INTRACRANIAL HYPERTENSIA

Clinic. Rising of intracranial pressure is characterised first of all by occurrence of headaches or intensifying already existing. Originally headaches are expressed weakly and changeably. However further, in process of rising of intracranial pressure, their force accrues, and light intervals between attacks become shorter. As a result headaches are stabilised. Pains amplify in the mornings, after a dream. Attacks of the strongest headaches are possible. Their intensity is sometimes so great, that the patient shouts, catches arms at a head. Quite often they are short and come to an end spontaneously. Such pains are typical for transient blockade likvo-roprovodjashchih ways (a tumour of ventricles of a brain). ultram 50mg
The nausea and vomiting are characteristic. Their intensifying coincides with the greatest expression of a headache though in some cases such dependence to note it is not possible. Vomiting can suddenly arise, for no apparent reason and feeling of a nausea previous it. Usually it does not depend on food intake. Giddinesses are possible.
Sometimes the mentality of the patient changes. It is braked, deafened, memory is weakened, the criticism is lowered. The patient hardly watches a course of conversation and hardly answers set questions. It is flaccid, indifferent also from time to time runs into a drowsy condition.
In serious cases pathological drowsiness, a sopor and even a coma are observed. Other patients, on the contrary, become irritable, quick-tempered, thoughtless, talkative. On occasion arise delirium and hallucinations.
On an eyeground congestive disks of optic nerves can be defined, is more rare - hemorrhages on a course of vessels. Sensations of misting and visual acuity depression are possible.
Vital functions change. So, pulse is slowed down or, on the contrary, is speeded up. The accruing bradycardia testifies to a progressing intracranial hypertensia. Breath becomes slowed down or accelerated. Its rhythm changes. In serious cases appear breath Chejna-Stoksa .
The general convulsive attacks are possible.
At a lumbar puncture the liquid follows under the raised pressure (frequent drops - more than 60 drops in a minute or a stream). However this sign not obligatory as at an edema-swelling of a brain and a disposition of its sites pressure of liquor in subarahnoidal th space of a spinal cord can be lowered.
The long rising of intracranial pressure estimated on months and more, is accompanied by changes of bones of a skull. In such cases on the excavation and expansion of vascular sulcuses, a thinning of bones of a skull or their divergence (at children), input expansion in a Turkish saddle, a dorsum sellae thinning are taped intensifying manual .
The originality of an intracranial hypertensia appreciably depends on the reasons of its occurrence which are extremely various.
It is known, that intracranial pressure even at the normal person varies and depends on many factors, and first of all from its position. It the greatest in a prone position, and in position standing can be even negative. Its tumours, disorder of a cerebral circulation, inflammatory diseases of a brain and its covers, a craniocerebral trauma can be the reason of rising of pressure an edema-brain swelling, etc. buy roxithromycin health
Superfluous clump of liquor in ventricles and a brain subarachnoid space, its plethora, the venous stagnation caused by difficulty of outflow of blood through bulbar veins or of venous sine, also can cause an intracranial hypertensia.
One of the frequent reasons of an intracranial hypertensia is the hydrocephaly.
Rendering assistance. At obvious signs of an intracranial hypertensia, irrespective of the reasons of its occurrence, it is necessary to prescribe first of all to the patient preparations. In urgent cases it is necessary to take advantage of intravenous introduction of Mannitum or urea.
Mannitum possesses the expressed diuretic property. It enter intravenously in the form of 10-15-20 % of a solution on an isotonic solution of sodium of Sodium chloridum or 5 % a glucose solution (till 40-60 a thaw in a minute) from calculation 0,5-1,5 g/kg of mass of a body. Urea also enter intravenously (30 % prepare a solution directly ahead of introduction on 10 % a glucose solution) with rate of 40-80 drops in a minute. At an intracranial bleeding urea to apply does not follow, as it promotes its intensifying.
If the urgent need in intravenous introduction is not present agents, it is possible to give inside Glycerinum - 40-50 ml on 100 150 ml of the cooled water or juice. action begins later 30-45 mines and lasts 4-6 ч. Within days it is possible to give Glycerinum in 3-5 times.
Good hypotensive action Furosemidum (Lasixum) possesses. It prescribe inside on 0,04 г once a day; intravenously or intramusculary on 2 ml of a solution of times of 1 % a day, in serious cases to 2 times.
Less expressed the effect is inherent in Fonuritum and its analogue Diacarbum which prescribe inside on 0,125-0,25 times a day within 2-4 days.
Quickly and strongly enough on wet brain Acidum etacrynicum (Uregitum) operates. It. inside, since 0,05 г to 0,1-0,2 г in the morning after food intake.
Intramuscular introduction of 25 % of a solution of magnesium of Zinci sulfas of 5-10 ml is shown.