Interhemispheric gap 4 mm at 2 months. Interhemispheric gap: concept, purpose, diagnostic rules, results, size of expansion and possible consequences

The key to health and proper adaptation of the baby in the future is the correct development of all organs. That is why, in the earliest childhood, it is very important to timely identify all the health problems of the child and immediately start to eliminate them. From this article you will learn how dangerous the expansion of the interhemispheric gap in infants is, what it is and why this pathology occurs in young children.

Causes

During an examination of the child's brain, doctors identify various pathologies, and also pay attention to the size of the interhemispheric gap. The distance is an anatomical feature of the newborn, it can be considered acceptable only if it is less than 3 mm. The rate of expansion of the interhemispheric gap in an infant depends on its age. From birth to six months, it should be from three to four millimeters. If the deviation is almost imperceptible, then it is necessary to periodically carry out diagnostics. Well, if the expansion of the interhemispheric gap in the baby is 7-4 mm or more, then urgent treatment is needed.

For what reasons can the gap increase

If a newborn has an enlarged gap, the size of which exceeds the permissible norm, then perhaps this is a manifestation of a hereditary feature that was passed on to the baby from his parents or closest relatives. The following reasons for its occurrence are also distinguished:

Fetal hypoxia during pregnancy.
The accumulation of fluid between the cerebral hemispheres.
Injuries, such as from a caesarean section.

Signs

In almost all cases, when a gap enlargement is detected in a newborn, parents wonder how to treat it. However, if the expansion of the gap is observed to a small extent, then no treatment is needed. Also, therapy is not necessary if the baby does not have any other signs that bother him. If symptoms are identified that accompany the clinical picture of a certain disease, then the necessary medications will be prescribed. For example, if a newborn has signs of rickets, and he lives in a climatic region where there is a lack of light, then the intake of the necessary vitamin complexes will be prescribed.

If symptoms are identified that indicate the development of intracranial pressure, then the necessary diuretics will be prescribed. Also, in parallel, you need to use potassium preparations, then this will prevent the development of hypokalemia and hypomagnesemia.

Also, a specialist may prescribe certain vascular drugs that are designed to improve cerebral circulation, and drugs with a sedative effect before bed. All this is necessary only if there are alarming symptoms that indicate neurological problems.

The main thing is the mode

It is worth noting that sleep problems in a newborn should be treated not through the use of medications, but only by normalizing the daily routine. It is necessary that every day the newborn was in the fresh air, and his room should always be ventilated, the nursery should be a little cool and fresh, and not hot and stuffy. You need to study how calm the atmosphere is in your house: are there constant screams, loud music, etc. After all, these factors can have a negative impact on the child's psyche, so they should not be.

Diagnostics

As a rule, it is on the conditions of the child's development in the very first years of life that his future life will depend. Further development entirely depends on how strongly the senses are developed in the growing person: vision, smell, touch and hearing.

Formed in all babies. It is a consequence of the special structure of the human body. In medical practice, it can be natural (physiological) and does not require increased attention, as well as with deviations, which indicates the accumulation of fluid between the cerebral hemispheres.

The key to better treatment of any disease is its timely diagnosis. So, to determine pathologies and disorders in the work of the brain in an infant, doctors conduct a number of diagnostic studies that can establish the current picture of everything that happens in a small organism.

What is neurosonography?

The best method for diagnosing the expansion of the interhemispheric bones is neurosonography. This process represents the same ultrasound examination (ultrasound), but only a point and more aimed at studying the structures of the brain and everything connected with it. It provides a unique opportunity to explore the inner space of the infant's cranium, establishing the degree of divergence of his head bones.

The bottom line is that ultrasound allows conclusions to be drawn regarding the presence in the baby's skull of certain pathologies associated with the discrepancy of the bones on the crown. Violations detected by ultrasound include even those that were obtained at the very beginning of a child's life, even in the womb.

What should be done in this situation and what will be the treatment?

Doctor Komarovsky says the following about the expansion of the interhemispheric gap in the baby: if the size of the expansion is insignificant, then treatment in this case is not necessary, since it is highly likely that it will disappear on its own with age. Also, therapy is not required if the expansion of the interhemispheric gap is the only factor of concern. However, it will be necessary to see a doctor from time to time.

Medicines are prescribed when additional symptoms appear that are characteristic of a particular disease. So, if the child lives in harsh climatic conditions with a lack of sunlight, or he has signs of rickets, vitamin D is prescribed. If the symptoms indicate the development of intracranial pressure in the child, the doctor prescribes diuretics that cause the outflow of excess fluid from the brain. Along with this, the administration of drugs containing potassium and magnesium is prescribed.

The effectiveness of drug treatment

If the baby has signs of neurological disorders, the doctor may prescribe vascular drugs, the action of which is aimed at improving cerebral circulation, as well as sedatives for a good night's sleep for the baby. But before embarking on the treatment of a child's anxious sleep with drugs, you first need to analyze the general atmosphere in which he lives, the causes of the failures. The problem can be solved without the help of drugs, by normalizing the child's day regimen and eliminating irritants.

If the increase in the interhemispheric gap of the baby occurred as a result of the penetration of an infection, then in this case the doctor prescribes a course of antibiotic treatment. Thus, the conclusion about the expansion of the interhemispheric gap in a child after undergoing an ultrasound scan is simply a statement of fact, if the indicator is only slightly higher than the norm.

The consequences of the expansion of the interhemispheric gap in infants are quite different. In most cases, it leads to developmental delay. Therefore, it is so important to start treatment as soon as possible, if necessary. He is prescribed on the basis of a specific diagnosis made not only by the results of neurosonography, but also on the basis of certain complaints, changes in the child's behavior.

Keywords : perinatal encephalopathy (PEP) or perinatal damage to the central nervous system (PN CNS), hypertensive-hydrocephalic syndrome (HGS); expansion of the ventricles of the brain, interhemispheric fissure and subarachnoid spaces, pseudocysts on neurosonography (NSG), muscular dystonia syndrome (MDS), hyperexcitability syndrome, perinatal convulsions.

It turns out ... more than 70-80%! children of the first year of life come for a consultation at neurological centers for a non-existent diagnosis - perinatal encephalopathy (PEP):

Pediatric neurology is a relatively recent birth, but it is already going through difficult times. At the moment, many doctors practicing in the field of neurology of infancy, as well as parents of infants with any changes in the nervous system and mental sphere, find themselves "between two fires." On the one hand, the school of "Soviet child neurology" is an overdiagnosis and incorrect assessment of functional and physiological changes in the nervous system of a child in the first year of life, combined with long-outdated recommendations for intensive treatment with a variety of medications. On the other hand, there is often an obvious underestimation of existing neuropsychiatric symptoms, ignorance of general pediatrics and the foundations of medical psychology, some therapeutic nihilism and fear of using the potential of modern drug therapy; and the result is wasted time and missed opportunities. At the same time, unfortunately, a certain (and sometimes significant) "formality" and "automaticity" of modern medical technologies lead, at least, to the development of psychological problems in the child and his family members. The concept of “norm” in neurology at the end of the 20th century was sharply narrowed down, now it is intensively and not always justifiably expanded. Probably the truth is somewhere in between ...

According to the clinic of perinatal neurology of the medical center "NEURO-MED" and other leading medical centers in Moscow (and probably in other places), so far, more 80%!!! children of the first year of life come in the direction of a pediatrician or neuropathologist from the district clinic for a consultation about non-existent diagnosis - perinatal encephalopathy (PEP):

The diagnosis of "perinatal encephalopathy" (PEP) in Soviet pediatric neurology very vaguely characterized practically any dysfunctions (and even structure) of the brain in the perinatal period of a child's life (from about 7 months of intrauterine development of a child to 1 month of life after childbirth) arising from pathology of cerebral blood flow and oxygen deficiency.

Such a diagnosis was usually based on one or more sets of any signs (syndromes) of a probable disorder of the nervous system, for example, hypertensive-hydrocephalic syndrome (HGS), muscular dystonia syndrome (MDS), hyperexcitability syndrome.

After an appropriate comprehensive examination: clinical examination in combination with the analysis of data from additional research methods (ultrasound of the brain - neurosonography) and cerebral circulation (Doppler ultrasonography of cerebral vessels), fundus studies and other methods, the percentage of reliable diagnoses of perinatal brain damage (hypoxic, traumatic, toxic-metabolic, infectious) decreases to 3-4% - this is more than 20 times!

The most bleak thing about these figures is not only a certain unwillingness of individual doctors to use the knowledge of modern neurology and conscientious delusion, but also the clearly visible psychological (and not only) comfort in striving for such "overdiagnosis".

Hypertensive-hydrocephalic syndrome (HHS): increased intracranial pressure (ICP) and hydrocephalus

Until now, the diagnosis "intracranial hypertension" (increased intracranial pressure (ICP)), one of the most common and "favorite" medical terms among pediatric neurologists and pediatricians, which can explain almost everything! and at any age, parental complaints.

For example, a child often cries and shudders, sleeps poorly, spits up a lot, eats poorly and gains little weight, goggles, walks on tiptoes, his hands and chin tremble, there are convulsions and there is a lag in psycho-speech and motor development: “only it is to blame - increased intracranial pressure ”. A convenient diagnosis, isn't it?

Quite often, “heavy artillery” - data from instrumental diagnostic methods with mysterious scientific graphs and numbers - is used as the main argument for parents. Methods can be used either absolutely outdated and uninformative / echoencephalography (ECHO-EG) and rheoencephalography (REG) /, or examination "from the wrong order" (EEG), or incorrect, in isolation from clinical manifestations, subjective interpretation of normal variants in neurosonodopplerography or tomography.

Unhappy mothers of such children unwittingly, at the suggestion of doctors (or willingly, feeding on their own anxiety and fears), pick up the flag of "intracranial hypertension" and for a long time fall into the system of observation and treatment of perinatal encephalopathy.

In fact, intracranial hypertension is a very serious and rather rare neurological and neurosurgical pathology. It accompanies severe neuroinfections and brain injuries, hydrocephalus, cerebrovascular accident, brain tumors, etc.

Hospitalization is obligatory and urgent!!

Intracranial hypertension (if it really exists) is not difficult to notice for attentive parents: it is typical for it constant or paroxysmal headaches (usually in the morning), nausea and vomiting, not associated with food. The child is often lethargic and sad, constantly naughty, refuses to eat, he always wants to lie down, snuggle up to his mother.

A very serious symptom can be strabismus or pupil difference, and, of course, impaired consciousness. In infants, bulging and tension of the fontanelle, divergence of the seams between the bones of the skull, and excessive growth of the head circumference are very suspicious.

Without a doubt, in such cases, the child must be shown to specialists as soon as possible. Quite often, one clinical examination is enough to exclude or pre-diagnose this pathology. Sometimes it requires additional research methods (fundus, neurosonodopplerography, computed or magnetic resonance imaging of the brain)

Of course, the expansion of the interhemispheric fissure, ventricles of the brain, subarachnoid and other spaces of the cerebrospinal fluid system on neurosonography images (NSG) or brain tomograms (CT or MRI) cannot serve as evidence of intracranial hypertension. The same applies to disorders of cerebral blood flow, isolated from the clinic, detected by Doppler ultrasonography of the vessels, and "digital impressions" on the X-ray of the skull

In addition, there is no connection between intracranial hypertension and translucent veins on the face and scalp, walking on tiptoes, trembling of the arms and chin, hyperexcitability, developmental disorders, poor academic performance, nosebleeds, tics, stuttering, bad behavior, etc. etc.

That is why, if your baby was diagnosed with AED, intracranial hypertension, based on the “goggle” of the eye (a symptom of Graefe, the “setting sun”) and walking on tiptoes, then you should not go crazy in advance. In fact, these reactions can be characteristic of highly excitable young children. They react very emotionally to everything that surrounds them and what is happening. Attentive parents will easily notice these relationships.

Thus, when diagnosing AED and increasing intracranial pressure, it is naturally best to go to a specialized neurological clinic. This is the only way to be sure of the correct diagnosis and treatment.

It is absolutely unreasonable to start treatment of this serious pathology on the recommendations of one doctor on the basis of the above "arguments", in addition, such unreasonable treatment is not at all safe.

What are only diuretics, which are prescribed to children for a long time, which has an extremely adverse effect on the growing body, causing metabolic disorders.

There is another, no less important aspect of the problem that must be taken into account in this situation. Sometimes medications are necessary and an unlawful refusal from them, on the basis of only the mother's (and more often the father's!) Own belief in drug-related harm, can lead to serious troubles. In addition, if there really is a serious progressive increase in intracranial pressure and the development of hydrocephalus, then often incorrect drug therapy for intracranial hypertension entails the loss of a favorable moment for surgery (bypass surgery) and the development of severe irreversible consequences for the child: hydrocephalus, developmental disorders, blindness , deafness, etc.

Now a few words about the no less "adored" hydrocephalus and hydrocephalic syndrome... In fact, we are talking about a progressive increase in intracranial and intracerebral spaces filled with cerebrospinal fluid (CSF) due to the existing one! at that moment intracranial hypertension. In this case, neurosonograms (NSG) or tomograms reveal the expansion of the ventricles of the brain, the interhemispheric fissure and other parts of the cerebrospinal fluid system that changes over time. It all depends on the severity and dynamics of symptoms, and most importantly, on the correct assessment of the relationship between the increase in intracerebral spaces and other nervous changes. This can be easily determined by a trained neurologist. True hydrocephalus, which does require treatment, as is intracranial hypertension, is relatively rare. Such children must be monitored by neurologists and neurosurgeons of specialized medical centers.

Unfortunately, in ordinary life, such an erroneous "diagnosis" occurs in almost every fourth or fifth baby. It turns out that some doctors often incorrectly call a stable (usually insignificant) increase in the ventricles and other cerebrospinal fluid spaces as hydrocephalus (hydrocephalic syndrome). This does not manifest itself by external signs and complaints, and does not require treatment. Moreover, if the child is suspected of hydrocephalus on the basis of the "big" head, translucent vessels on the face and scalp, etc. - this should not cause panic among the parents. The large size of the head in this case plays almost no role. However, the dynamics of the increase in head circumference is very important. In addition, you need to know that among modern children, so-called "tadpoles" are not uncommon, in which the head is relatively large for their age (macrocephaly). In most of these cases, babies with large heads show signs of rickets, less often - macrocephaly, due to the family constitution. For example, dad or mom, or maybe grandfather has a big head, in a word, it's a family matter, does not require treatment.

Sometimes, during neurosonography, the ultrasound diagnostics doctor finds pseudocysts in the brain - but this is not at all a reason for panic! Pseudocysts are single rounded tiny formations (cavities) containing cerebrospinal fluid and located in typical areas of the brain. The reasons for their appearance, as a rule, are not known for certain; they usually disappear by 8-12 months. life. It is important to know that the existence of such cysts in most children is not a risk factor for further neuropsychic development and does not require treatment. Nevertheless, although quite rarely, pseudocysts form at the site of subependymal hemorrhage, or are associated with previous perinatal cerebral ischemia or intrauterine infection. The number, size, structure and location of cysts provide specialists with very important information, taking into account which, on the basis of clinical examination, final conclusions are formed.

Description of HCG is not a diagnosis! and not necessarily a reason for treatment.

Most often, NSG data give indirect and uncertain results, and are taken into account only in conjunction with the results of a clinical examination.

Once again I remind you of the other extreme: in difficult cases, sometimes there is a clear underestimation on the part of the parents (less often - and doctors) of the child's problems, which leads to a complete refusal of the necessary dynamic observation and examination, as a result of which the correct diagnosis is made late, and treatment does not lead to the desired result.

Undoubtedly, therefore, if there is a suspicion of increased intracranial pressure and hydrocephalus, the diagnosis should be carried out at the highest professional level.

What is muscle tone and why is it so "loved"?

Look at your child's medical record: there is no such diagnosis as "muscular dystonia", "hypertension" and "hypotension"? - probably, you just did not go with your baby to a neurologist at the clinic for up to a year. This is, of course, a joke. However, the diagnosis of "muscular dystonia" occurs no less often (and perhaps more often) than hydrocephalic syndrome and increased intracranial pressure.

Changes in muscle tone can be, depending on the severity, either a normal variant (most often) or a serious neurological problem (this is much less common).

Briefly about the external signs of changes in muscle tone.

Muscular hypotensioncharacterized by a decrease in resistance to passive movements and an increase in their volume. Spontaneous and voluntary physical activity may be limited, palpation of the muscles is somewhat reminiscent of "jelly or very soft dough." Pronounced muscle hypotonia can significantly affect the pace of motor development (for more details, see the chapter on movement disorders in children of the first year of life).

Muscular dystoniacharacterized by a condition when muscle hypotonia alternates with hypertension, as well as a variant of disharmony and asymmetry of muscle tension in individual muscle groups (for example, more in the hands than in the legs, more on the right than on the left, etc.)

At rest, these children with passive movements may experience some muscle hypotonia. When you try to actively perform any movement, with emotional reactions, with a change in the body in space, muscle tone sharply increases, pathological tonic reflexes become pronounced. Often, these disorders further lead to improper formation of motor skills and orthopedic problems (for example, torticollis, scoliosis).

Muscular hypertension is characterized by an increase in resistance to passive movements and a limitation of spontaneous and voluntary motor activity. Severe muscle hypertension can also significantly affect the pace of motor development.

Violation of muscle tone (muscle tension at rest) can be limited to one limb or one muscle group (obstetric paresis of the arm, traumatic paresis of the leg) - and this is the most noticeable and very alarming sign, forcing parents to immediately consult a neurologist.

It is sometimes quite difficult for a competent doctor to notice the difference between physiological changes and pathological symptoms in one consultation. The fact is that a change in muscle tone is not only associated with neurological disorders, but also strongly depends on the specific age period and other characteristics of the child's condition (excited, crying, hungry, drowsy, cold, etc.). Thus, the presence of individual deviations in the characteristics of muscle tone does not always cause concern and requires any treatment.

But even if functional disorders of muscle tone are confirmed, there is nothing to worry about. A good neurologist will most likely prescribe massage and exercise therapy (exercises on large balls are very effective). Medication is rarely prescribed.

Hyperexcitability syndrome

(syndrome of increased neuro-reflex excitability)

Frequent crying and whims with or without, emotional instability and increased sensitivity to external stimuli, disturbed sleep and appetite, profuse frequent regurgitation, motor restlessness and flinching, trembling of the chin and arms (etc.), often in combination with poor weight gain weight and stool disorders - do you recognize such a child?

All motor, sensory and emotional reactions to external stimuli in a hyperexcitable child arise intensely and abruptly, and can fade just as quickly. Having mastered these or those motor skills, children continuously move, change positions, constantly reach for some objects and grab them. Usually children show a keen interest in their surroundings, but increased emotional lability often complicates their contact with others. They are very impressionable, emotional and vulnerable! They fall asleep extremely badly, only with their mother, they constantly wake up, cry in their sleep. Many of them have a long-term fear reaction to communication with unfamiliar adults with active protest reactions. Usually the syndrome of hyperexcitability is combined with increased mental exhaustion.

The presence of such manifestations in a child is just a reason for contacting a neurologist, but in no case is it a reason for parental panic, and even more so for drug treatment.

Constant hyperexcitability in a causal relation is not very specific and can most often be observed in children with peculiarities of temperament (for example, the so-called choleric type of response).

Much less often, hyperexcitability can be associated and explained by the perinatal pathology of the central nervous system. In addition, if the child's behavior suddenly and unexpectedly and for a long time was disturbed for almost no apparent reason, he developed hyperexcitability, the likelihood of developing a reaction of adaptation disorder (adaptation to external environmental conditions) due to stress cannot be excluded. And the sooner the specialists look at the child, the easier and faster it is to cope with the problem.

And finally, most often, transient hyperexcitability is associated with pediatric problems (rickets, impaired digestion and intestinal colic, hernias, teething, etc.).

There are two extremes in the tactics of monitoring these children. Or the “explanation” of hyperexcitability with the help of “intracranial hypertension” and strenuous drug treatment using often drugs with serious side effects (diacarb, phenobarbital, etc.). Or complete neglect of the problem, which can lead in the future to the formation of persistent neurotic disorders (fears, tics, stuttering, anxiety disorders, obsessions, sleep disturbances) in the child and his family members, and will require long-term psychological correction.

Of course, it is logical to assume that an adequate approach is somewhere in between ...

Separately, I would like to draw the attention of parents to seizures - one of the few disorders of the nervous system that really deserves close attention and serious treatment. Epileptic seizures are not common in infancy, but sometimes they are difficult, insidious and disguised, and immediate medical therapy is almost always necessary.

Such seizures can be hidden behind any stereotyped and repetitive episodes in the child's behavior. Incomprehensible jerks, head nods, involuntary eye movements, "fading", "pinching", "limp", especially with stopping gaze and lack of reaction to external stimuli, should alert parents and force them to turn to specialists. Otherwise, a late diagnosis and an untimely prescribed drug therapy significantly reduce the chances of treatment success.

All the circumstances of the episode of seizures must be accurately and completely remembered and, if possible, recorded on video for further detailed story at the consultation. If the convulsions last for a long time or are repeated - call "03" and urgent consultation with a doctor.

At an early age, the child's condition is extremely changeable, therefore, developmental deviations and other disorders of the nervous system can sometimes be detected only during long-term dynamic monitoring of the baby, with repeated consultations. For this purpose, specific dates have been determined for routine consultations of a pediatric neurologist in the first year of life: usually at 1, 3, 6 and 12 months. It is during these periods that most serious diseases of the nervous system of children of the first year of life can be detected (hydrocephalus, epilepsy, cerebral palsy, metabolic disorders, etc.). Thus, the identification of a specific neurological pathology at the early stages of development makes it possible to start complex therapy on time and at the same time achieve the maximum possible result.

And in conclusion, I would like to remind parents: be empathetic and attentive to your kids! First of all, it is your meaningful participation in the lives of children that is the basis for their further well-being. Do not heal them for "alleged illnesses", but if something worries or worries you, find an opportunity to get independent advice from a qualified specialist.

Antipyretics for children are prescribed by a pediatrician. But there are emergency situations for fever in which the child needs to be given medicine immediately. Then the parents take responsibility and use antipyretic drugs. What is allowed to be given to infants? How can you bring down the temperature in older children? What are the safest medicines?

How well all the organs and their systems are developed in a child by the time of birth determines how he will adapt to life in the future and what his health will be. It is for this reason that it is important to timely identify all existing deviations and, if possible, eliminate them.

The size of the interhemispheric gap is individual for each baby, but it should not exceed three millimeters.

Among the most accurate diagnostic procedures for the brain for children under one year old is neurosonography ... The procedure has been known since the nineties of the last century.

This is the same ultrasound, and the fontanelles, which every baby has, allow the ability to explore the intracranial space. The sensor is lubricated with a special gel that provides better glide over the baby's head, and is applied to these natural holes in the baby.

Ultrasound can determine serious pathologies of the brain or exclude them, and also answer the question of why the interhemispheric gap is enlarged. This research is inexpensive, very simple, does not require special training, but it is quite informative. It makes it possible to identify even those violations that have arisen in the prenatal period.

An increase in the gap between the hemispheres and the subarachnoid space in an infant: causes and consequences

The main reasons for the expansion of the interhemispheric fissure and subarachnoid cavity are:

mother's ailments during pregnancy;
surgical delivery (caesarean section);
accumulation of fluid between the hemispheres of the brain.

In the event of an expansion of this gap, the baby must be monitored: it is important to monitor whether it increases even more.

An urgent consultation with a pediatric neuropathologist is required if the child also has:

The widening of the gap between the hemispheres and the subarachnoid space is not an independent disease, but only a symptom of certain neurological pathologies, such as hydrocephalus (increased fluid content in the interventricular space) or intracranial hypertension.

Brain abnormalities, hemorrhages, cysts and brain tumors can also be found.

Not all of these diagnoses are dangerous, but children with the identification of such symptoms should be constantly monitored. .

A cyst in the brain of an infant is nothing more than a small vesicle that is filled with fluid. Such a baby does not need treatment, but the growth of these cysts must be monitored.

Doctors are often alarmed by the size of the head above average. But this does not mean at all that every such child will have a serious pathology. Large head sizes can be associated with many reasons. For example, many parameters in our body are associated with heredity. If dad, mom or next of kin wear a size 60 hat, why can't a child have a head circumference larger than most of his peers.

The subrachnoid space is the cavity between the meninges of the brain and spinal cord. This cavity contains cerebrospinal fluid and cerebrospinal fluid. Normally, it contains about 140 ml of cerebrospinal fluid, flowing from the fourth ventricle of the brain of the head through special holes.

The subarachnoid cavity expands in parallel with the head circumference. At the same time, the fontanelles protrude, the timing of their overgrowth is delayed. If there is a local expansion of this space, then this means that the circulation of the cerebrospinal fluid is impaired.

If such deviations are found in a child with an enlarged interhemispheric gap, do not immediately panic. Most minor deviations in babies mean absolutely nothing, because the child's brain is actively developing during this period. If the conclusions of a specialist seem doubtful, an ultrasound examination should be performed again in another clinic, where these conclusions will either be confirmed or refuted.

Pediatric neurology is a fairly young science that is now constantly faced with problems of varying complexity. This is both a lack of high-quality equipment and a shortage of well-trained specialists. Despite this, one should not take any of the doctor's conclusions with hostility, because this is nothing more than an opportunity to make sure of the full health of your child, and, possibly, to start the necessary therapy on time.

In order to timely identify the pathology, infants are constantly under the supervision of a local pediatrician. At certain stages of their development, babies up to one year old should be consulted by various specialists several times.

This list also includes a pediatric neurologist who should be seen at one, three, six and twelve months. You should not neglect these consultations, so as not to reproach yourself later. Suspicions of a brain tumor and intracranial hypertension require immediate hospitalization, serious examination, and long-term treatment. Fortunately, most of the suspicions of neurologists, more often than not, remain suspicions, but their instructions should not be ignored.

More about neurosonography and other methods for diagnosing such a pathology

Neurosonography lasts no more than fifteen minutes, babies usually tolerate it well. Some children may oversleep the entire procedure, which does not interfere with its implementation at all. But there are very capricious crumbs that you cannot force to lie still for even a minute, they can be irritated by a sensor, a new environment, or even a doctor conducting a study. In this case, you need to take a pacifier, bottle with drink or favorite toy with you. Ultrasound examination is good because it is not tied to food intake, because it is known that some children cannot be made to endure several hours without food and drink.

Another advantage of this procedure is that the baby is not taken away from the mother. She can be nearby and even ask the doctor questions of interest to her. Sometimes a specialist needs to clarify something, for example, about how the pregnancy proceeded, what the mother was sick with before giving birth or the baby was sick throughout her life. He can learn all the necessary information from his mother, so her presence during neurosonography is simply necessary.

You can do this research from the first day of life. ... Data decryption is carried out by a pediatrician or pediatric neurologist. Only a specialist can link the research data with the existing clinic and make a diagnosis.

If serious abnormalities are identified, sometimes it is necessary to resort to examinations such as magnetic resonance imaging and computed tomography. These techniques are expensive and take much longer, so they are performed only after dubious or alarming neurosonography results.

MRI is by far the most accurate of all known studies. With its help, you can see a layer-by-layer image of the required area. But it is very difficult to examine infants in this way: during the procedure, you need to lie still, but how can this be required from a child under one year old? But there are times when this research is indispensable. If there is a serious need for an MRI, the baby will have to be given anesthesia.

Treatment methods

With a slight expansion, treatment is not carried out, but it is still necessary to examine the child periodically. If, during diagnostic procedures, fluid accumulation is found in the subarachnoid cavity, treatment is prescribed.

Usually, the list of prescribed funds includes:

substances that promote the removal of excess fluid from the body;
potassium and magnesium-containing preparations;
b vitamins;
vitamin D3, if it turns out that there is not enough of it in the body.

If a strong and progressive increase in the subarachnoid cavity is found, then all therapy consists in eliminating the cause that caused this violation. If intracranial pressure is increased, then drugs are prescribed to reduce it (diuretics). If an infection has led to a pathology, then a small patient is prescribed a course of antibiotic treatment.

hydrocephalus

If a baby has hydrocephalus without a significant increase in the ventricles and the head as a whole, it should be remembered that in four out of five cases, it can compensate itself by two years. But you should not rely too much on this opinion, and if in several clinics this diagnosis was confirmed by ultrasound, then it is better to undergo the necessary treatment.

Hydrocephalus is dangerous because if the head has greatly increased under the pressure of the fluid, then its size will not return to normal even after surgical treatment. Vision may also decrease up to blindness, the child may lag behind in development, speech and other important functions of the body may be impaired.

If, during the treatment of this formidable ailment, then its outcome is quite favorable.

Thus, if a child has an enlarged gap between the hemispheres, but he develops normally, sleeps calmly, does not get too restless, most likely there is no reason for worry. But doctor's advice should not be neglected.

Post date: 06.12.2011 11:40

vika

Hello! Please tell me what these data say Subarachnoid space 2mm. interhemispheric gap 6mm. Ventricular system, all parameters by 3mm. The cistern in the sagittal plane is 2.6mm. Doppler sonography: PMA RI 0/54? OA-RI 0.52. Vienna Galena speed 12 cm per second.
Is it worth taking asparkam for vitamin D deficiencies.

Post date: 06.12.2011 21:29

Papkina E.F.

Vic, the expansion of the interhemispheric gap is a sign of fluid accumulation between the cerebral hemispheres. In such cases, diacarb is usually prescribed to drain excess fluid along with asparkam to prevent the excretion of potassium and magnesium salts, which it contains.
With a lack of vitamin D, vitamin D3 or other drugs (vigontol, fish oil) are prescribed, but asparks are not needed in this case.

Post date: 12.03.2012 16:42

a guest

Hello! Please explain, we were diagnosed with mild dilation of the lateral ventricular bodies, is it very scary?

Post date: 13.03.2012 21:08

Papkina E.F.

Mild dilation of the lateral ventricular bodies does not require therapy and is not dangerous for the child.

Post date: 04.05.2012 18:02

Irina

Hello. we did an ultrasound of the brain. Uzist said that there is some expansion of the interhemispheric fissure. We are 4 months old - Sharina interhemispheric gap 8mm. What is the threat? very worried

Post date: 05.05.2012 22:14

Papkina E.F.

Irina, isolated expansion of the interhemispheric fissure does not threaten anything bad.

Post date: 06.07.2012 11:07

Anastasia

Hello, does the child have a 7mm interhemispheric gap should it be treated or can I get by with a massage?

Post date: 07.07.2012 20:31

Papkina E.F.

Anastasia, if no other pathology has been identified and the child is developing normally, then medication is not required.

Post date: 21.08.2012 13:00

a guest

We are 6 months old, the inter-hemispheric gap is 6mm, is it dangerous and does it need to be treated somehow, the neurologist said it is possible to drink lingonberries, is that so?

Post date: 23.08.2012 21:59

Papkina E.F.

With the normal development of the child, this is not dangerous.

Post date: 02.09.2012 22:38

a guest

Good evening! The child was doing an ultrasound of the brain. Ventricular index 31% interhemispheric fissure 7.3 width of bodies left 20 right 20, depth of anterior horns left 7.8 right 8.4 width of posterior horns left 4.8 right 5.4 width of 3rd ventricle 9.6 blood flow 14.8 ... Do you need treatment? The child is developing normally.

Post date: 05.09.2012 22:03

Papkina E.F.

According to ultrasound data - manifestations of intracranial hypertension. Consult a neurologist, he will check the compliance of reflexes and development of the child with his age. In case of deviations, treatment is required.

Post date: 05.09.2012 22:32

a guest

Many thanks!

Post date: 19.09.2012 11:02

yulia

Good day! The child underwent an ultrasound scan of the brain. We are 9 months old, msc 8mm, Front horns vs 4.6 vd 4.6 Occipital horns 15.8 and 16.3. third ventricle 4.1 Cistena magna slit-shaped. Subarachnoid space to the right 6.3 to the left 6.3. The blood flow velocity in the vein of Galen was 10.6 (it decreased more). The child is developing well, there are no deviations. Decipher please. Uzi did 8 times. They drank diacarb, there was a tank 6 * 12, it closed and the mpsch increased (it was 5mm) They said to drink diacarb again. Is this correct, if outwardly we were told everything is fine with him, if the ultrasound is not the norm. Thank you in advance

Post date: 24.09.2012 21:29

Papkina E.F.

Julia, if there are no deviations in the development of the child, then on the basis of the expansion of the MPS only, treatment is not indicated.

Post date: 26.09.2012 09:54

Yulia

Thank you very much for your answer! and it is possible one more question to us noticed that the Subarachoidal space is enlarged to the right 6.3 to the left 6.3. It doesn't require treatment. And what it means.

Post date: 26.09.2012 19:36

Papkina E.F.

Julia, this means a moderate accumulation of fluid on the outer surface of the brain and between the convolutions. Treatment is required only if the child lags behind in motor or emotional development.

Post date: 29.09.2012 05:08

Angelica

Hello! My son is 1 year old. Do an ultrasound of the brain today: The structures of the brain are developed in accordance with gestational age. The figure of the convolutions is differentiated. The subarachnoid space is enlarged - 6 mm. The interhemispheric fissure is widened -6.2 mm. The cavity of the transparent septum is 3.5. Lateral ventricles: The depth of the anterior horns right-5 left-5, the depth of the bodies right -8, left -7, the width of the occipital horns right -13 left -14. The choroid plexuses of the lateral ventricles are homogeneous. The width of the 3 ventricles is -3. Depth of the 4th ventricle -3. Large tank -5. Subcortical ganglia: echogenicity, echo structure on the right and left - b / o, Periventricular area: echogenicity, echo structure on the right and left - b / o. Please tell me what this all means? What are the consequences? What to do at all. Nothing like that can be seen in the child, it develops normally. Very worried. Thanks a lot in advance.

Post date: 03.10.2012 21:12

Guzel

Hello! My baby is 8 months old. They did an ultrasound of the brain. The interhemispheric gap is widened to 3-4 mm in all. At 7 months, there were febrile convulsions that lasted 4 minutes. and never repeated. The doctor prescribed Picamilon, Vintocetin and Cortexin injections. She also prescribed a long-term administration of Depakine. I read the instructions of the drugs and was horrified by the side effects. Is the child's condition so dangerous and is it worth taking these drugs? The child is very active and develops normally. Thank you in advance!

Keywords: perinatal encephalopathy (PEP) or perinatal damage to the central nervous system (PN CNS), hypertensive-hydrocephalic syndrome (HGS); expansion of the ventricles of the brain, interhemispheric fissure and subarachnoid spaces, pseudocysts on neurosonography (NSG), muscular dystonia syndrome (MDS), hyperexcitability syndrome, perinatal convulsions.

It turns out ... more than 70-80%! children of the first year of life come for a consultation at neurological centers for a non-existent diagnosis - perinatal encephalopathy (PEP):

According to the clinic of perinatal neurology of the medical center "NEURO-MED" and other leading medical centers in Moscow (and probably in other places), so far, more 80%!!! children of the first year of life come in the direction of a pediatrician or neuropathologist from the district clinic for a consultation about non-existent diagnosis - perinatal encephalopathy (PEP):

After an appropriate comprehensive examination: clinical examination in combination with analysis of research data (ultrasound of the brain - neurosonography) and cerebral circulation (Doppler ultrasonography of cerebral vessels), fundus studies and other methods, the percentage of reliable diagnoses of perinatal brain damage (hypoxic, traumatic, toxic metabolic, infectious) decreases to 3-4% - this is more than 20 times!

Hypertensive-hydrocephalic syndrome (HHS): increased intracranial pressure (ICP) and hydrocephalus

Until now, the diagnosis is "intracranial hypertension" (increased intracranial pressure ( ICP)), one of the most common and "favorite" medical terms among pediatric neurologists and pediatricians, to whom almost everything can be explained! and at any age, parental complaints.

Quite often, “heavy artillery” - data from instrumental diagnostic methods with mysterious scientific graphs and numbers - is used as the main argument for parents. Methods can be used either completely outdated and uninformative / echoencephalography ( ECHO-EG) and rheoencephalography ( REG) /, or surveys "not from that opera" ( EEG), or an incorrect, in isolation from clinical manifestations, subjective interpretation of the normal variants in neurosonodopplerography or tomography.

Hospitalization is obligatory and urgent!!

Of course, the expansion of the interhemispheric gap, the ventricles of the brain, the subarachnoid and other spaces of the cerebrospinal fluid system on neurosonography (NSG) or brain tomograms (CT or MRI) cannot serve as evidence of intracranial hypertension. The same applies to disorders of cerebral blood flow, isolated from the clinic, revealed by Doppler ultrasonography of the vessels, and "digital impressions" on the X-ray of the skull

Thus, when diagnosing PEP and increasing intracranial pressure, it is naturally best to go to a specialized neurological clinic. This is the only way to be sure of the correct diagnosis and treatment.

What are only diuretics, which are prescribed to children for a long time, which has an extremely adverse effect on the growing body, causing metabolic disorders.

Now a few words about no less "adored" hydrocephalusand hydrocephalic syndrome... In fact, we are talking about a progressive increase in intracranial and intracerebral spaces filled with cerebrospinal fluid (CSF) due to the existing one! at that moment intracranial hypertension. In this case, neurosonograms (NSG) or tomograms reveal the expansion of the ventricles of the brain, the interhemispheric fissure and other parts of the cerebrospinal fluid system that changes over time. It all depends on the severity and dynamics of symptoms, and most importantly, on the correct assessment of the relationship between the increase in intracerebral spaces and other nervous changes. This can be easily determined by a trained neurologist. True hydrocephalus, which does require treatment, as is intracranial hypertension, is relatively rare. Such children must be monitored by neurologists and neurosurgeons of specialized medical centers.

Sometimes, during neurosonography, the ultrasound diagnostics doctor finds in the brain pseudocysts - but this is not at all a reason for panic! Pseudocysts are single rounded tiny formations (cavities) containing cerebrospinal fluid and located in typical areas of the brain. The reasons for their appearance, as a rule, are not known for certain; they usually disappear by 8-12 months. life. It is important to know that the existence of such cysts in most children is not a risk factor for further neuropsychic development and does not require treatment. Nevertheless, although quite rarely, pseudocysts form at the site of subependymal hemorrhage, or are associated with previous perinatal cerebral ischemia or intrauterine infection. The number, size, structure and location of cysts provide specialists with very important information, taking into account which, on the basis of a clinical examination, final conclusions are formed.

Description of HCG is not a diagnosis! and not necessarily a reason for treatment.

Most often, NSG data give indirect and uncertain results, and are taken into account only in conjunction with the results of a clinical examination.

Undoubtedly, therefore, if there is a suspicion of increased intracranial pressure and hydrocephalus, the diagnosis should be carried out at the highest professional level.

What is muscle tone and why is it so "loved"?

Changes in muscle tone can be, depending on the severity, either a normal variant (most often) or a serious neurological problem (this is much less common).

Briefly about the external signs of changes in muscle tone.

Muscular hypotensioncharacterized by a decrease in resistance to passive movements and an increase in their volume. Spontaneous and voluntary physical activity may be limited, palpation of the muscles is somewhat reminiscent of "jelly or very soft dough." Pronounced muscle hypotonia can significantly affect the pace of motor development (for more details, see the chapter on movement disorders in children of the first year of life).

Muscular dystoniacharacterized by a condition when muscle hypotonia alternates with hypertension, as well as a variant of disharmony and asymmetry of muscle tension in individual muscle groups (for example, more in the hands than in the legs, more on the right than on the left, etc.)

Hyperexcitability syndrome

(syndrome of increased neuro-reflex excitability)

The presence of such manifestations in a child is just a reason for contacting a neurologist, but in no case is it a reason for parental panic, and even more so for drug treatment.

And finally, most often, transient hyperexcitability is associated with pediatric problems (rickets, impaired digestion and intestinal colic, hernias, teething, etc.).

Of course, it is logical to assume that an adequate approach is somewhere in between ...

I would also like to draw the attention of parents to convulsions is one of the few disorders of the nervous system that really deserves close attention and serious treatment. Epileptic seizures are not common in infancy, but sometimes they are difficult, insidious and disguised, and immediate medical therapy is almost always necessary.

Post date: 27.10.2011 08:23

ksyusha

HELLO! MY SON IS 2 MONTHS. HYPOXIA WAS DURING THE BIRTH. DEVELOPS NORMALLY. BUT THE USE SHOWED AN INTERHEMESAL FISSION DISPENSED 0.56 (IN NORMAL UP TO 0.4). NOT DISPLACED.

Post date: 27.10.2011 18:11

Svetlana

My son also had hypoxia during childbirth and a tight entanglement of the umbilical cord around the neck. According to ultrasound, the expansion of the interhemispheric gap is more than normal. Grew and developed according to age. We had small problems with speech. We worked with a speech therapist. Soon we are seven years old. Calm and intelligent boy. Very creative. DO NOT EXPERIENCE ANYTHING SCARY!

Post date: 27.10.2011 20:26

Papkina E.F.

Ksyusha, a slight expansion of the interhemispheric gap is not dangerous for a child's development.

Post date: 28.10.2011 02:43

ksyusha

oh thank you very much! you reassured me, otherwise it is difficult to find a good specialist with us, but we ourselves are not competent in matters of medicine at all. I forgot to say that we still do not hold our heads well. Sometimes I am too lazy to raise it. When it lies on my stomach, it lifts it well. But on the bed it is bad and not always upright. Doctors say that he should already keep it well at 2 months. We have 41 cm, at birth it was 36. Please comment.

Post date: 28.10.2011 22:17

Papkina E.F.

Ksyusha, head growth in 2 months-4 cm, this is normal. For uncertain head holding, it is necessary to regularly, 8-10 times a day, lay the baby on his stomach on a hard surface before feeding. In addition, exercises on an inflatable ball (putting the baby tummy on the ball and roll. Well strengthens muscle tone also a course of general tonic massage.

Post date: 29.10.2011 01:36

ksyusha

thank you again. We will definitely buy a ball and use the rest of the recommendations. Health to you!

Post date: 15.05.2012 16:14

yulia

please tell me, my son had an ultrasound scan of his head for 4.5 months, and we were told that he had a m / n gap of 6mm, at a rate of 5mm, how should we be in this situation, it is necessary to treat it somehow ... and they also advised to make control in speakers .. thanks for your reply.

Post date: 17.05.2012 22:06

Papkina E.F.

Julia, if there are no other changes in the ultrasound scan and in the development of the child, then a small expansion of the MPS is not dangerous.

Post date: 31.05.2012 05:51

Tatyana

Hello, we have an extension all the way up to 2.4 mm, we are 2 months old, should you worry about this?

Post date: 03.06.2012 22:05

Papkina E.F.

Tatyana, this is the norm.

Post date: 06.06.2012 18:34

a guest

Hello! my son is 1.5 months old, in the maternity hospital there was a chin trimmer while crying, we got magnesia pierced, everything went away. after discharge, after 2 weeks, the same thing began, and in a calm state the child sometimes shakes his chin. At the first examination, the neurologist sent me for an ultrasound scan. the conclusion of the ultrasound showed the expansion of the MPSH and something else (it is illegible written there). the doctor prescribed treatment for asparkam, pantogam and hypothiazide for a month. having diagnosed us with intracranial pressure. tell me what is the expansion of the mpsch and is the pressure dangerous at this age ????

Post date: 27.07.2012 10:53

a guest

Hello! My son is 4 months old, the expansion of the MPSH is 5.0 mm, diastasis is hm / bone D 5.2 S 4.8 mm, the third ventricle is 3.8 mm. PRB Zh on the left 3.4mm on the right 4.3mm. The diagnosis was enlargement of the BEM, dimetaia of the PAD, expansion of the third ventricle. Impaired resorption. No treatment was prescribed. Control at 6-7 months. What to do??

Post date: 14.08.2012 10:12

Yulia

Good day! Our son is 3.5 months old, today an ultrasound of the brain was done, in the conclusion it is indicated that the expansion of the interhemispheric gap is 9mm. How can you get rid of this? What are the best treatments? thank

Post date: 18.08.2012 19:40

Papkina E.F.

Dear Parents! Expansion of the MPS and the 3rd ventricle is a manifestation of the transferred hypoxia and moderate intracranial hypertension. Treatment without examination is impossible, consult a neurologist in person.

Post date: 30.08.2012 09:26

OLGA V.

Hello! My son is 2 months old, they did an ultrasound of the brain, they said that the expansion of the interhemispheric gap \u003d 10.6 mm and intracranial pressure. At birth, og \u003d 36 cm, and at 2 months \u003d 42.5 cm, while height \u003d 60 cm, and weight \u003d 6065g We went to a neurologist, he prescribed us to drink Diacarb + Asparcam + Cavinton. Vaccinations were postponed for a month. With ultrasound, the ventricles are normal. The pediatrician said that we have all the indicators of growth, weight and og correspond to a 3-month-old baby. that childbirth was very difficult by an emergency caesarean section, there was hepoxia, the baby was born blue, but immediately screamed, on the Apgar scale-8/9 points. The baby is calm from birth, sleeps well at night, wakes up only to eat and continue to sleep, observes objects , walks, tries to get toys with his hands, holds his head, but the truth is not long. Please tell me how absurd is the deviation from the norm of the interhemispheric gap in our situation, and whether the doctor prescribed the treatment correctly and is it necessary at all? now 7 years old, viewer I took her card and in 1 month og \u003d 42cm, and they didn’t send us anywhere and we didn’t do any neurosonography, unlike the second child, she was restless, and nothing grew up a healthy girl and by the year the spring had healed. What should I do in this situation, I ask help? Thank you in advance!

Experts under the interhemispheric gap mean the gap between the hemispheres of the human brain. With timely development, newborn children do not have problems with well-being and adaptation to the world around them. Timely diagnosis of deviations and proper treatment are of great importance for babies.

For small patients on ultrasound, the size of the interhemispheric gap is often checked

In this article, you will learn:

What is the interhemispheric gap

In the process of studying the child's brain using ultrasound, tomogram, neurosography, specialists can detect pathological changes, and the parameters of the interhemispheric gap are also assessed. The gap should not be more than 3 mm - this is the normal anatomical characteristic of the child.

In newborns, the gap between the cerebral hemispheres can exceed the standard values \u200b\u200bfor the following reasons:

Accumulation between the hemispheres of fluid.
Illness of a woman while carrying a child.
Delivery by cesarean section.

How its size is estimated

It should be emphasized that the distance between the hemispheres of the human brain, which does not exceed the standard values, does not belong to pathology - this is the anatomical characteristic of a particular child.

The interhemispheric fissure can be of different sizes

To detect deviations in the dimensions of the interhemispheric fissure, neurosonography is performed. In the process of diagnostics, ultrasound sensors are used, the study is carried out through the temporal region, anterior or posterior fontanelle. Modern diagnostic research is indicated for children under one year of age. During the examination, ultrasound imaging of the brain is clearly monitored.

How is the procedure performed

As soon as the baby reaches 1 month of age, this procedure is performed as part of a screening diagnosis. Repeated examinations are carried out at 3 and 6 months of age.

You should not be afraid of such a diagnostic procedure. For a child, it does not pose any danger, in time it does not take more than 10 minutes. Diagnostic examination is performed by a highly qualified doctor who is able to interpret the information received. In the conclusion, if necessary, a list of additional studies is prescribed.

During the diagnosis, the child does not undergo unpleasant or painful procedures; there is no need to recover from the procedure. Therefore, parents should not have any concern about the diagnostic examination.
Indicates deviations
If your child develops any of the following symptoms, see a doctor immediately:
Restless and short-term sleep.

Strong crying and restless sleep can talk about problems.
Increased arousal.
Harsh sounds provoke loud crying or screaming.
With fluctuations in atmospheric pressure, anxiety arises.

An increase in the interhemispheric space is one of the possible signs of serious abnormalities. During the diagnostic examination, a connection is established between this indicator and other clinical nervous manifestations.
What is the tactic for deviations
Before starting treatment, the interhemispheric gap should be determined. If the doctor prescribes neurosonography, the parameters of the interhemispheric fissure should be established during the examination.
Treatment is not prescribed if an isolated increase or slight expansion of the gap is detected. This condition does not pose a health hazard to the newborn. In other situations, treatment is prescribed without fail.
In this video, you will learn all about conducting brain ultrasound in young children:
If an accumulation of fluid is found between the hemispheres of the brain, complex treatment with the following drugs is recommended:
For vitamin D deficiency, vitamin D
To replenish Mg and K in the body - Asparkam.
A product designed to remove accumulated liquid.

Pay attention to the fact that an enlarged interhemispheric gap does not indicate the presence of intracranial hypertension in a newborn.

When, in the process of diagnosis, an enlarged interhemispheric gap is found, and the child develops in accordance with his age, while there are no health problems, one should not panic and be nervous about this. In this situation, timely scheduled examinations by specialists are required.

With the advent of scientific progress in our life, more and more new methods of researching the human body appear. One of these studies in infancy is neurosonography - the study of brain structures using ultrasound through ungrown fontanelles.

However, looking at the sheet describing the results of an ultrasound scan, you involuntarily get scared when you see a lot of unfamiliar words and incomprehensible numbers standing next to it. What do they mean? The answer can be given by a competent specialist when deciphering the results, as well as a neurologist. One of the indicators that can be alarming is the expansion of the interhemispheric gap in the baby. How dangerous this condition is and whether it needs to be treated somehow - let's figure it out.

About the gap between the hemispheres

There is a gap between the cerebral hemispheres, the anatomical dimensions of which are on average up to 3 mm. But some of the children may have more - then in most cases they talk about the anatomical features of development.

Of course, if the interhemispheric gap is expanded, and besides, it is filled with fluid, this may indicate the development of diseases such as rickets, intracranial pressure, hydrocephalus. But the diagnosis is never made on the basis of only the data of the results of neurosonography. The clinical picture as a whole is taken into account.

The doctor may ask the following questions:

how the child sleeps, how many hours a day, at what interval he wakes up;

how often the baby spits up;

how restless his behavior is, are there any causeless tantrums lasting more than 5 minutes;

whether the baby reacts to changes in atmospheric pressure, whether sharp sounds frighten him, how things are with reflexes;

whether the baby has signs of rickets: enlarged fontanelle, large forehead, smooth nape (without hairs).

With the help of neurosonography, you can look into the brain of a child, however, it is important that the results are correctly decoded, otherwise the study loses its meaning

Also taken into account (with their persistent increase there are reasons to suspect the development of hydrocephalus), the condition of the skin (is there a marble pattern), how well the fontanelles are overgrown, whether there is strabismus or Graefe's symptom, when the eyes roll in such a way that the white of the eye is clearly visible.

Reasons for increasing the gap

So, an enlarged gap in a baby, exceeding the so-called norm, can manifest itself as a hereditary feature transmitted from parents or close relatives.

It can also occur due to:

fetal hypoxia during pregnancy;

accumulation of fluid between the cerebral hemispheres;

, for example, during a caesarean section or during labor with obstetric benefits.

Do I need to treat

Often, mild expansion of the gap does not require any treatment.

Therapy is not carried out even in the case when an increase in the interhemispheric gap in an infant is the only disturbing factor.

When identifying symptoms accompanying the clinical picture of a disease, various groups of drugs can be prescribed.

For example, with signs of rickets and a newborn living in a climatic zone where there is little light, an additional intake of vitamin D is prescribed.

With symptoms of the development of intracranial pressure, special light diuretics are prescribed to facilitate the outflow of fluid from the brain structures. In parallel, Asparkam or Diacarb (potassium preparations) are taken to prevent the development of hypokalemia and hypomagnesemia.

The well-being of a child is one of the most important indicators of his health.

In addition, the neurologist may consider it necessary to take vascular
drugs that improve cerebral circulation, and a sedative at night. But this is only if there are warning signs that indicate neurological disorders.

It is worth noting that the baby's “bad sleep” itself is treated primarily not with drugs, but by normalizing the daily routine. It is very important that there are daily walks in the fresh air, and that the room where the child sleeps is cool and fresh. It is necessary to analyze how calm the atmosphere in the house is: whether there are frequent quarrels, the habit of listening to music loudly or watching horror films - all this can negatively affect the psyche of the baby.

So, if in the conclusion of an ultrasound of the brain it is noted that the interhemispheric gap in a child is enlarged, this is just a statement of the fact that it is wider than usual. The diagnosis of a specific disease is made not only on the basis of neurosonography, but also on the basis of specific complaints, real changes in behavior.

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