Ischemia of the brain in a newborn is a pathological condition associated with insufficient intake of oxygen. Sharp constriction or blockage of small vessels adversely affects blood circulation. Regardless of the reasons, untimely started therapy leads to sad consequences.
Cerebral ischemia in newborns - what is it?
Up to 85% of all cases of ischemia are recorded during the neonatal period. At the same time about 70% of all pathologies occur even at the intrauterine stage of development. Ischemic encephalopathy is associated with the formation of a blood clot in a vessel that feeds the brain, or with insufficient development of the vessel itself. More often the disease is registered in children born before the prescribed time, premature .
As a result of impaired circulation, the brain lacks oxygen. In the place where there is a pronounced lack of it, areas of ischemia - damaged tissue are formed. The lack of appropriate medical care in the early stages leads to an increase in the volume of the affected tissue, increases the risk of hemorrhage in the brain.
Ischemia of the brain - causes
Often, cerebral ischemia in newborns occurs even in the last weeks of pregnancy, but it is possible to develop it in the process of birth. Among the main reasons for the development of pathology doctors distinguish the following:
- partial placental abruption or impaired blood circulation in it;
- pinching of the umbilical cord during passage of the fetus along the generic pathways;
- violation of peripheral blood circulation in the fetus;
- defects of the cardiovascular system;
- intrauterine hypoxia ;
- acute placental insufficiency;
- open arterial duct.
To provoke ischemia the factors connected with pregnancy are capable:
- toxicosis on late terms;
- multiple pregnancies ;
- water scarcity;
- prematurity.
Cerebral ischemia - degrees
A feature of the pathology is its early diagnosis - the disease is detected within a few hours after the birth of the child. The ischemia of the brain in a newborn is determined by the characteristic deviations in checking the reflexes. The result of the blood test shows an increase in the concentration of carbon dioxide, insufficient oxygen saturation. Depending on the clinical picture and the observed symptoms, the cerebral ischemia of the newborn is divided into 3 degrees.
Ischemia of the brain of 1 degree in newborns
Light ischemia or cerebral ischaemia of the 1st degree is characterized by the presence of mild signs of pathology. Symptomatic is present for the first 3-5 days, after which its self-elimination disappears. At an easy degree doctors fix:
- nervous excitement or, on the contrary, the oppressed state of the newborn;
- decreased muscle tone;
- intensification of tendon reflexes.
For a given degree of impairment, if it is not complicated by anything, doctors use expectant tactics. For a newborn, a dynamic observation is established, periodic reflex tests are performed, the general condition of the baby is evaluated. After 5 days, this ischemia of cerebral vessels in newborns disappears, the progression of pathology with proper therapy is rarely observed.
Ischemia of the brain in a newborn of 2nd degree
Cerebral ischemia of grade 2 in newborns occurs due to complex disorders during pregnancy and childbirth. In this type of pathology, doctors record the following symptoms:
- pronounced apnea (stopping breathing in a dream);
- decrease in reflex activity - grasping and sucking reflexes are violated;
- weak muscle tone;
- periodic loss of consciousness;
- lack of coordination;
- an increase in the volume of the head due to the accumulation of fluid in it.
Often cerebral ischemia in infants manifests itself in the first day of life, with distant symptoms of the disease can occur after 2-4 weeks. This whole period for the baby is closely monitored by doctors, a course of special therapy is being conducted. In some cases, in the presence of indications, an operative intervention to remove the blood clot, restore the patency of a blood vessel can be prescribed.
Ischemia of the brain of the third degree in newborns
This form of pathology has a marked symptomatology, so cerebral ischaemia of grade 3 in newborns is already determined at the 5 minute of life. Among the main signs of violation should be:
- complete absence of reflexes;
- development of coma;
- heart rhythm disorder;
- a sharp increase in blood pressure;
- violation of the breathing process.
For a given degree of disease, artificial ventilation is often required. The newborn is transferred to the intensive care unit, where he is constantly monitored. Timely and correct treatment helps to avoid serious consequences of the disease, prevent the development of complications, exclude the adverse outcome of cerebral ischemia in the newborn.
Signs of cerebral ischemia in newborns
Explicit symptoms of the disease make it possible to identify it at an early stage. Cerebral ischemia in children is accompanied by a vivid clinical picture. Among the signs that a young mother should pay attention to in the first days after the birth of a child, it is necessary to distinguish the following:
- the baby is easily excited, constantly crying for no apparent reason;
- poor sleep of the baby, wincing in a dream;
- the appearance of tremors of hands and feet;
- decreased motor activity;
- increase of springs;
- marble shade of the skin;
- convulsions, twitching of the head and limbs;
- disruption of the gastrointestinal tract: bloating, constipation, diarrhea.
Ischemia of the brain in newborns - treatment
Before treating cerebral ischemia in newborns, doctors conduct numerous studies to establish the cause of the pathology. Elimination of the factor that caused the disorder, excludes the development of relapse. The goal of the therapeutic process with ischemia is to restore normal blood circulation and eliminate the consequences. In this case, 1 degree of the disease often does not require medical treatment - doctors are limited to the appointment of a therapeutic massage.
Ischemia of the brain in a newborn 2 and 3 degree requires the use of medications. In some cases, when the cause of circulatory disorders is the presence of a blood clot in the lumen of the vessel, surgical intervention can be performed. The operation involves a complete restoration of the bloodstream. To exclude the consequences of cerebral ischemia, a long course of restorative therapy is prescribed for the child.
Ischemia of the brain - treatment, drugs
Depending on the child's cerebral ischemia, the treatment is selected individually. Medicamentous therapy of infants with this pathology includes the use of the following groups of medicines:
- vasodilator drugs - help restore blood circulation, improve oxygen supply to the brain;
- nootropics - restore the work of the brain;
- diuretics - exclude the development of edema, prevent the accumulation of fluid in the brain.
Among drugs belonging to these groups of drugs, more commonly used are:
- Ceraxon;
- Pentoxifylline;
- Piracetam;
- Actovegin.
Massage with cerebral ischemia in newborns
As mentioned above, cerebral ischemia in children is always accompanied by a decrease in muscle tone. This requires certain physiotherapeutic procedures, among which a special place is occupied by medical massage. During the procedure, by simple stroking and exposure to certain areas of the body, there is an increase in muscle strength. Over time, absent reflexes are restored, motor activity returns to normal.
Ischemia of the brain in a newborn - consequences
Timely initiation of therapy reduces the risk of complications. Pathology of the 1st degree often passes without a trace for a small organism. If there is a marked violation, 2 degrees of the disease, parents can record certain consequences of cerebral ischemia in newborns, among them:
- headache in the baby;
- sleep disturbance;
- irritability;
- decreased motor activity.
Calling the consequences of cerebral ischemia in children of the third degree, doctors singled out:
- Cerebral palsy ;
- attention deficit disorder ;
- reduction of mental abilities.