Ventriculomegaly is an enlargement of the ventricles of the brain in the fetus. Special children are happy children! Signs of ventriculomegaly in infants

Publication date: 2014-09-20

Ventriculomegaly is a disease characterized by pathological changes in the fetal brain. As the disease progresses, the size of the ventricles may increase varying degrees, leading to neurological abnormalities and brain damage. Ventriculomegaly in the fetus is isolated or manifests itself as a defect that appears against the background of other pathologies.

Examination of the fetus reveals big sizes ventricles of the brain, which can reach up to 20 mm. Ventriculomegaly sounds like a death sentence for many pregnant women. In some difficult cases that threaten the death of the fetus and further mental disorders, the doctor raises the question of terminating the pregnancy.

Asymmetrical and right-sided shape - causes

The causes of ventriculomegaly in the fetus are associated with chromosomal abnormalities. They occur in almost 20% of pregnant women with various pathologies - obstructive hydrocephalus, physical trauma, infectious diseases, hereditary factors and hemorrhage.

Sometimes the problem associated with hydrocephalus is detected visually. The size of the head varies significantly from the girth of the chest (normally healthy baby the difference does not exceed three centimeters). If the head is too large and the chest girth is small, additional examinations will be required - clinical tests and ultrasound examination. Sometimes the diagnosis is made to be on the safe side, but over time the children begin to actively develop, and no complaints are received from the parents.

Ventriculomegaly is clearly visible during ultrasound examination, especially in the twentieth weeks of pregnancy. If the disease relates to the only pathology that has developed in the fetus, then the likelihood of serious chromosomal abnormalities is reduced, but if the same or is observed in the fetus, then this is already serious signal for the expectant mother. Possible development Brain diseases in a newborn are determined by the doctor depending on the size of the enlargement of the ventricles of the brain.

An accurate diagnosis is made using a transverse scan of the head. The prenatal diagnosis provider may have difficulty identifying the disease in infant, if during intrauterine development it had an isolated character. After diagnosis, 80% of children with moderate ventriculomegaly develop normally without deviations and lead a normal lifestyle. The remaining percentage of children may have minor developmental disorders or severe neurological abnormalities. In some cases, children with the syndromes do not live beyond the age of two. The overall percentage of mortality from the total number of all children suffering from pathology is about 14%.

Ventriculomegaly type of enlarged ventricles

Lateral. Characterized by enlargement of the left and posterior ventricle.
Pathology of the third ventricle is an increase in the area of the location of the visual tuberosities in the front of the forehead.
Pathology of the fourth ventricle - enlargement in the cerebellar region and medulla oblongata (rear end heads).

Ventriculomegaly has several forms, which determine the severity of the disease, and can also be asymmetrical and right-sided.

Mild type or moderate ventriculomegaly is sporadic. Usually, at this stage of the disease in a newborn, it is not necessary serious treatment. Moderate pathology causes dilatation of the ventricles to 10-12 mm.
The average type of the disease is characterized by enlargement of the ventricles up to 15 mm and causes changes in the flow cerebrospinal fluid.
At severe form the cerebral ventricles of an infant are significantly enlarged, which provokes the occurrence of various pathologies brain.

Treatment and consequences

Symptomatic prenatal treatment is necessary to prevent the development and consequences of the pathology. Prescribed by a neurologist and pediatrician drug therapy- antihyperoxidants, diuretics and vitamin complexes. For elimination neurological disorders drugs are introduced that retain potassium in the body. If the degree is mild and there are no developmental disorders in the infant, treatment may not be carried out. In extremely rare cases, surgical intervention is prescribed for cerebral hypertension.

With moderate ventriculomegaly, when appropriate treatment has been carried out, the risk of developing serious complications is practically eliminated. When the ventricles of the brain enlarge by more than 15 mm and hydrocephalus occurs, the consequences are sharply negative. Rapidly increasing fetal disease can provoke neurological abnormalities, sometimes incompatible with life.

Pathology in the fetus can increase significantly if other developmental abnormalities are present, for example. Against the background of ventriculomegaly, a newborn may develop Down syndrome, and other psychical deviations. The disease has direct influence on the structure of the brain, heart muscle and musculoskeletal system. Most dire consequences- intrauterine death of the fetus or severe disability of the child after birth. Treatment can prevent all of the above complications if the pregnant woman strictly follows all the doctor’s recommendations and undergoes a scheduled ultrasound on time.

Despite the serious consequences that ventriculomegaly can cause, there is a high percentage of favorable outcomes. It cannot be precisely determined, as is the risk of further enlargement of the ventricles of the brain. Nowadays, this pathology is diagnosed in many adults through computed tomography. At the same time, the person leads a normal lifestyle without deviations in health.

The term ventriculomegaly means a slight enlargement (dilatation) of the ventricles with a diameter of 10 mm or more. Prevalence: 0.5-1.5 per 1000 births (according to other sources, 1:500), on average, about 1% of children have this condition at some point in life.

The most common cause of ventriculomegaly is a change in the structure of brain tissue due to damage or developmental abnormalities.

Brief dictionary:

Ventricles are cavities in the structure of the brain filled with CSF (cerebrospinal fluid).
CSF or cerebrospinal fluid is a liquid substance produced by the choroid plexuses of the ventricles, serves to cushion and regulate the environment in the empty (unfilled with cells) space, demarcates the brain and spinal cord from the hard bone membranes.

In ventriculomegaly, cerebrospinal fluid accumulates in the ventricular system of the brain due to increased production or impaired outflow.

It is important to classify ventriculomegaly into types depending on concomitant findings on NSG or MRI:

isolated - an independent anomaly, not combined with other developmental defects;
associated - accompanies other pathologies nervous system.

Is ventriculomegaly dangerous?

No, a slight enlargement of the ventricles of the brain is not dangerous. Pathologies that cause changes in the process of cerebrospinal fluid circulation are harmful to health and an obstacle to full development.

Features of asymmetric ventriculomegaly

Asymmetric ventriculomegaly is unequal enlargement of the ventricles or an excess of cerebrospinal fluid in only one of them: right or left. For example, the size of the first (left) ventricle is 9.5 mm, and the second (right) is 12 mm. Asymmetry is recognized if one ventricle is 2 mm or more larger than the diameter of the other.

Asymmetric (or unilateral) ventriculomegaly accounts for about 60% of all cases. Bilateral occurs in only 40% of diagnosed children. Asymmetry is also observed with unequal enlargement of both ventricles.

Right- or left-sided asymmetry of the lateral ventricles - optional bad sign. With an isolated (mild) form of ventriculomegaly, it occurs more often than with an associated (statistically more dangerous) form.

Degrees

Degrees of ventriculomegaly:

light - 10-12 mm;
moderate (average) - up to 15 mm;
heavy - more than 15 mm.

Isolated ventriculomegaly easy or grade 1 has a favorable prognosis, the newborn will most likely not have developmental anomalies. Slight enlargement of the cerebral ventricles is usually random and benign, but can occur in genetic disorders and neurocognitive deficits, and is sometimes associated with structural abnormalities due to impaired neuronal migration in the fetus during embryogenesis. Mild ventriculomegaly is more common in boys (up to 75%) than in girls.

Moderate Ventriculomegaly also does not compromise survival, but increases the risk of neurological complications.

Heavy Ventriculomegaly is often associated with cerebrospinal fluid obstruction and represents hydrocephalus - an increase in cerebrospinal fluid in the ventricular system, accompanied by increased intracranial pressure.

The presence of ventriculomegaly indicates that something may be wrong in the brain structure, but without taking into account other pathologies detected visually or using instrumental diagnostics, this is simply a discrepancy with the standard norm. It may go away on its own.

Causes

Understanding the cause of ventriculomegaly makes it easier differential diagnosis. Enlargement of the ventricles can be considered as a variant of normal development (short-term failure), but sometimes it is a sign of mild, moderate and severe disorders, and the severity of pathologies of the nervous system cannot always be determined by the diameter of the cerebrospinal fluid spaces. For example, mild degree Ventriculomegaly is one of the signs of not only mild, but also some severe pathologies of the central nervous system.

Development option

The mark of 10-12 mm is most likely a normal development option, if the examination does not reveal other anomalies. It is important not only a postpartum examination, but also the diagnosis of pathologies of the central nervous system and/or other diseases during the period when ventriculomegaly is detected. You can refuse further diagnostics if there are no unexplained problems bothering the child.

Only 10% of fetuses with a slight enlargement of the cerebral ventricles (up to 1.2 cm) are diagnosed with concomitant anomalies after birth. The fact that ventriculomegaly is isolated can only be detected after birth. At prenatal screening, the doctor can only make assumptions that there are no other disorders.

Benign macrocrania (an enlargement of the brain portion of the skull without developmental anomalies) is associated with mild ventriculomegaly and is characterized by rapid growth head, but does not require treatment.

Structural anomalies

Disturbances in the structure of the brain that provoke the development of ventriculomegaly:

agenesis corpus callosum;
Dandy-Walker syndrome;
defects in the development of the fetal neural tube;
neuronal migration disorders;
gray matter heterotopia;
stenosis of the Sylvian aqueduct (a common cause of severe ventriculomegaly);
a brain tumor;
bleeding (posthemorrhagic ventriculomegaly);
choroidpapilloma (tumor formed from the epithelium lining the ventricles of the brain);
Choroid plexus cysts may cause transient dilatation of the ventricles, but due to their benign nature, ventriculomegaly is minor).

Some other developmental disorders of the central nervous system should not be confused with ventriculomegaly. They can be combined, but are not themselves accompanied by ventricular enlargement:

dysembryogenetic stigmas;
holoprosencephaly;
hydranencephaly;
schizencephaly;
porencephaly;
cerebellar hypoplasia;
arachnoid cerebrospinal fluid cyst;
Syringomyelia.

Infectious diseases

Congenital infections cause many cases of moderate ventriculomegaly:

cytomegalovirus;
toxoplasmosis;
Zika virus;
syphilis;
chicken pox.

In rare cases, the ventricles become enlarged under the influence of the activity of other viruses:

parotitis;
enterovirus type 71;
parainfluenza virus type 3;
parvovirus B19;
lymphocytic choriomeningitis.

Infection can cause isolated ventriculomegaly due to atrophy or fibrosis (overgrowth) of the soft tissue of the brain.

Genetic disorders

Some cases of mild and moderate ventriculomegaly are caused by an abnormal karyotype (often Down syndrome). Approximately 15%, according to foreign studies, are associated with chromosomal mutations. Enlargement of the ventricles accompanies some birth defects developments associated with defects spinal cord, heart or kidneys.

Signs

Newborns with ventriculomegaly do not usually experience symptoms specific to this condition. If the ventricles continue to enlarge, some of the signs listed below may appear:

head growth exceeds the age norm;
the contours of the skull are disproportionate (hydrocephalic head shape);
protruding fontanel;
prominent veins are visible on the forehead and temples;
difficult to look up;
The child always seems to be looking down (sunset syndrome);
developmental delays;
increased excitability or severe drowsiness;
poor appetite;
nausea, vomiting.

Based on the MR signs of ventriculomegaly (size of the ventricles) and changes in other cerebrospinal fluid spaces of the brain, one can assume the type of CNS anomaly.

Probable group of pathologies	What do the ventricles look like?	Associated findings on MRI
Gross malformations of the brain	Moderate to severe asymmetric ventriculomegaly	Narrowing of the septum transparent to 0.5-1 mm when the norm is more than 5 mm, expansion of the retrocerebellar space 2 times compared to the norm (6-7 mm)
Dysfunction of the midline and stem structures of the brain	Moderate enlargement of the ventricles, no or insignificant asymmetry	Narrowing of the septum pellucida and expansion of all structures containing cerebrospinal fluid: cerebral aqueduct, cistern magna, subarachnoid (subarachnoid) space
Isolated vascular disorders	Significant asymmetry of the cerebral ventricles with a moderate degree of enlargement	MRI signs of hemorrhages in the brain parenchyma, possible edema
Cysts, tumors of the posterior cranial fossa	Ventriculomegaly may be absent, but if present it is mild	Rapid expansion of the retrocerebellar space (can be tracked if an ultrasound, CT or MRI was done with a short break)
Arnold-Chiari malformation	40% of patients have severe ventriculomegaly, asymmetry is uncharacteristic	Narrowing of the retrocerebellar space to 0.2 mm and the convexital parieto-occipital subarachnoid space (a region in the angular gyrus of the left hemisphere in right-handers, and vice versa in left-handers) to 0.5 mm ( normal indicator: 3-4 mm)

Treatment

Treatment is prescribed only if there are neurological abnormalities or severe delay development.

Which doctors' consultations can help?

A radiologist, a genetic counselor (geneticist), a pediatric neurologist or neurologist, or a neurosurgeon with experience in diagnosing and treating ventriculomegaly can offer help.

What medications are used?

Pharmacological groups	Specific drugs
Diuretics (reduce brain swelling and reduce the amount of fluid in the ventricles)	For ventriculomegaly, Diacarb is often prescribed. Popular treatment regimen: 1 tablet/day. or 1/2 table. We drink twice a day on the principle of 3 days, skipping the fourth for several months. (indications, contraindications, what is best to combine with to reduce the risk side effects). Analogues - Furosemide, Veroshpiron, Lasix
Antivirals and immunomodulators	Amiksin, Cerebrum compositum, Timalin
Angioprotectors (prescribed if ventriculomegaly is caused by vascular disorders)	Emoxipin, Instenon, Neuromultivit
Nootropics	Cereton, Pantogam, Cortexin, Encephabol, Pantocalcin (for delayed speech development), Glycine
Antihypoxants	Actovegin, Cytoflavin
Drugs that promote myelination (protection of nerve cells)	Glycine, Gliatilin, Dibazol, magnesium preparations, Neuromultivit, Multi-tabs or vitamins A, B, E and C separately

Operation: who needs it and when?

The reason for consulting a neurosurgeon is head growth that is faster than normal (more than 1.4 cm per week). With a constant slow increase in the volume of the ventricles, they no longer speak of ventriculomegaly, but of hydrocephalus (a consequence of the continuous accumulation of fluid with difficulty in its outflow or due to increased secretion). Neurological and neurosurgical examination, measurement of head circumference and NSG for rapidly progressing ventriculomegaly/hydrocephalus are carried out 2 times a month.

On a note! For occlusive hydrocephalus, diuretics are inappropriate.

Quickly reduce intracranial pressure(without surgery) can be done using several procedures (performed by a doctor in a treatment room or ward):

ventricular (access through the fontanel) or lumbar puncture;
external ventricular drainage (provided antibacterial therapy can be used for 1-2 weeks);
subgaleal drainage (creating a pocket between the bone and the external soft tissues, drainage of cerebrospinal fluid into the resulting cavity through a silicone tube, periodic sampling of the contents using a syringe).

All these procedures are carried out under local or general anesthesia, are low-traumatic, and allow you to achieve the desired result - evacuation of cerebrospinal fluid, but temporarily.

The best and most reliable way to relieve severe ventriculomegaly that has developed into hydrocephalus is shunt surgery. An additional pathway for the outflow of cerebrospinal fluid is artificially created.

Operation options:

ventriculoperitoneal shunting (diversion of cerebrospinal fluid into the abdominal cavity);
ventriculoatrial shunt (CSF diversion into the right atrium).

If doctors recommend surgery for a child, it is worth checking whether it is possible to perform endoscopy - the creation of natural ducts in the brain without implanting shunts. The most gentle way surgical correction progressive ventriculomegaly with a minimum of complications.

Consequences

The prognosis of infants with ventriculomegaly varies significantly and depends on the presence of structural or genetic disorders, infections, and the degree of dilatation of the cerebral ventricles. With mild isolated ventriculomegaly, a favorable outcome can be expected. A meta-analysis in the journal Ultrasonography in Obstetrics and Gynecology showed that the incidence of neurological abnormalities in children with this diagnosis is no more than 8%, which is similar to the average level in the population.

With moderate isolated ventriculomegaly, a favorable prognosis, according to various sources, has 75-90% of children. If after comprehensive examination no other pathologies are identified, one can count on the absence of problems in the future, however, such children require periodic monitoring of the state of the central nervous system due to the risk of neurological consequences.

The prognosis for ventriculomegaly combined with other anomalies depends primarily not on the degree of ventricular dilatation, but on the nature and course of the diseases that caused the accumulation of cerebrospinal fluid. The lack of progression and development of the child by age casts doubt on the real risk associated with the characteristics of brain development, since more than 90% of children in this case do not suffer from the consequences of early age pathologies.

The best result (no consequences in 98% of cases) is observed under the following conditions:

the ventricles are slightly enlarged (up to 15 mm);
there are no echo signs of other anomalies;
satisfactory results of genetic testing.

Ventriculomegaly in the fetus is pathological condition, characterized by a change in the size of the cerebral ventricles and can cause the development of various types of diseases in a child, as a result of which the central and peripheral nervous system is affected: in particular, the spinal cord and brain, cranial and peripheral nerves, nerve roots, autonomic nervous system, neuromuscular nodes and muscles.

Prerequisites for the development of ventriculomegaly

Normally, each person has four cerebral ventricles. Two of them - ventriculi laterales (telencephalon) - are located in the thickness white matter: below the corpus callosum, symmetrically on both sides of the midline. Communication with the third of the ventricles - ventriculus tertius (diencephalon) - is carried out through the Monroe (or interventricular) foramina.

The third of the ventricles is located between the visual thalamus, it has the shape of a ring, and in its walls, formed by the gray matter of the brain, there are subcortical autonomic centers. Through the cerebral aqueduct of the midbrain, it communicates with the fourth ventricle - ventriculus quartus (mesencephalon), which is connected to the central canal of the spinal cord.

The main function of the ventricles of the brain is the synthesis of cerebrospinal fluid (CSF), which then, if there are no malformations, enters the subarachnoid (or subarachnoid) space. Impaired outflow of cerebrospinal fluid provokes the development of ventriculomegaly.

Causes of ventriculomegaly

Ventriculomegaly corresponds to an increase in the cerebral ventricles from 12 to 20 mm. In this case, the condition can be observed both in isolation and against the background of other developmental defects. It should be noted that dilatation of the ventricles of the brain, which is an independent disorder, is quite often not accompanied by chromosomal abnormalities in the child.

The main cause of ventriculomegaly in the fetus is genetic diseases and chromosomal abnormalities in women whose pregnancy is complicated by various pathologies. In addition, there is a certain relationship between the enlargement of the ventricles in the fetus and the age of the expectant mother: for example, in women over 35 years of age, the risk of giving birth to a child with ventriculomegaly is three times higher than the same outcome in younger mothers.

Other causes of ventriculomegaly include:

Intrauterine infections;
Physical injuries;
Obstructive dropsy of the brain (obstructive hydrocephalus), developing against the background of obstruction (blockade) of the outflow tract of cerebrospinal fluid at the level of the cerebral ventricular system;
Hemorrhage (bleeding);
Fetal hypoxia;
Lissencephaly;
Destructive brain damage (for example, due to perivericular leukomalacia);
Hereditary predisposition.

Ventriculomegaly is a prerequisite for the development in a child of diseases such as Down syndrome, gonadal dysgenesis (Bonnevie-Ulrich syndrome), trisomy 18 (Edwards syndrome). In addition, the pathology affects the function of the heart, causes disorders of the musculoskeletal system and all structures of the brain.

Ventriculomegaly is usually detected in the fetus during the procedure ultrasound examination even in the period between 17 and 34 weeks of intrauterine development. However, the data obtained from ultrasound are not enough to make a final accurate diagnosis. Therefore, to begin with, a recommendation is given to undergo a repeat examination, which will allow us to evaluate the development of the fetus over time (as a rule, it is carried out 2-3 weeks after the first ultrasound). Based on its results, the pregnant woman is additionally sent for a consultation with a geneticist and to undergo a fetal karyotyping procedure, thanks to which it is possible to identify possible deviations in the structural structure and quantitative composition of chromosomes.

Types of ventriculomegaly in the fetus

Ventriculomegaly is usually divided into three different types:

Mild ventriculomegaly - which is characterized by a single lesion and does not require serious treatment;
Average ventriculomegaly – characterized by an increase in the size of the ventricles up to 15 mm and causing certain disturbances in the outflow of cerebrospinal fluid;
Severe ventriculomegaly is characterized by a pronounced enlargement of the cerebral ventricles, which is observed in the fetus against the background of other brain pathologies.

In general, one of the characteristics of the human brain is that its ventricles are somewhat asymmetrical. This asymmetry is determined during gestation. As a rule, in male children the differences are slightly more pronounced than in female children.

The term "borderline ventriculomegaly" is used when the width of the atrium lateral ventricle ranges from 10 to 15 mm. This condition greatly increases the risk of developing all kinds of anomalies in the central nervous system, as well as other systems and organs.

Isolated borderline ventriculomegaly in most cases is not accompanied by any clinically significant consequences, however, in some situations it is considered as one of the manifestations of initial brain damage caused by negative effects various reasons: malformations of the brain, its destructive lesions, infections, fetal hypoxia during intrauterine development, etc.

Consequences of congenital ventriculomegaly

Perinatal mortality caused by severe intrauterine growth retardation, premature birth, or previous intrauterine infection, is 4%.

Also, in 4% of cases, newborns have various kinds of chromosomal abnormalities.

9% of newborns are born with vascular malformations of the brain.

In another 11% of cases, mental retardation and mental retardation are diagnosed against the background of congenital ventriculomegaly. physical development, the severity of which can vary from mild to medium degree gravity.

Moreover, the risks of developing an unfavorable neurological outcome of ventriculomegaly for a female fetus are higher than similar risks for a male fetus.

Treatment of ventriculomegaly

Treatment for ventriculomegaly is aimed at preventing negative consequences pathologies, including various serious illnesses brain and central nervous system.

When the cause of the disease is infection, the goal of the prescribed therapy is to eliminate it. If the manifestations of the pathology are mild or moderate, specific treatment, as a rule, is not required, since similar condition rarely causes disruption of intrauterine development of the fetus.

If it is still shown drug treatment ventriculomegaly, pregnant women are prescribed:

Diuretics;
Antihypoxants;
Vitamins.

Ventriculomegaly therapy is supplemented with massage and a set of physical therapy exercises that involve static loads on the pelvic floor muscles.

Galimova Rezeda Maratovna, pediatric neurosurgeon, Ph.D.

According to the number of questions sent to the mail and blog, I get the impression that doctors in our country are not familiar with this concept: all babies with slightly enlarged ventricles are diagnosed with hydrocephalus (there are its amazing forms and variants, which are sometimes not included in the classification), and a life-saving treatment is prescribed diacarb for months and periodically a neurosonographic study is performed, bringing the parents to an extreme degree of fear. This post is painful because I’m tired of responding to such messages.

Let's define the terms.

Hydrocephalus is a dynamic process of ventricular expansion with a certain clinical picture if there are no complaints or neurological disorders for a long time, but according to the NSG, the sizes of the ventricles do not fit into standard indicators- This ventriculomegaly. Isolated ventriculomegaly - changes are detected only on the side of the lateral ventricles without pathological changes on the part of the brain parenchyma.

Let's decide on the sizes.

Ventriculomegaly is diagnosed in a child when the size of the lateral ventricles is more than 10 mm! Values up to 10 mm are the norm!

Ventriculomegaly is divided into three degrees:
light - 10-12 mm
moderate - 12-15 mm
pronounced - more than 15 mm

Reasons for development.

Approximately 2% of newborn babies are diagnosed with this condition. The reasons for the development are different. There are idiopathic and symptomatic ventriculomegaly.
Idiopathic - the cause of development is unknown with a wonderful pregnancy and healthy parents.
Symptomatic - with genetic, chromosomal abnormalities, transferred infectious complications, fetal hypoxia, hemorrhages, structural pathologies of the brain.

Diagnostics.

Intrauterine diagnosis is carried out using ultrasound examination of the mother. In cases of severe ventriculomegaly, fetal MRI is recommended. Subsequently, the frequency of ultrasound examinations is once every 2-4 weeks, depending on the progression of the process.

After the birth of the baby, neurosonography in a maternity hospital and at the age of one month in a clinic. If the process has stabilized, further execution The NSG makes no sense. Fluctuations of 2-3 or 3-4 mm are not a statistically reliable indicator negative dynamics. In this case, we remember that neurosonographic research is a rather subjective method and much depends on the level of the equipment and the qualifications of the doctor.

If severe ventriculomegaly is detected, consult a neurosurgeon and geneticist!

Therapy.

In the presence of isolated ventriculomegaly there are no indications for therapy! We're talking about ventriculomegaly, not hydrocephalus!

Outcomes.

According to our own observations and numerous studies analyzing the outcomes of isolated ventriculomegaly, with mild and moderate long-term results are favorable for children without the development of neurological disorders.
According to the analysis of Gagliotti P. (2005), where the neurological status of 176 newborns with various forms ventriculomegaly at the age of 2 years in 93% with mild degree, 75% with moderate and 62.5% with severe pathological changes were not determined. This indicates that even the presence of pronounced dilatation does not cause disturbances in most patients.

To summarize the post: Having received NSG data with numbers that do not fit into those written next to each other in brackets as the norm, we do not lose our heads and do not despair! We carefully monitor the child and ask the neurologist the right questions about the presence or absence of disorders. If everything is fine in the neurological status from the point of view of a professional, we rejoice and thank heaven for the miracle!

Other posts on the topic of hydrocephalus on the author's blog.

Ventriculomegaly – pathological change, in which the fetus experiences an increase in the size of the ventricles of the brain, leading to brain diseases and neurological disorders.

Causes

The disease may be isolated, or may be the result of a defect that is associated with other developmental pathologies. In the fetus, it is characterized by an increase in the size of the ventricles of the brain to 12-20 millimeters.

The main causes are chromosomal abnormalities observed in women who have pathologies during pregnancy. The cause may be physical trauma, obstructive hydrocephalus, infectious diseases, hemorrhage, hereditary factors. Ventriculomegaly in the fetus is a cause for the development of Down, Turner and Edwards syndrome. Pathology affects changes in the heart, brain structures, and musculoskeletal system.

Ultrasound can help identify symptoms. Signs begin to appear as early as 20-23 weeks of pregnancy. There are cases of pathology detection at the beginning of the third trimester.

It occurs in pregnant women who give birth after 35 years of age. Young women giving birth are less susceptible to this diagnosis. According to statistics, the disease occurs in 0.6% of cases.

Types

There are three main types of pathology:

the mild type is isolated. This type of serious treatment does not require;
the middle type is characterized by enlargement of the ventricles, their size reaches 15 millimeters. The disease occurs with slight changes in the outflow of cerebrospinal fluid;
the severe type is characterized by a significant increase in the ventricles of the newborn’s brain in combination with other brain pathologies;

Diagnostics

Diagnosis of ventriculomegaly is carried out at 17-33 weeks of pregnancy using ultrasound examination and spectral karyotyping of the fetus. The examination includes a complete study of the anatomical structures, especially the ventricular system of the brain.

A more accurate diagnosis is made on the basis of scanning the fetal head with the obligatory determination of the threshold value of the lateral ventricles of the brain. The disease occurs if the size of the ventricles is more than 10 millimeters.

Treatment

Treatment of ventriculomegaly is aimed at preventing the consequences that can cause this pathology. The most dangerous occurrence serious illnesses brain, central nervous system.

Drug treatment involves taking diuretics, antihypoxants, and vitamins. The doctor also prescribes massage, physiotherapy, which focuses on static loads of the pelvic floor and pelvic muscles.

Reception medicines, whose action is aimed at preventing the development of neurological disorders, is necessary for retaining potassium in the body.

If a disease is detected in a newborn, it is very difficult to predict how it will develop. In most cases, if the defect is isolated, the outcome of treatment will be normal. When the disease is combined in the fetus with chromosomal abnormalities, there is a high probability of developing severe neurological disorders.