Ventrikulit

Description:

Ventrikulit represents inflammatory process in cerebral cavities. In literature of the post-war period ventrikulit had also other names – an ependymitis or periventrikulyarny purulent encephalitis. Ventrikulit as a complication after gunshot wounds of the head it was described still by N. I. Pirogov (1853), and then – O. M. Holbeky (1911). However as an independent form of complications at head wounds this type of inflammatory changes was allocated and studied during the Great Patriotic War. Ventrikulita were revealed on opening at 5,5% of the died wounded with fire injuries of the head.

Ventrikulit's symptoms:

The clinical picture in the form of the expressed, accruing headache, repeated vomiting, high temperature, frequent pulse, motive excitement with kloniko-tonic spasms, rapid development of meningeal symptoms, consciousness oppressions is characteristic of primary ventrikulit. Quickly respiratory and cardiovascular disturbances join. At a spinal puncture reveal muddy liquor with blood impurity.

The break of pus in cerebral cavities often comes from abscess at rather compensated condition of patients and is characterized by sudden emergence of a sharp headache, vomiting, expansion of pupils, kloniko-tonic spasms, emergence of frequent breath, bystry temperature increase, rapid increase of pulse, sharp hyperemia or pallor of integuments of the face. At liquor there are all cellular elements of the broken abscess in the form of a cellular detritis in which it is not possible to specify structure of cells. In similar ventrikulyarny contents always high is a protein content, it reaches 18–20%.

The diagnosis of a ventrikulit is confirmed by computer and tomographic diagnosis. Liquid density in cerebral cavities increases to 30 units of N.

Ventrikulit's reasons:

At gunshot craniocereberal wounds distinguish primary and secondary purulent ventrikulit.

Primary ventrikulit develops as a result of direct entering of microflora in cerebral cavities foreign bodys, bone fragments, hurting shells.

Secondary purulent ventrikulit develops preferential in the periods of an otgranicheniye of the infectious center and development of late complications. Are a proximate cause of development of a secondary ventrikulit: basal meningitis, break of purulent contents from an abscess cavity in cerebral cavities, implementation of an infection in cerebral cavities through ventricular likvorny fistula, spread of purulent encephalitis on a wall of a ventricle and vascular textures.

Ventrikulit's treatment:

Treatment of ventrikulit is carried out the same as meningitis and encephalitis. Early and massive prescription of antibiotics, sulfanamide drugs, before obtaining results of bacteriological crops is necessary. After identification of the activator apply purposeful treatment.

At ventrikulita V. V. Lebedev, V. V. Krylov (2001) recommend drainage of both cerebral cavities silicon drainage tubes with a diameter of 2-4 mm for washing by isotonic solution of sodium chloride with antibiotics within 5–9 days. The single puncture of cerebral cavities with washing by their solutions containing antibiotics is inefficient.

According to B. V. Gaidar and соавт. (2002), at the progressing purulent ventrikulita an effective method of treatment is the likvorosorbtion for which performance punktirut the right side ventricle of a brain, establish a silicone catheter through which carry out a liquor intake. After sorption sanitation cerebrospinal liquid is returned through the second catheter located in the final tank of the vertebral channel.