Patent foramen ovale. Such a diagnosis parents hear about one of the three hundred crumbs. This diagnosis is based on ultrasound examination of the heart of the child. Of course, any mom and dad are just stunned to hear such a diagnosis from a doctor. They appear dozens of wide variety of concerns and questions, such as why it happened, whether to go on their own, and how soon, what the consequences might be, who is to blame and what to do?

And the anxiety of parents is absolutely clear and natural - in fact the child's health is always at the first place any mom and dad. I would like to reassure parents at once - do not engage in self-flagellation, in fact provide for the possibility of such anomalies in advance, even with all the great desire, quite simply impossible. And the second - no matter how unpleasant was not the pathology, it does not represent a direct threat to a child's life.

What is a patent foramen ovale?

The doctor should tell parents in detail about all the nuances of the cardiac anomalies. However, in practice, unfortunately, it is not always. For some reason, many doctors mistakenly believe that this information does not need parents. And the parents are either in painful ignorance or their own trying to find information from various sources, sometimes not quite right.

It is for these parents and this article was written. After reading it, you will have enough information to allow you to have an accurate idea of ​​what is happening with your child, and how he can help.

So, what is a patent foramen ovale? This term doctors call the cardiac anomaly in which either fully or partially, but kept the communication between the right and left atrium, which exists in any child during fetal development. The blood supply to the baby during fetal development occurs with a wide oval window in the center.

After pipsqueak born and will make his first breath, the pressure between the atria radically changed. With the right edge of the child's development of a wide oval window fused with the edges of the valve. At about six months old baby oval window closes completely in about half of all kids. Another 30% of children closure of patent foramen ovale occurs at the end of the first year of life.

In all other cases, the closure of the PFO can occur spontaneously, and at any time. According to medical statistics and the observations of doctors - cardiologists, approximately 15 percent of adults diagnosed as patent foramen ovale.

Symptoms of this disease

As a rule, in most cases, the presence of a child PFO does not show any symptoms themselves. It is revealed most completely by chance during a routine ultrasound. But still there are some nuances, which experienced doctor - a pediatrician may suspect that the child may be present this heart disease:

• In the event that during exercise, as well as coughing or crying, the child appears even only slightly pronounced cyanosis. For reference: the purchase of the skin called cyanosis of the lips and nasolabial triangle, as well as any of the mucous membranes a bluish tint.
• Common diseases child colds or inflammatory diseases of the respiratory system - the bronchi or lungs.
• Slowing the pace of normal physical development, especially pronounced.
• The inability of the child to any physical activity, especially if there is respiratory failure.
• Child systematically loses consciousness, or he has symptoms of cerebral circulation.

If the doctor will have - or a suspicion of patent foramen ovale, it is sure to send a child on ultrasound of the heart, and consultation with a doctor - a cardiologist.

Two views on one issue

There are two points of view of physicians to the problem of patent foramen ovale in children. Supporters of one of the versions are firmly convinced that the patent foramen ovale completely harmless phenomenon that requires absolutely no attention from the doctor - a cardiologist. And even more so, it should not become a cause for concern and panic parents. Proponents of this view believe that for a given cardiac hemodynamic abnormality occurs. A respectively, and the surgical intervention for correction has no sense justified.

Supporters of different point of view believe that this cardiac anomaly clearly demonstrates that the child, whose patent foramen ovale, a much higher risk of developing conditions that threaten a child's life, such as embolism. However, experience shows that children with patent foramen ovale such complications occur more frequently than in healthy children.

The only case in which the risk of such complications is really largely increases - if the child is professionally engaged in some kind of sport. This happens due to the fact that psycho-emotional and physical activity are largely exceed the position of the child by age norms.

Another case in which the risk of developing complications of the Open-oval window may increase - if the child is, among other things, there is such an anomaly of the heart as an aneurysm inter-atrial septum. In this case, the probability of occurrence of cardioembolic complications increases by at least 50%.

What to do?

So, the doctor made the necessary examination of the child, which was based on an accurate diagnosis, "foramen ovale". The most important question that needs to be discussed and parents cardiologist - what to do? What measures will take the doctor, and what should be the line of conduct of parents, if the crumbs discovered the pathology of heart?

Usually, the doctor chooses the following tactics like little patient. The child should be kept under strict supervision of a doctor - a cardiologist. Parents should keep in close contact with your doctor - a cardiologist, telling him all, even very small changes in the status of the child.

About once a year, a child must pass a study that will help to establish the exact size of the oval window. In that case, if the size of the oval window begin to decrease, the doctor will continue to take a wait and see policy. Sooner or later, in such cases, the oval window all by itself is completely closed

In the same case, if it is for some - any reason does not happen for a long time, your doctor may decide on the need for surgical intervention which is intended to artificially close the window.

I would like to appeal once again to moms and dads whose children have revealed patent foramen ovale, for calm. Panic is never a good helper!

Your pipsqueak finally to you. Mom and Dad with adoration and a certain amount of trouble looking at the crumbs. And this concern is understandable - little kids are exposed to various plagues and diseases. And one of these evils is the increased intracranial pressure. In our country, pediatricians love to put such a diagnosis, just for reassurance, not carry out the necessary examinations.

But at the heart of increased intracranial pressure, as a rule, are rather serious disease that requires immediate treatment. Otherwise, the child will only get worse, because the treatment of intracranial pressure is meaningless if not eliminated the source - the disease itself. In most cases, the increased intracranial pressure is a consequence of the disease, as hydrocephalus brain.

What is hydrocephalus?

Hydrocephalus is popularly called brain edema. Hydrocephalus volume brain ventricles increases, often very significant. The baby's brain is organized as follows: it has a number of cavities, called the ventricles, which communicate with each other. These cavities are filled with cerebrospinal fluid - liquor.

In the case of liquor produced too much, it accumulates in the cavities of the brain. This fact leads to the development of dropsy of brain, or hydrocephalus. Moreover, the greater the excess fluid, the more pronounced the disease, and the more general health suffers child and his brain.

Hydrocephalus is of several types, depending on the location of liquor. In that case the liquor can not fall from one to the other ventricle, hydrocephalus is called occlusive or unreported. If the liquor is free to move from one ventricle to the other, called hydrocephalus communicating and whether open.

In addition, hydrocephalus can be a major disease - primary or secondary: the result of other diseases, such as congenital malformations of the central nervous system, blood vessels of the brain, tumors of different nature backgrounds. There is still quite a large number of varieties of hydrocephalus, but they are all derivatives of these basic types.

Symptoms of hydrocephalus

It goes without saying that the malabsorption of cerebrospinal fluid and its circulation can not pass unnoticed to children's health. And the manifestations may be very different in different children, especially different age categories - up to two years, and after two years of age.

Symptoms before the age of two years:

The most important sign that a child is suffering from hydrocephalus, a rapid growth of head circumference. This happens due to the fact that the sutures of the skull in a small child not yet grown together, and the bones apart expands brain. There is approximately the same as when the balloon is inflated, but in the brain instead of air is excess water.

As you know, until the child reaches one year of age need to come to the pediatrician for a check once a month. The compulsory examination included measurement of head circumference. The doctor is a graph of growth of head circumference, with which you can track the increase in head circumference.

The most common cause of abnormal increase in head circumference is precisely hydrocephalus. In addition to the very rapid growth in head circumference of hydrocephalus may indicate changes in a large fontanelle - it increases in size and bulges excessively. Normally fontanelle should be closed to the age of one year, but if the child is suffering from hydrocephalus, fontanelle may be open in two years.

If you are interested in the look of hydrocephalus in children, a photo will help you get an idea. Varying proportions of the head - the skull bone is much thinner, resulting in the forehead increases and baby steps forward, becoming disproportionate. Under the skin of the forehead and the face is clearly visible venous network. If the disease continues to progress, eyes crumbs begin to descend, increases muscle tone of arms and legs.

There is a clear lag in the psychomotor development of the child:

• The child begins to hold the head in due time.
• The child begins to sit alone and even to attempt to sit down.
• The same goes for attempts to get up on their own.

A child suffering from hydrocephalus brain, sluggish, he is not of interest to anything around, often suddenly starts crying for no apparent reason. Doctors suggest that the child often feels headaches as a pipsqueak often grabs his head.

There is a huge number of different symptoms of increased intracranial pressure. However, most of them are able to recognize only experienced doctors - a pediatrician, neurologist or neurosurgeon. The only thing that the power of parents - is independently measured the circumference of the baby's head and mark a change in his behavior and psychomotor development. In that case, if the parents and the district pediatrician notice any abnormalities in the growth and development of the child, this should be a serious cause for a complete and thorough examination of the child. This examination is necessary to exclude the presence of a child hydrocephalus.

Symptoms of hydrocephalus in children older than two years of age:

If hydrocephalus develops in children older than two years of age, symptoms of the disease looks a little - other than babies. The most classic symptom of increased intracranial pressure in children older than two years is a constant headache, accompanied by nausea and even vomiting exhausting. Most often this phenomenon is observed in the night and morning hours. In addition, a child suffering from hydrocephalus, often occur pathological changes of the fundus, due to the fact that the child comes papilledema. Such violations easily detected on examination of the child doctor - ophthalmologist.

Parents should always remember that any headaches in children, and especially those that are accompanied by nausea and vomiting, are almost always terrible symptoms that require immediate examination of the child doctor - neurologist or neurosurgeon. After hydrocephalus is not the only possible cause of these symptoms. Nausea and vomiting can be caused by a variety of tumors and malformations of the brain.

Tragically, pediatricians often just simply overlooked this fact. As a result, the child gets it absolutely right treatment of diseases such as pancreatitis, gastritis, dyskinesia of the gallbladder, poisoning and other gastrointestinal disease. As a result, the child goes to the doctor - neurologist only when it becomes clear to doctors that the treatment failed. But valuable time has been lost, the disease can take the form of running, and the treatment will be much more difficult and less productive.

In that case, if the parents notice their child have these symptoms, they should insist on the immediate examination of the child by a neurologist. In that case, if the disease is diagnosed in the early stages, the prognosis is much more favorable than in advanced forms. And sometimes only timely diagnosis can save the life of a baby.

There are a number of symptoms that may indicate the presence of a child hydrocephalus. These symptoms include epileptic seizures, increased tone of the arms and legs, incontinence, impaired vision. Furthermore, frequent hydrocephalus various disorders of the endocrine system: lead or lag in growth, precocious puberty, obesity.

Causes of Hydrocephalus

Of course, knowing that their child is sick hydrocephalus, they begin to wonder, "Why? ". Clear answer to this question is simply impossible. The following are the main reasons leading to the development of hydrocephalus:

• Fetal Hydrocephalus

The level of modern medicine is quite high, and modern methods of prenatal diagnosis allows doctors to identify the fetus hydrocephalus. For example, ultrasound diagnosis reveals hydrocephalus brain already at 16 - 20 weeks of pregnancy. Most often hydrocephalus in utero cause intrauterine infections such as herpes, toxoplasmosis or cytomegalovirus.

That is why, when planning a pregnancy, it is important to pass all the tests for latent infection, and, if necessary, pass the appropriate course of treatment. This measure will help you prevent a huge number of health problems in the crumbs, and not just the risk of hydrocephalus. In more rare cases, hydrocephalus may develop due to genetic predisposition.

• Hydrocephalus Zippers

The cause of hydrocephalus of the brain in newborn infants in 90% of all cases are congenital malformations of the brain or spinal cord, as well as transferred intrauterine infections. Much less often, but it happens that the cause of hydrocephalus is the birth trauma, especially those crumbs that were born prematurely.

• Hydrocephalus in older children

In that case, if the development of hydrocephalus occurs in children over one year of age, the causes can be myriad. Such reasons may include: meningitis, encephalitis, infectious diseases such as, vascular malformations of the brain, brain injury, genetic disorders. Sometimes, unfortunately, reveal why hydrocephalus of the brain in children, in some cases, not possible.

Diagnosis of the disease

In order to diagnose hydrocephalus, the physician should interview the parents and the child to explore. After that, the crumbs will be a number of studies:

• NSG - (neurosonography).
• Computed tomography.
• Magnetic resonance imaging (MRI)
• Ultrasound examination of the brain. Held children under two-year-old.

Based on these data the doctor will put the correct diagnosis and choose is suitable for your child's treatment policy.

Treatment of Hydrocephalus

In that case, if the diagnosis of hydrocephalus is confirmed, the child just need to consult a neurosurgeon. In almost all cases, the treatment of hydrocephalus should be surgical. And it is able to identify both the neurosurgeon indications and contraindications for surgery. In case this is not done in a timely manner, adopt a chronic disease during running, and the treatment will be more difficult.

Of course, all parents worry about the upcoming operation. However, do not tighten too much with the decision. It constantly increased intracranial pressure leads to psychomotor retardation, which is not always possible to make up later.

Also, do not forget about the size of baby's head. As already mentioned, it leads to hydrocephalus, brain which the circumference of the head is constantly increasing. And after the surgery she will not return to the same size, and only cease to grow. And the longer you delay the operation, the greater the increase in size of your baby's head.

The sense operation is to move from the ventricles of the brain in which - or other body cavity, from where it is easily eliminated from the body. Most often used for this purpose ventriculo-peritoneal shunt. Doctor system assembles a kind of silicone catheters which CSF from the ventricles of the brain to the peritoneal cavity.

These operations each year not only to save hundreds of children's lives, but also allow the kiddies like to lead a full life: to attend kindergarten, school.