METHOD FOR DIAGNOSING THE STAGE OF INTRACRANIAL HYPERTENSION IN NEUROINFECTIONS IN CHILDREN IN THE ACUTE PERIOD

摘要

FIELD: medicine. ;SUBSTANCE: invention relates to medicine, namely to diagnostics and resuscitation. In children aged from 1 month to 17 years in the acute period of the disease, on the first day of hospitalization, neurosonography is consistently performed with an assessment of the structure of the brain and cerebrospinal fluid dynamics, cerebral hemodynamics is evaluated using transcranial duplex scanning, the thickness of the optic nerve and its membranes is measured, the fundus is evaluated. When visualizing clear contours of the brain stem using neurosonography, the size of the lateral ventricles from 12 to 16 mm, the size of bone-brain diastases from 1 mm to 4 mm; when registering using transcranial duplex scanning the systolic blood flow rate along the middle cerebral artery from 60 cm/sec to 180 cm/sec, Rosenthal veins from 10 cm/sec to 20 cm/sec, increasing the resistance index in the arteries to 0.8, in the veins to 0.5; in the presence of the thickness of the optic nerve and its shells in children aged 1 month - 5 years 5.5±0.6 mm, aged 5 years to 17 years 5.8±0.8 mm; dilation of veins on the fundus, intracranial hypertension is diagnosed in the compensation stage. And when neurosonography reveals a deformation of the brain stem pattern, narrowing of the cerebrospinal fluid spaces: lateral ventricles up to 11 mm, the size of bone-brain diastases less than 1 mm; registration by transcranial duplex scanning of a decrease in the systolic blood flow rate along the middle cerebral artery up to 60 cm/sec, Rosenthal veins up to 10 cm/sec, detection of a reverberation pattern; detection of an increase in the thickness of the optic nerve 6.5+0.43 mm with loss of clarity of the contours of the optic nerve; stagnation of the optic nerve disk on the fundus, intracranial hypertension in the decompensation stage. ;EFFECT: method provides for early and timely diagnosis of the stages of intracranial hypertension syndrome in children with neuroinfection (meningitis, encephalitis) upon admission to the hospital for a quick decision on the possibility of performing a diagnostic lumbar puncture, the expediency of conducting expert expensive subcutaneous neuroimaging methods, the choice of therapeutic tactics. ;1 cl, 3 ex, 4 dwg