. They stabilize the membrane of affected cells, strengthening the vascular walls.

Oxygen therapy

This method involves introducing oxygen directly into the blood artificially. This manipulation provides nutrition to the brain, helping to eliminate swelling.

With the help of surgery, the cause that caused the swelling of the brain tissue is removed. This is the only way to get rid of a dangerous disease if it is caused by a neoplasm, a violation of the integrity of blood vessels, or traumatic injuries to the skull.

The fluid accumulated in the head is drained with a catheter, which reduces intracranial pressure.

Surgeries performed on the brain are among the most complex.

Symptoms

The clinical picture of cerebral edema consists of general cerebral and focal symptoms. The sequence of their manifestation directly depends on the initial cause of the development of the pathology. It is worth noting that clinicians distinguish gradual and fulminant forms of cerebral edema.

With gradual progression, doctors have a certain amount of time to stop the development of the pathological process and protect the patient from dangerous consequences.

It is extremely difficult to stop the fulminant form, since the symptoms appear and increase rapidly. In most clinical situations, this form of the disease ends in death.

Symptoms of cerebral edema:

disturbance of consciousness. This symptom is present with any type of cerebral edema;
headache;
weakness;
drowsiness;
lethargy;
dizziness;
memory impairment;
nausea;
gagging, as well as vomiting, which does not bring relief to the patient (a characteristic symptom);
visual impairment;
a person ceases to orientate himself normally in space;
short-term spasms of muscle structures that occur involuntarily;
decrease in blood pressure;
short-term convulsions;
hyperthermia.

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At-risk groups

The following are more susceptible to cerebral edema:

People with problems with the cardiovascular system. These include previous ischemic disease, hypertension, and atherosclerosis.
Patients whose professions involve a risk of injury or falling from a height.
Adults suffering from alcoholism. When drinking alcohol excessively under the influence of ethanol, nerve cells die and fluid accumulates in their place.
Newborns passing through the birth canal.

Diagnostics

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

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

Most often, an integrated approach to diagnosis is used to ensure an accurate diagnosis. After all, the slightest mistake can cost a small patient his life and health. A premature baby is examined more carefully, because many of its organs have not properly developed, which means that the chances of recovery are less.

To establish the correct diagnosis, a clinical examination alone is not always sufficient. Cerebral edema, which occurs in a fairly mild form, can only be diagnosed using additional instrumental methods.

Ultrasound examination of the brain using Doppler scanning helps to identify various brain pathologies in children, including the presence of stagnant fluid inside the brain formations.

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Using special echo signs, the doctor determines the severity of functional disorders. This study is completely safe, has no radiation exposure and can be used even in the youngest patients.

High-precision brain examinations today also include magnetic resonance imaging and computed tomography. These methods allow doctors to obtain an accurate description of the existing structural abnormalities and various pathological processes in the brain tissue.

Additional diagnostic methods also include fundus examination to identify indirect signs of intracranial hypertension, which is a common consequence of severe cerebral edema.

If swelling of the brain is suspected, the patient is prescribed:

examination by a neurologist and ophthalmologist;
blood analysis;
examination of the cervical spine;
MRI and CT of the brain;
neurosonography for children under one year old.

In the early stages of the disease, when the symptoms are not clearly expressed, an examination of the fundus will be necessary. Edema will be indicated by congestion of the optic discs, the reaction of the pupils, and characteristic movements of the eyeballs.

The disease is diagnosed in two ways. Firstly, this is an examination of the baby by a neurologist. The doctor checks the baby’s reaction to various stimuli, looks at his reflexes and evaluates the external manifestations of the disease.

The second way is to conduct research: neuroophthalmoscopy, MRI, spinal cord puncture. Usually, to make a diagnosis it is necessary to use these methods in combination. This way you can most accurately assess the severity of the disease and the baby’s health condition.

Cerebral edema in a newborn is treated strictly in a hospital setting. It is impossible to remove it without hospitalization, since the destruction occurs too quickly. Drug therapy is aimed at restoring full oxygen metabolism in brain cells.

In addition, the baby is prescribed diuretics, which remove fluid and prevent the development of swelling, and agents that normalize blood circulation. From time to time, the method of hypothermia is used, when body temperature is artificially lowered.

Diagnosis should begin as soon as symptoms indicating progression of cerebral edema appear. Timely adequate diagnosis and therapy will help avoid dangerous consequences. The set of diagnostic measures for this disease is as follows:

examination of the cervical region;
neurological examination.

Ultrasound examination of the brain using Doppler scanning helps to identify various brain pathologies in children, including the presence of stagnant fluid inside the brain formations.

Using special echo signs, the doctor determines the severity of functional disorders. This study is completely safe, has no radiation exposure and can be used even in the youngest patients.

Additional diagnostic methods also include fundus examination to identify indirect signs of intracranial hypertension, which is a common consequence of severe cerebral edema.

Etiology

There are quite a few reasons that can lead to cerebral edema. It is worth noting that this pathological condition will develop in the presence of the following contributing factors:

prolonged brain hypoxia;
reduced protein concentration in the bloodstream;
increased concentration of carbon dioxide in the bloodstream.

The main reasons for the progression of cerebral edema:

severe intoxication of the body with alcohol, its breakdown products, as well as various narcotic substances;
TBI of varying severity (a common cause of cerebral edema);
allergic reaction;
tumor;
inflammatory diseases – and so on;
somatic ailments - burn disease, severe infections, etc.