Intracranial pressure in a child: symptoms, signs, causes. Treatment of intracranial pressure in children. Intracranial hypertension in children

Intracranial hypertension (in other words, increased intracranial pressure in medicine) in children is a fairly common phenomenon. In the majority of all identified cases, the diagnosis of this condition is superficial and does not take into account its real severity. But for parents whose children are diagnosed with such a pathology, it is important to understand that increased intracranial pressure in a child is not a simple problem, but represents quite serious health problems, especially if it is permanent.

Intracranial hypertension

ICP is the pressure of the cerebrospinal fluid, which is located in the spinal canal and ventricles of the brain. Its volume affects the pressure inside the skull. Under normal conditions, its level is stable, but its composition changes periodically. When the amount of cerebrospinal fluid increases, the pressure also increases. If this condition is observed constantly, then the doctor speaks of increased intracranial pressure.

It is worth understanding that intracranial hypertension is not a diagnosis, but just a manifestation of some problem in the body. Therefore, before prescribing treatment, the neurologist must find out the exact cause of this condition.

How to treat intracranial pressure in a child with medication?

The main criteria for deciding whether to prescribe medications to a child with increased intracranial pressure are his or her weight gain, the quantity and quality of sleep, and the development of the child himself. If these indicators in a child’s first months of life are within the normal range, then there is no need to panic and treat the child with medications.

The prescription of treatment methods largely depends on the root cause, which became a provoking factor in the increase in intracranial pressure. However, its basic principles should be aimed at reducing intracranial pressure, improving blood circulation in the brain tissue, and taking sedatives that have a beneficial effect on the child’s mobile nervous system.

Causes of high ICP

Doctors distinguish 2 forms of hypertension:

Congenital.
Acquired.

There is also temporary or benign intracranial hypertension; in children it develops after prolonged crying, physical activity, weather changes, changes in muscle or vascular tone, or with vegetative-vascular dystonia. This condition goes away on its own and occurs only in infants. In some cases, it may appear before the age of 2 years.

Congenital hypertension

This form is diagnosed in infants and is associated with:

Genetic defects and disturbances in the development of cerebrospinal fluid outflow tracts, resulting in cerebrospinal fluid stagnation.
Hydrocephalus is a disorder of the outflow of cerebrospinal fluid.

Hemorrhage during childbirth. As a result of the occurrence of a hematoma, pressure of the cerebrospinal fluid appears on the brain tissue.
Brain edema, which can develop as a result of fetal hypoxia during intrauterine development or during childbirth.

In almost 90% of all cases of congenital pathology, the cause is infection of the fetus with certain infections or birth trauma. Its peculiarity is that congenital ICP in children is detected immediately after birth or in the first weeks of life. Sometimes doctors can diagnose it during the last trimester of a woman's pregnancy.

Pediatrician Yu. V. Ermolina will help you understand the causes and mechanism of the appearance of congenital and acquired ICP:

Today, there are effective diagnostic methods that make it possible to determine high intracranial pressure in a baby and prescribe adequate treatment that guarantees a favorable outcome for the baby. Subsequently, such children are no different from their peers.

Acquired hypertension

Increased intracranial pressure in a child under 7 years of age may occur for the following reasons:

Traumatic brain injury, which leads to swelling of brain tissue and high cerebrospinal fluid pressure.
Early closure of the fontanelle. The norm is considered to be the closure of the large fontanel by 12-18 months of the baby’s life. But sometimes this can happen earlier. In this case, the brain continues to grow and intracranial pressure may increase.
Brain hemorrhage. At the same time, tissue compression appears at the site of hemorrhage and the pressure of the cerebrospinal fluid on the surrounding tissue increases.

Inflammatory processes of brain tissue (encephalitis, meningitis). As a result of inflammation, brain tissue swells, and in the case of purulent forms of the disease, the composition of the cerebrospinal fluid changes. In this case, it becomes too thick, which makes it difficult to drain.
Swelling of brain tissue due to exposure to toxic substances in the body.
Any neoplasms (malignant or benign) in the brain that put pressure on its tissues and disrupt the outflow of cerebrospinal fluid.
Previous brain surgery, which may result in the formation of adhesions that impede the movement of cerebrospinal fluid.

Causes of intracranial pressure in a child

An increase in intracranial pressure in a child can be short-term in nature, as a result of the baby suffering from various infections or changes in weather conditions.

In this case, consultation with a specialist is not so necessary. If this happens over a long period of time or makes itself felt regularly, then immediate consultation with a specialist and appropriate treatment will be required.

Child problems associated with increased intracranial pressure have recently become common. Quite often they can appear almost from birth, usually from the age of 1 month. The causes of this disease are mainly of both endogenous and exogenous nature.

These include:

a large amount of cerebrospinal fluid (CSF) in the ventricles of the brain;
poor absorption of cerebrospinal fluid;
poor outflow of cerebrospinal fluid.

The occurrence of such causes is a consequence of prenatal disorders: oxygen starvation of the fetus, asphyxia, or traumatic brain injuries received during childbirth.

Increased intracranial pressure is not always pathological and may be temporary. In this case, other factors influence its occurrence:

muscle tone disorders;
vegetative-vascular dystonia.

Another reason for increased pressure is a drop in atmospheric pressure. This factor is external and, unlike the above, is not controlled by humans.

The intracranial pressure of a child is greatly influenced by the diseases he suffers, especially such serious ones as influenza or a severe form of ARVI. A persistent, prolonged increase in intracranial pressure may indicate defects in the central nervous system, pathologies at the gene level, or other anomalies caused by the following diseases :

A brain tumor
Various brain infections: meningitis, encephalitis
Brain injuries
Toxic poisoning of brain cells
Intracerebral hemorrhage

Sometimes the cause of increased intracranial pressure can be the rapid overgrowth of the fontanel in an infant.

At birth, a child may be diagnosed with increased intracranial pressure, but it would be wrong to immediately say that the baby suffers from such a pathology.

For babies, this condition is in most cases the norm. However, there are cases when, during pregnancy or childbirth, the fetus experienced oxygen starvation, as a result of which brain cells experienced oxygen deficiency and began to die.

As a consequence of this condition, there is a violation of the child’s development processes, his inferiority, and disability.

Quite often during pregnancy, women experience toxicosis. This phenomenon is considered a normal symptom of pregnancy, especially in the first trimester. But severe toxicosis affects the fetal absorption of oxygen and causes hypoxia. As a result of this, an excess amount of cerebrospinal fluid is formed, which will also lead to increased intracranial pressure in the child.

Symptoms in infants

Children have a large number of symptoms of ICP and they are all very diverse. But they need to be perceived only comprehensively, since individually, they can arise due to completely different pathologies. Signs of intracranial pressure in a child who is not yet 1 year old are:

Swelling and pulsation of the fontanel.
Divergence of the skull bones, which occurs due to the accumulation of cerebrospinal fluid under them.
Cramps.
Graefe's symptom is a dysfunction of the oculomotor nerve. The symptom may develop due to increased ICP. In this case, the eyeballs periodically deviate downward, and a white stripe is clearly visible above the iris. Another name for this condition is “setting sun symptom.”
Increased tearfulness and anxiety, especially at night. This is due to the fact that at this time the baby is predominantly horizontal, and in this position the venous outflow slows down significantly. As a result, the volume of cerebrospinal fluid increases.

With ICP, many veins are clearly visible on the head, which are filled with blood.
Regular, profuse regurgitation is one of the symptoms of the disease, although not very reliable, since this condition may be associated with other causes.
Infant lethargy and muscle hypotonicity. With ICP, vomiting is considered a reflex and is associated with the fact that those parts of the brain that are responsible for the occurrence of nausea and vomiting are irritated.

Developmental delay.
Small weight gain. It is due to the fact that a child with high ICP often refuses to feed. The fact is that during sucking, intracranial pressure naturally increases, and in such situations the baby experiences pain and refuses the breast.

How can you tell if your child has intracranial pressure?

Signs that allow you to understand that a child has increased intracranial pressure are quite clear and understandable. As a rule, they are not isolated, that is, they appear in a complex. Of these, there are both short-term ones and those that develop over a long period of time. These signs or symptoms have an age-related characteristic. They are different and specific for different age periods.

Symptoms of intracranial pressure in children under one year old

The main symptom accompanying this disease, like anything that causes discomfort or pain to the baby, is restless behavior, loud crying and poor activity.

The child's sleep is unstable, he often wakes up or, on the contrary, cannot fall asleep. The baby may refuse to feed or spit up profusely, which is a consequence of nausea.

In children under one year of age, there may also be external signs indicating pathology of intracranial pressure. They are expressed in visible changes in the baby’s body:

the size of the head is disproportionate to the body, it is too large;
swelling of the fontanelle, enlargement of the frontal part of the skull;
the appearance of blood veins on the baby’s head, since an increase in pressure contributes to oversaturation of the circulatory system and stagnation of blood in it;
the so-called “Graefe symptom” or in other words “the setting sun symptom”, when the child’s eyeballs deviate much downwards, so that a white stripe - the sclera - becomes visible;
There are deviations in weight gain, it is too slow;
physical and mental development are slowed down.

Intracranial pressure in a child at 3 years old, at 5-7 years old

In older children, the symptoms are much clearer. The child can now independently tell his parents what is bothering him and where. Therefore, it becomes much easier to determine the increase in intracranial pressure.

These signs include children’s complaints about:

severe and prolonged headache, especially in the evenings or at night;
nausea and vomiting, after which relief still does not come;
pain in the eyes, which occurs due to pressure on the orbital region of the cerebrospinal fluid;
shadows or flashes before the eyes, or double vision.

Symptoms in children over 3 years of age

Intracranial pressure in a child whose fontanelle has already closed has other symptoms. In preschoolers and children of primary school age, its manifestation can be considered inattention, retardation in mental and physical development, and difficulty remembering new information. Such children, as a rule, have poor and uneven handwriting.

The main symptoms of ICP in a child of this age:

Big forehead.
Poorly developed speech.
Visual impairment, double vision, spots or flashes before the eyes, pain in the eye area.
Closed eyes.
Increased fatigue.

A detailed story about the pathology will be given to you by a wonderful specialist - a pediatrician, candidate of medical sciences, author of popular books and television programs dedicated to children's health, Evgeniy Olegovich Komarovsky:

Frequent whims.
Frequent headaches, which mainly occur closer to the night.
General weakness.
Poor coordination of movements.
Frequent vomiting. After another vomiting, no relief is observed. This type of vomiting differs from that which appears after food poisoning.

At the same time, the baby’s well-being worsens in the evening.

Diagnosis of ICP

The only method that makes it possible to compare the normal indicators of a child with the indicators of a sick baby is a spinal puncture. But in practice it is used very rarely, since modern medicine has many other safer ways to diagnose ICP based on its signs and symptoms:

Examination of the child by a neuropathologist, who may notice reflex disturbances, swelling of the fontanel, an increase in the volume of the head and Graefe's symptom. The doctor will ask the mother about the child’s behavior, sleep patterns and wakefulness, changes in the baby’s weight and appetite.
Examination by an ophthalmologist, during which the doctor will check the fundus of the eye. With ICP, dilated veins, spasmed vessels and changes in the optic nerve head will be clearly visible.
How to measure intracranial pressure? For infants whose fontanelle has not yet closed, the most informative method is neurosonography of the brain or ultrasound, which makes it possible to take measurements and identify an increase in the volume of the ventricles, interhemispheric fissures, displacement or deformation of brain structures, and the presence of space-occupying neoplasms.

The photo shows a procedure for neurosonography of a baby’s brain.

To identify the problem in time, neurosonography is recommended at the ages of 1, 3 and 6 months. Regardless of what the first examination showed, it is necessary to undergo it again, since the problem can strike the baby at any time. If necessary, the doctor may recommend doing the examination until the child’s fontanel is completely closed. This procedure will not cause harm, but if necessary, it will allow you to identify the pathology at the initial stage and successfully treat it.

For a child whose fontanel is already closed, computed tomography or magnetic resonance imaging is used.

Treatment of ICP

Treatment of intracranial pressure in children is prescribed based on the disease that led to the problem. Common treatment methods include:

Normalization of the child's daily routine.
Long walks outside.
Moderate physical activity. For intracranial hypertension, swimming has a good effect.
Physiotherapeutic procedures.

Taking diuretics: Triampur, Diacarb, etc.
Taking medications that help improve blood circulation in the brain and nootropic drugs: Cavinton, Piracetam, Nicotinic acid, Pantogam, etc.
Taking neuroprotectors (“Glycine”).

We will take medications with a mild sedative effect.
If tumors are present, surgery is performed.
If there is hydrocephalus, the child undergoes shunt surgery, during which a special shunt is installed.

Endoscopic ventriculostomy - insertion of a catheter into the cavity of the cerebral ventricle and drainage of excess cerebrospinal fluid

There are also traditional methods for treating ICP. They cannot be called an independent method of treatment and are used only in combination with drug therapy. The following drugs have shown good results for ICP:

Tincture from mulberry branches, which is drunk twice a day, 100 ml.
A mixture of pollen with natural honey in a ratio of 2 to 1.
Peppermint decoction is used for head compresses, which should be applied 1-2 times a day.

You will learn more traditional medicine recipes from the video:

Baths with the addition of linden decoction.
Inhalation of bay leaf decoction vapors.
A mixture of garlic and lemon. To prepare it, chop 2 medium heads of garlic and 2 medium lemons. The mixture is poured with 2 liters of boiling water and infused for 24 hours. After this, strain the tincture and take 50 mg before meals.

Before you start using any of the listed folk remedies, you should definitely consult your doctor, since even medicinal herbs may have contraindications for use.

Complications of high ICP

If high intracranial pressure is not treated, serious consequences may develop, including:

Violation of the child's mental state.
Development of epilepsy.
Deterioration of vision.
The occurrence of ischemic or hemorrhagic strokes.
If there is infringement of the cerebellum, then the baby’s breathing is impaired, weakness in the limbs develops, and a disorder of consciousness is possible.
Delay in physical and mental development.

In newborns, this diagnosis occurs quite often. Many parents know about the existence of this frightening diagnosis, but when faced with it, they are lost and do not know what to do next.

Of course, the consequences of this phenomenon cannot but worry. This article will answer all questions regarding symptoms of intracranial pressure in children. This will help to identify the disease in time.

Why is intracranial pressure dangerous in a child?

Increased intracranial pressure usually begins to manifest itself when the child begins to engage in mental work. As a rule, in the morning such children often have headaches, dizziness, and are lethargic, tearful and rude. They are in a state of chronic fatigue.

Children remember poems and stories poorly, and their thinking is inhibited. Visual disturbances are observed: double vision, flying “spots”, strabismus may appear. There are signs of hypo- or hyperactivity, the most obvious of which is a trembling of the chin.

However, children with increased intracranial pressure do not necessarily have to be completely exempted from physical education; in extreme cases, they can belong to special medical health groups and play sports according to a light program.

Strong but regular physical activity improves the child’s condition and helps him achieve good academic results.

What is elevated ICP?

To understand what this disease is, it is necessary to understand in more detail the structure of the brain.
The latter has several membranes, between two of which, in the subarachnoid space, there is cerebrospinal fluid.

Inside the brain there is a system consisting of ventricles, which are also completely filled with this fluid.

This allows you to provide reliable protection against various injuries. The pressure of cerebrospinal fluid (CSF) on the surface of the cerebral cortex is called intracranial pressure.

An increase in ICP levels entails a lot of serious consequences.

In what cases is increased ICP a pathology?

A slight increase does not always indicate that irreversible processes are occurring in the body.

It may fluctuate up and down throughout the day - this is normal.

For example, when going to the toilet, when lifting a massive object, during stress and when the mother is suckling, its level may increase slightly.

Moreover, this does not pose any serious danger to the newborn. If high intracranial pressure remains unchanged, then emergency treatment is necessary.

Symptoms

In a young child

The main symptoms of ICP include:

severe crying and fussiness
. One distinctive feature that is characteristic of high blood pressure is that the child can be completely calm throughout the day, but at night he begins to cry loudly. This is due to the specific structure of the venous system. Since in the dark the child is predominantly in a lying position, the outflow of blood during this period gradually slows down, the veins of the brain become extremely congested, which significantly increases the volume of cerebrospinal fluid. This is what leads to increased pressure inside the skull;
sleep disturbance, endless awakenings, difficulty falling asleep. These signs of intracranial pressure in a child are also due to the reason described in detail above;
nausea, vomiting and quite frequent profuse regurgitation . These phenomena are considered reflexive, but they also cannot be ignored;
increase in head volume . Disproportional head sizes, protruding fontanelles, enlarged frontal lobe and divergence of the sutures of the skull. This is explained by the fact that cerebrospinal fluid gradually accumulates in the brain. The consequence of this is hydrocephalus;
visibility of veins under the scalp. When blood overflows the veins of the head and stagnates there, this leads to expansion of the subcutaneous vessels. As a result, the veins are clearly visible under the skin;
Graefe's symptom . It is characterized by a serious impairment of the oculomotor nerves, which occurs as a result of birth trauma. The manifestation is characterized by downward deviations of the eyeballs, after which a strip of sclera can be seen below the upper eyelid;
refusal of mother's milk . Since the baby’s blood pressure increases during feeding, he eventually refuses it due to the presence of painful sensations. As a result, the baby does not gain weight, which negatively affects his health and general condition;
inhibition in physical and psycho-emotional development . This alarming symptom is the result of prolonged high blood pressure and refusal to feed.

In most cases, high cranial pressure in infants is caused by trauma during childbirth or pregnancy complications. If signs of this phenomenon appear, you should consult a doctor.

In older children

For the most part, the main symptoms are very similar to those observed in infants.

They can also include pain on the inside of the eyeballs, which occurs as a result of the pressure of the cerebrospinal fluid on the area of the head located behind them.

Children may also notice symptoms such as double vision, bright flashes or streaks in front of their eyes. They appear due to irritation of the optic nerves.

Symptoms of cranial pressure in children can vary. Therefore, at the first manifestations of this disease, you should make an appointment with a doctor.

In a teenager

The list of symptoms that indicate the presence of increased cranial pressure includes:

fast fatiguability;
apathy;
increased drowsiness;
tearfulness;
intense headaches;
blue circles under the eyes;
nausea, vomiting;
cardiopalmus.

Diagnostics

If the symptoms of intracranial pressure in a 6-year-old child are pronounced, then you should immediately visit a specialist. He will definitely prescribe the appropriate tests for the child to measure the pressure inside the skull as accurately as possible. Since the large fontanel is open in infants, an ultrasound examination can be performed. This method is called neurosonography.

Ultrasound of the brain (neurosonography) in children

You definitely need to visit an ophthalmologist. He will carefully examine the fundus of the eye and clarify whether more radical methods of examination are needed or not. If one of the signs of increased intracranial pressure in a child is dilation of the retinal veins, then additional research is urgently needed.

It is imperative to do a tomography and echoencephalogram of the brain. These types of studies make it possible not only to measure pressure, but also to accurately assess the condition of the ventricles of the brain.

If all previously used methods have not brought the expected benefit, and the signs of increased intracranial pressure in a 1-year-old child are very alarming, it is necessary to turn to more radical procedures.

One of these methods is puncture of the ventricles of the brain and spinal puncture, which make it possible to learn more about the data characterizing the amount of pressure inside the skull. They must be carried out according to strict guidelines.

How to measure intracranial pressure in children?

Diagnosis of intracranial pressure indicators is carried out in one only known way - by taking a spinal puncture. Of course, a large number of different methods are used in the diagnosis of intracranial pressure. They make it possible to successfully determine the presence of this disease in a child and the degree of its complexity, but cannot give exact figures. This is only possible by analyzing the cerebrospinal fluid.

In order for a patient to be prescribed such a test, it is first necessary to visit a neurologist. Such an analysis is performed only with the written consent of the patient. Naturally, the child’s parents give written consent. You will first need to undergo other general tests to determine the functioning of the patient’s main organs.

The meal should be no later than 20 hours before the spinal tap is taken. When carrying out this procedure, the presence of parents or relatives is required.

Taking a spinal tap is a fairly common practice in neurology. However, to determine indicators of intracranial pressure, it is used only as a last resort , since it has a large number of different safer methods for determining this pathology, but without accurate indicators.

These include:

Ultrasound of the brain - neurosonography.
Measuring the speed of blood flow and the level of blockage of blood vessels - Dopplerography.
Detection of abnormalities in the structure of the skull - X-ray of the head.
CT scan.

Treatment

After passing the examination, only the doctor can prescribe appropriate treatment.

The set of measures aimed at eliminating ICP includes:

complete elimination of the consequences of difficult pregnancy and childbirth with complications, which include prolonged breastfeeding, adherence to sleep patterns, maintaining emotional contact and long walks in the fresh air;
prescribing appropriate medications that are aimed at calming the nervous system, improving blood circulation, and also saturating the body with vitamins;
taking diuretics;
the use of physiotherapeutic procedures;
if the cause of increased intracranial pressure is an anatomical disorder, immediate surgical intervention is necessary in order to completely restore the outflow of cerebrospinal fluid from the brain.

In addition to drug treatment, you should follow a few simple rules:

limiting the amount of fluid consumed;
limiting the consumption of fried and salty foods;
inclusion of lemons, oranges, herbs, potatoes and dried apricots in the diet;
introduction of the rule of sleeping on high pillows (this promotes the outflow of cerebrospinal fluid downwards).

One of the activities that is aimed at eliminating the symptoms of intracranial pressure in an 8-year-old child is swimming. In combination with drug treatment, it can give excellent results.

Forecast

Symptoms of high intracranial pressure in children under 3 years of age can vary, so it is important to monitor the child's condition.

While a teenager can talk about what worries him, a baby cannot. Therefore, you need to carefully monitor his health in order to notice any changes in his well-being in time.

Typically, in most newborns, intracranial pressure returns to normal closer to six months of age.

This is possible when perinatal encephalopathy (correctable brain damage) is contributed to by the so-called hypertension syndrome.

If no changes occur, this does not at all indicate that the child is already sick. Most likely, he simply has a weak nervous system. A symptom of high intracranial pressure in such a child is deterioration in health. However, cranial pressure may increase in stressful situations.

Parents should not fear that their child will be mentally retarded. ICP (intracranial pressure) syndrome cannot in any way affect his intelligence, but, on the contrary, can develop some talents in him, such as excellent memory and musical abilities.

Intracranial hypertension in children

Intracranial hypertension or increased intracranial pressure in children is quite common. Diagnosis of this disease, unfortunately, is kept to a minimum; at best, a child undergoes an ultrasound (or ECHO) of the brain once a year, which is not sufficient to prescribe adequate treatment.

Important factors related to identifying the severity of the disease remain unnoticed. But it is extremely necessary to know how periodic the child’s attacks are, how the brain reacts to a specific treatment, so that there is a need to correct it in time, especially if the problem is constant.

Video on the topic

Dr. Komarovsky about ICP syndrome:

Symptoms of intracranial pressure in children under 2 years of age are significant. It is very important for parents to pay attention to them in order to help their child cope with painful sensations. If the slightest symptoms appear that indicate the presence of ICP in the baby, you should immediately visit a specialist. This will help to conduct a thorough examination of the child’s condition in a timely manner and make a correct diagnosis in order to immediately begin appropriate treatment with medications in combination with vitamins. It will be successful only if parents approach this task responsibly.

Traditional treatment of intracranial pressure in children

Before talking about the possibility of treating increased intracranial pressure in children using traditional methods, it should be noted that any such treatment must be agreed upon with the attending physician, which means it will not be possible to avoid meeting with him.

This is due to the fact that if you really go into your brain, you need to be absolutely sure of the correctness of your actions. Any medicinal plant may have contraindications, which few people know about, and treatment with folk decoctions can harm the child.

If the doctor allows you to use folk remedies, then you can use fireweed, valerian, motherwort, mint, hawthorn, horsetail, mistletoe, wild rosemary, orthosiphon and other herbs for decoctions.

For bathing newborns, you should use string, birch leaf, sweet clover, immortelle, clover, bay leaf, and linden blossom.

It is useful to drink natural birch sap for both children and adults. A decoction of lingonberry leaves perfectly calms the nervous system. Using camphor oil, the patient’s hair is washed, this relieves spasms and reduces intracranial pressure.