Enlargement of the ventricles of the brain in infants

It’s normal for parents to worry when they learn about illnesses that could affect their child’s health. The enlargement of the brain ventricles in infants is one such problem that may be brought up during routine checkups. Despite the frightening sound of the term, it’s critical to comprehend the nature of this condition and the appropriate course of action.

Cerebrospinal fluid, which fills the ventricles in the brain, acts as a cushion for the brain and spinal cord. A condition called ventriculomegaly occurs when these ventricles enlarge more than usual. This can be found soon after delivery or during prenatal ultrasounds.

There is considerable variation in the severity and consequences of enlarged ventricles, despite the diagnosis often being unsettling. Although it usually doesn’t cause major issues, it’s important to keep an eye on things under medical supervision to make sure your baby’s development continues as planned.

Ventricular system of the brain

The ventricles of the brain are several interconnected collectors in which the formation and distribution of cerebrospinal fluid occurs. Cerebrospinal fluid washes the brain and spinal cord. Normally, when the ventricles always contain a certain amount of cerebrospinal fluid. Two large collectors of cerebrospinal fluid are located on both sides of the corpus callosum. Both ventricles are interconnected. On the left side is the first ventricle, and on the right is the second. They consist of horns and a body. The lateral ventricles are connected through a system of small openings with the 3rd ventricle. In the distal part of the brain between the cerebellum and the medulla oblongata is the 4th ventricle. It is quite large in size. The fourth ventricle has a diamond shape. At the very bottom there is an opening called the rhomboid fossa.

When necessary, cerebrospinal fluid can enter the subarachnoid space thanks to the ventricles’ proper operation. This region of the brain is situated between the arachnoid membrane and the dura mater. This capacity enables you to keep your cerebrospinal fluid at the necessary level under a variety of pathological circumstances.

The lateral ventricles dilate in newborns frequently. The ventricles’ horns are dilated in this condition, and the fluid buildup around their bodies may also be increased. The left and right ventricles both frequently enlarge as a result of this illness. Asymmetry in the region of the primary brain collectors is disregarded in differential diagnosis.

Normal ventricular size

The ventricles are frequently dilated in newborns. This condition does not indicate a life-threatening illness in the child. There are particular values for each ventricle’s size. The table includes these indicators.

The definition of each lateral ventricle’s structural component is also used to evaluate normal indicators. The depth of the anterior horns should be between 2 and 4 mm, the occipital horns between 10 and 15 mm, and the lateral cisterns less than 4 mm.

Reasons for enlarged ventricles

Dilated ventricles can appear in premature babies as soon as they are born. They are in a symmetrical location. In children with this condition, intracranial hypertension symptoms typically do not manifest. It could be a sign of pathology if there is only one small enlargement on the horns.

• Fetal hypoxia, anatomical defects in the structure of the placenta, development of placental insufficiency. Such conditions lead to disruption of the blood supply to the brain of the unborn child, which can cause expansion of the intracranial collectors.
• Traumatic brain injuries or falls. In this case, the outflow of cerebrospinal fluid is disrupted. This condition leads to stagnation of water in the ventricles, which can lead to the appearance of symptoms of increased intracranial pressure.
• Pathological childbirth. Traumatic injuries, as well as unforeseen circumstances that arise during childbirth, can lead to disruption of the blood supply to the brain. These emergency conditions often contribute to the development of ventricular enlargement.
• Infection with bacterial infections during pregnancy. Pathogenic microorganisms easily penetrate the placenta and can cause various complications in the child.
• Prolonged labor. Too long a time between the discharge of amniotic fluid and the expulsion of the baby can lead to the development of intrapartum hypoxia, which causes a violation of the outflow of cerebrospinal fluid from the dilated ventricles.
• Oncological formations and cysts that are located in the brain. The growth of tumors puts excessive pressure on the intracerebral structures. This leads to the development of pathological dilation of the ventricles.
• Foreign bodies and elements, that are in the brain.
• Infectious diseases. Many bacteria and viruses easily penetrate the blood-brain barrier. This contributes to the development of numerous pathological formations in the brain.

How it manifests itself?

The development of adverse symptoms is not always a result of ventricle dilation. Typically, there is no discomfort that the child feels that would point to the existence of a pathological process.

The first negative symptoms of the disease don’t show up until the disorder is quite severe. Among them are:

• Gait disturbance. Babies begin to walk on tiptoes or step heavily on their heels.
• Visual disturbances. They often manifest in babies in the form of strabismus or insufficiently good focusing on various objects. In some cases, the child may experience double vision, which intensifies when looking at small objects.
• Tremors of the hands and feet.
• Behavioral disorders. Babies become more lethargic, sleepy. In some cases, even apathetic. It is very difficult to captivate the child with any games or entertainment activities.
• Headache. Appears with increased intracranial pressure. Vomiting may occur at the height of pain.
• Dizziness.
• Loss of appetite. Babies in the first months of life refuse breastfeeding, eat poorly. In some cases, the child regurgitates more.
• Sleep disturbance. Children may have difficulty falling asleep. Some children sleepwalk.

There are differences in the disease’s severity. They describe mild symptoms and a mild course. The illness progresses to a moderately severe state when headaches, lightheadedness, and other signs of elevated intracranial hypertension manifest. The illness has already taken a serious turn if the child’s overall health is seriously compromised and hospital treatment is necessary.

Consequences

The child’s future development may be impacted by a delayed diagnosis of the pathological conditions that caused the brain’s ventricles to enlarge. In children, ventricular dilation first manifests as persistent symptoms around the age of six months.

Intracerebrospinal fluid outflow violations can result in a sustained rise in intracranial pressure. This plays a role in the development of consciousness disturbances in severe cases of the disease. A child’s development of hearing loss and visual impairment is caused by visual and hearing disorders. Fits and seizures caused by epilepsy occur in certain children.

Diagnostics

Doctors recommend a number of examination techniques to measure the ventricles precisely and to ascertain their depth.

The most trustworthy and enlightening are:

• Ultrasound examination. Allows you to accurately describe the quantitative indicators of the ventricles, as well as calculate the ventricular index. Ultrasound can be used to estimate the volume of cerebrospinal fluid that is present in the brain collectors during the study.
• Computer tomography. Allows you to describe the structure and size of all ventricles of the brain with high accuracy. The procedure is safe and does not cause pain in the baby.
• Magnetic resonance imaging. Used in complex diagnostic cases when diagnosis is difficult. Suitable for older children who are able to remain still during the entire examination. In young children, MRI is performed under general anesthesia.
• Examination of the fundus.
• Neurosonography.

Treatment

A neurologist typically administers therapy for pathological conditions that have caused the cerebral ventricles to dilate and become asymmetrical. A neurosurgeon is sometimes involved when the disease is caused by lesions that occupy space or by the aftereffects of traumatic brain injuries.

The aforementioned therapeutic approaches are employed to eradicate pathological symptoms:

• Prescribing diuretics. Diuretics help reduce the manifestations of intracranial hypertension and improve the baby"s well-being. They also help normalize the formation of cerebrospinal fluid.
• Nootropics. Improve brain function and also promote good blood filling of blood vessels.
• Medicines with a sedative effect. Used to eliminate increased anxiety and agitation.
• Potassium preparations. Positively affect urine excretion. This helps to reduce the increased amount of cerebrospinal fluid in the body.
• Multivitamin complexes. Used to compensate for all the necessary microelements involved in vital processes. They also help to strengthen the body and promote better resistance to diseases.
• Soothing and relaxing massage. Allows to reduce muscle tone, and also helps to relax the nervous system.
• Therapeutic gymnastics. Helps to normalize the outflow of cerebrospinal fluid and prevents its stagnation in the cerebral ventricles.
• Prescribing antibacterial or antiviral drugs according to indications. Used only in cases where viruses or bacteria are the cause of the disease. Prescribed for a course of treatment.
• Surgical treatment. Used in the presence of various volumetric formations or to remove bone fragments as a result of a skull fracture due to traumatic brain injury.

Infantile brain ventricle enlargement can be a worrying condition, but effective management requires early diagnosis and routine monitoring. Parents need to be well-informed and pay close attention to medical advice.

The illness frequently goes away on its own or gets better with treatment, allowing the child to grow normally. However, it’s critical to report any changes in the baby’s behavior to the healthcare providers and to stay in contact with them.

In the end, parents can give their child the best care possible and ensure that they grow up happy and healthy by remaining composed and proactive.

There are a number of reasons why an infant’s brain ventricles can enlarge, including fluid accumulation or problems with development. Although this may sound concerning, it doesn’t always mean there is a major issue and might go away on its own. However, early detection and treatment can prevent potential complications, so it’s crucial for parents to speak with a doctor to ensure proper monitoring and the baby’s development is on track.

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