Depending on the cause of the occurrence, external hydrocephalus is divided into acquired and congenital. Acquired appears as a result of inflammatory processes, traumatic brain injury or tumors, congenital - intrauterine lesions of the nervous system or malformations. The clinical manifestations of a progressive disease differ significantly depending on the age of the patient, but the basis is still an increase in intracranial pressure.
In the treatment of progressive external hydrocephalus in children, both surgical and medical methods are used. In premature infants without obvious signs of active hydrocephalus, but with hemorrhages, diuretics are widely used, but only if it is possible to sanitize the cerebrospinal fluid and restore normal absorption. Thus, it is possible to stabilize the intracranial pressure and the size of the cerebral ventricles in half of the patients under the age of 12 months. But the use of diuretics is justified only when there are no signs of increased intracranial pressure and the excretory function of the kidneys is functioning normally.
In addition, it is possible to use drugs that promote the excretion of sodium from the body, which increases urine output and reduces cerebrospinal fluid production.
Surgical treatment is performed to normalize intracranial pressure and optimize brain function, but problems associated with inflammatory complications, overdraining and impaired drainage systems can arise.
If the functions of the shunt system are impaired, all signs of progressive hydrocephalus appear: nausea, headache, drowsiness, and behavioral disturbances. Often, such phenomena are acute and are manifested by paresis of the abducens nerves, passing blindness and loss of visual fields.
In patients who have undergone implantation of liquor-shunted systems, any disturbance in the work of the drainage system is accompanied by a sharp deterioration in the condition, up to respiratory distress, coma and death. Such patients need to restore the drainage system and reduce intracranial pressure.
The question often arises of removing a shunting system that does not function, but even a system that does not work for any indicators can retain its drainage function at least partially. Therefore, it is necessary to remove the shunting system only with the development of meningitis, ventriculitis or meningoencephalitis, which do not respond to antibacterial treatment.