Внутрішньочерепний тиск у немовлят і немовлят: симптоми, причини і лікування, ознаки підвищеного тиску

Внутрішньочерепний тиск у немовлят і немовлят: симптоми, причини і лікування, ознаки підвищеного тиску

Внутрішньочерепний тиск у дитини

Існує думка, що немовлята постійно кричать і погано сплять. Те, що малюк не дає мамі висипатися і не відпускає її від себе, вважається нормою. Однак це глибока помилка. Адже малюк погано спить і нервує неспроста, по всій видимості, його щось тривожить. Така поведінка може бути викликано безліччю причин, однією з яких є підвищення внутрішньочерепного тиску (ВЧТ).

Причини

Це відбувається через затяжні пологів, ускладненої вагітності, обвиття пуповиною, як наслідок, у дитини розвивається гіпоксія (кисневе голодування). Його мозок намагається компенсувати недолік кисню підвищеним виробленням рідини, що заповнює череп і гнітючої на мозок. Після того, як малюк з’явиться на світ, у нього відбувається відновлення від дородових проблем. Внутрішньочерепний тиск підвищується незначно, а з часом і приходить в норму.

Проте в деяких випадках у дітей буває стійке підвищення ВЧД. Це відбувається при гідроцефалії (надмірному скупченні ліквору в порожнині черепа). Існує 2 форми цього захворювання: набута і вроджена. Вроджена гідроцефалія з’являється через крововилив в порожнину черепа, генетичних аномалій, дефектів шляхів відтоку ліквору. Уже в період новонародженості можна виявити вроджену гідроцефалію, а її своєчасна діагностика та лікування допомагає немовляті досить добре розвиватися, щоб не відставати від своїх ровесників.

Ознаки та симптоми підвищеного внутрішньочерепного тиску у дітей

Симптоми таких захворювань, як підвищений внутрішньочерепний тиск і гідроцефалія головного мозку у новонароджених мають свої особливості. У грудних діточок джерельця (відстані між кістками) збільшуються в розмірах, якщо внутрішньочерепний тиск підвищується. Це призводить до збільшення розмірів голови. Діти старшого віку джерелець не мають, тому при підвищенні ВЧД збільшення голови у них не відбувається.

Ознаки ВЧД у дітей молодшого віку

    Плаксивість, підвищена дратівливість. Великий опуклий лоб, непропорційний розмір голови. Добре розвинена підшкірна венозна мережа на голові малюка. Прискорені темпи зростання голови. Симптом Грефе або симптом «призахідного сонця». Між райдужною оболонкою ока та його верхнім століттям можна побачити смужку білої склери, при цьому очі дитини дивляться вниз. Велике джерельце набухає. У нормі він повинен бути злегка опуклим і запалим. Уповільнений розвиток. Немовля пізніше починає, сидіти, тримати голівку, ходити. Відсутність збільшення ваги. Сонливість, млявість.

Ознаки ВЧД у дітей старшого віку

    Нудота, блювота. Біль за очницями. Двоїння в очах. спалаху перед очима. Дратівливість, плаксивість, апатія, сонливість. Сильні головні болі. Підвищена стомлюваність, слабкість.

Придбана гідроцефалія розвивається в будь-якому віці, якщо дитина раніше переніс енцефаліт або страждає пухлинами головного мозку. Іноді, після нейрохірургічних операцій, в тканини мозку утворюються спайки, що також сприяє розвитку гідроцефальний синдрому.

Діагностика ВЧД у дітей

Огляд лікаря-невролога є найнадійнішим способом постановки правильного діагнозу. Лікар призначить дитині дослідження, які дозволять виміряти внутрішньочерепний тиск. Так як у новонароджених велике тім’ячко відкритий, то дослідження мозку можна провести за допомогою УЗД. Такий метод називається «нейросонографія».

Огляд офтальмологом очного дна дитини дозволить уточнити, чи необхідні більш серйозні методи обстеження. При підвищенні ВЧД відзначається розширення вен сітківки, при цьому диск зорового нерва набрякає.

Також роблять томографію і Ехоенцефалограма головного мозку. Ці методи не тільки дозволяють вимірювати тиск, але і достовірно показують стан шлуночків мозку.

Такі складні процедури, як пункція шлуночків мозку і спинно-мозкова пункція допомагають дізнатися цифри, які характеризують величину внутрішньочерепного тиску. Ці процедури проводяться тільки за суворими показаннями при неефективності інших методів дослідження.

Лікування

Тільки лікар повинен призначати лікування ВЧД у дітей.

    Щоб ліквідувати наслідки важкої вагітності та важких пологів потрібно тривалий час годувати маля грудьми, дотримуватися режиму сну, зберігати з ним емоційний контакт і частіше гуляти на свіжому повітрі. Дитині виписуються кошти, що заспокоюють нервову систему, поліпшують кровообіг, вітаміни, сечогінні препарати. Застосовуються фізіотерапевтичні процедури. Добре допомагають заняття плаванням. Якщо причиною підвищення ВЧД є анатомічне порушення, то дитині роблять операцію для того, щоб відновити відтік ліквору від головного мозку.

Зверніть увагу на таку проблему, як кіста головного мозку у дитини.

Прогноз при ВЧД

У більшості дітей до шестимісячного віку внутрішньочерепний тиск приходить в норму. Так трапляється, коли перинатальної енцефалопатії (обратимому пошкодження головного мозку) сприяє гіпертензійного синдром.

Якщо одужання не настає, діагноз вже звучить інакше: «Мінімальна мозкова дисфункція». Це не говорить про те, що малюк важко хворий. Просто він має слабку нервову систему, і ВЧД в критичні життєві моменти може підвищитися, а самопочуття – погіршитися.

Щоб таке не відбувалося, необхідно проходити курси профілактичного лікування восени і навесні, перед тим, як чинити в садок або школу. Обмежувати навантаження і уникати конфліктних ситуацій. Систематичним має стати спостереження у лікаря-невропатолога.

Батькам не потрібно боятися, що дитина стане розумово відсталим. Синдром ВЧД не знизить його інтелект, а, навіть навпаки, може розвинути деякі таланти, такі, як хороша пам’ять і музичні здібності.

Але не забувайте, що малюк може легко порушуватися і швидко втомлюватися, а іноді просто втомлювати вас балакучістю.

Ставтеся до дитини з розумінням, адже це спадщина, яку залишила хвороба.

У дуже важких випадках при гідроцефалії виробляють хірургічне втручання. Під час втручання встановлюють трубку, яка з порожнини черепа буде виводити зайву рідину. Після такої операції діти швидко поправляються, добре розвиваються і не відстають від однолітків.

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