Perinatal lesions of the central nervous system. PCNS in a newborn - what is the diagnosis, what are the symptoms of the disease in children, is there treatment?
Perinatal lesion of the central nervous system includes all diseases of the brain and spinal cord.
They happen in the process intrauterine development, during birth process and in the first days after the birth of a newborn.
The course of perinatal CNS damage in a child
The disease occurs in three periods:
1. Acute period. It occurs in the first thirty days after the birth of a child,
2. Recovery period. Early, from thirty to sixty days of a baby’s life. And late, from four months to one year, in children born after three trimesters of pregnancy, and up to twenty four months at early birth.
3. Initial period of the disease.
In certain periods, various clinical manifestations of perinatal CNS damage occur in a child, accompanied by syndromes. One baby may exhibit several disease syndromes at once. Their combination helps to determine the severity of the disease and prescribe qualified treatment.
Features of syndromes in the acute period of the disease
IN acute period the child experiences depression of the central nervous system, coma, increased excitability, manifestation of seizures of various etiologies.
In a mild form, with minor perinatal damage to the central nervous system in a child, he notices an increase in the excitability of nervous reflexes. They are accompanied by shuddering in silence, muscle hypertonicity, and may also be accompanied by muscle hypotonia. In children, tremor of the chin, trembling of the upper and lower limbs. The child behaves capriciously, sleeps poorly, cries for no reason.
With perinatal damage to the central nervous system in a child of average form, he is little active after birth. The baby does not latch well. His milk swallowing reflexes are reduced. After living for thirty days, the symptoms disappear. They are changed by excessive excitability. At average shape damage to the baby's central nervous system causes skin pigmentation. It looks like marble. The vessels have different tone, the functioning of the heart is impaired. vascular system. Breathing is not uniform.
In this form, the child’s gastrointestinal tract is disrupted, stools are rare, the child regurgitates milk that was eaten with difficulty, and bloating occurs in the tummy, which can be clearly heard by the mother’s ear. IN in rare cases The baby's legs, arms and head shudder with convulsive attacks.
An ultrasound examination shows in children with perinatal damage to the central nervous system an accumulation of fluid in the compartments of the brain. The accumulated water contains spino-cerebral fluid, which provokes in children intracranial pressure. With this pathology, the baby's head grows by one centimeter every week, this can be noticed by the mother by the rapid growth of the caps and appearance your child. Also, due to the fluid, the small fontanel on the child’s head bulges. The baby often spits up, behaves restlessly and capriciously due to constant pain in my head. May roll his eyes upper eyelid. The child may exhibit nystagmus, in the form of a wince. eyeball when placing the pupils in different directions.
During a sharp depression of the central nervous system, the child may fall into a coma. It is accompanied by the absence or confusion of consciousness, a violation of the functional properties of the brain. In such a serious condition, the child must be under constant supervision medical personnel in the intensive care unit.
Features of syndromes in the recovery period
The syndromes of the recovery period with perinatal damage to the central nervous system in a child include a number of symptomatic features: increased nervous reflexes, epileptic seizures, disruption of the musculoskeletal system. Children also experience delays psychomotor development caused by hypertonicity and hypotonicity of muscles. When prolonged, they cause involuntary movement facial nerve, as well as nerve endings of the trunk and all four limbs. Muscle tone prevents normal physical development. Does not allow the child to perform natural movements.
With delayed psycho-motor development, the child later begins to hold his head up, sit up, crawl and walk. The baby has a lethargic daily state. He does not smile, does not make grimaces typical of children. He is not interested in educational toys and in general what is happening around him. Speech lag occurs. The baby later begins to say “gu-gu”, cries quietly, and does not utter clear sounds.
Closer to the first year of life with constant monitoring qualified specialist, prescribing the correct treatment and depending on the form initial disease central nervous system, symptoms and signs of the disease may decrease or disappear altogether. The disease carries with it consequences that persist at one year of age:
1. Psycho slows down - motor development,
2. The child starts talking later
3. Mood swings,
4. Bad dream,
5. Increased weather dependence, especially the child’s condition worsens in strong winds,
6. Some children are characterized by hyperactivity, which is expressed by attacks of aggression. They do not concentrate on one subject, have difficulty learning, and have poor memory.
Epileptic seizures and cerebral palsy can become serious complications of damage to the central nervous system.
Diagnosis of perinatal CNS damage in a child
For staging accurate diagnosis and prescribing qualified treatment, diagnostic methods are used: ultrasound with Dopplerography, neurosonography, CT and MRI.
Ultrasound of the brain is one of the most popular in diagnosing the brain of newborns. It is done through a fontanel on the head that is not yet strong with bones. Ultrasound examination does not harm the child’s health and can be performed frequently, as necessary to monitor the disease. Diagnostics can be done in young patients who are inpatient treatment in ARO. This study helps determine the severity of CNS pathologies, determine the amount of cerebrospinal fluid and identify the cause of its formation.
Computer and magnetic resonance tomography will help identify problems with the vascular network and disorders of the brain in a young patient.
Ultrasound with Doppler sonography will check the functioning of the blood flow. Its deviations from the norm lead to perinatal damage to the central nervous system in the child.
Causes of perinatal damage to the central nervous system in a child
The main reasons are:
1. Fetal hypoxia during intrauterine development, caused by limited oxygen supply,
2. Injuries received during the birth process. Often occur during slow labor and retention of the child in the mother’s pelvis,
3. Diseases of the fetal central nervous system can be caused by toxic drugs used by the expectant mother. Often these are drugs, alcohol, cigarettes, narcotic drugs,
4. Pathology is caused by viruses and bacteria during intrauterine development.
Treatment for perinatal damage to the central nervous system in a child
If a child has problems with the central nervous system, it is necessary to contact a qualified neurologist to prescribe recommendations. Immediately after birth, it is possible to restore the baby’s health by maturing dead brain cells to replace those lost during hypoxia.
First of all, the child finds urgent Care V maternity hospital, aimed at maintaining the functioning of the main organs and breathing. Medicines and intensive therapy, including mechanical ventilation, are prescribed. Treatment of perinatal CNS damage in a child is continued, depending on the severity of the pathology, at home or in the children's neurological department.
The next stage is aimed at the full development of the child. It includes constant monitoring by an on-site pediatrician and a neurologist. Drug therapy, massage with electrophoresis to relieve muscle tone. Treatment is also prescribed pulse currents, medicinal baths. A mother should devote a lot of time to the development of her child, massage at home, walks fresh air, fight ball classes, follow up proper nutrition baby and fully introduce complementary foods.
Unfortunately, central nervous system disorders in newborns are not uncommon. Up to 50% of all children are exposed to this disorder to one degree or another.
Today we will talk about perinatal damage to the central nervous system (CNS) in newborns, we will tell you what symptoms this disease is characterized by, what methods of diagnosing and treating damage to the central nervous system exist, and we will also understand what the consequences may be of this disease.
The essence of the disease
Damage to the central nervous system is diagnosed quite often, and Among premature babies, this diagnosis occurs many times more often. This disease includes a number of different diagnoses characterized by damage to the brain and/or spinal cord.
In most cases, damage to the central nervous system has a favorable outcome. Now let's take a closer look at the causes of this disease.
Causes of central nervous system damage in children
The causes of this disease during pregnancy may be:
- somatic diseases in the mother;
- metabolic disorder;
- poor nutrition;
- unfavorable environmental conditions;
- mother's age is over 35 or less than 18 years;
- acute infectious diseases;
- pathological course of pregnancy;
- the influence of toxins on the body of the expectant mother (smoking, drinking alcohol and drugs).
In some cases, the causes of damage to the central nervous system are injuries and fetal hypoxia during the birth process.
Any lesions of the central nervous system can be divided into two types.
Organic damage to the central nervous system
This diagnosis occurs among people different ages. Organic damage to the central nervous system in both children and adults is characterized by pathological changes in the brain.
Perinatal CNS damage
Diagnosed in newborns. Depending on the period in which this lesion occurred, the following types are divided:
- antenatal (the period of intrauterine development from 28 weeks until birth);
- intrapartum (damage occurs directly during childbirth);
- neonatal (the lesion is diagnosed in the first week of life).
Depending on the causes, this disease is divided into several types.
Hypoxic damage to the central nervous system
Hypoxic, or hypoxic-ischemic, damage to the central nervous system in newborns is characterized by oxygen starvation for one reason or another. It appears in the womb or due to asphyxia during childbirth.
Traumatic
Traumatic, or residual, damage to the central nervous system in children is residual effects after injuries and structural changes in the brain.
It is very important to diagnose this pathology as early as possible, since brain cells in infants have the ability to regenerate. Respectively, dire consequences can be avoided.
Diagnosis of central nervous system lesions in children
An experienced doctor can diagnose central nervous system damage with one look at the child. But to make a final diagnosis, the following research methods are used:
- various types of tomography;
- electroencephalogram;
- Ultrasound of the brain with Dopplerography of blood vessels;
- X-ray of the skull and spine.
These studies are easy to perform even in the youngest patients. Moreover, an open large fontanel in newborns allows one to perform ultrasound of the brain repeatedly and monitor its condition over time.
Also, one of the diagnostic methods is collecting anamnesis and monitoring the symptoms of the disease.
Symptoms of the disease
According to its course, perinatal damage to the central nervous system can be divided into three stages, each of which is characterized by its own symptoms.
Acute period
This period lasts up to one month and is characterized by the following symptoms:
- CNS depression syndrome (hypodynamia, lethargy, decreased reflexes, muscle hypotension);
- CNS hyperexcitability syndrome is less common (restless and often light sleep, trembling chin, muscle hypertonicity, ).
Early recovery period
This period lasts for the 2nd and 3rd months and is characterized by a decrease in the symptoms of the acute period. At the same time, the location of the lesion becomes obvious. This phenomenon is characterized by the following symptoms:
- divergence of the sutures of the skull, increase in head circumference;
- violation motor activity;
- thermoregulation disorder, marbled skin color, disruption of the gastrointestinal tract.
Late recovery period
The period lasts up to 1 year in children born at term, and up to 2 years in premature children. IN this period static functions and muscle tone are restored. The recovery process depends on the degree of damage during the perinatal period.
Period of residual effects
In most cases, during this period there is complete restoration of all neurological functions. At the same time, every fifth child experiences serious consequences of neurological dysfunction during this period.
Treatment of the disease
Important! Carry out the necessary examination and prescribe correct treatment Only a doctor can.
Treatment of moderate to severe central nervous system damage is often carried out in an intensive care setting, often using special equipment to support the functioning of vital organs.
In the acute period The following treatment methods are used for the disease:
- reducing brain swelling and maintaining function internal organs;
- reduction in the frequency of seizures;
- restoration of nervous tissue metabolism;
- restoration of oxygen metabolism in cells.
IN recovery period In addition to the above methods, the following therapy is used:
- stimulant drugs;
- sedative therapy for increased excitability;
- drugs to improve cerebral circulation;
- massage;
- physiotherapy;
IN further treatment carried out up to three times a year under the supervision of a neurologist for several years.
Prevention of central nervous system damage
The most important thing is to eliminate everything possible factors, provoking oxygen starvation of the fetus during pregnancy. Treat infectious diseases in a timely manner, ensure favorable conditions stay of the pregnant woman, as well as prevent the possibility birth injuries.
For you to receive complete information We suggest watching the following video about perinatal damage to the central nervous system.
Damage to the central nervous system in newborns - video
From this video you will learn about the nuances of central nervous system damage and methods of treating this disease.
To summarize, I would like to note that changes due to this pathology are completely reversible if treatment is started on time, namely in the first weeks of the baby’s life. Don't ignore the first symptoms. If any suspicious signs of this disease appear, immediately contact a neurologist for consultation.
Have you encountered CNS damage in your children? What treatments were you prescribed? What was the result? Tell us about your experience in the comments.
When a baby is born, its internal organs and body systems are not yet fully formed. This also applies to the central nervous system, which is responsible for the normal social functioning of a person. For the formation process to be completed, a certain period of time is required.
IN recent years the number of central nervous system pathologies in infants has increased significantly. They can develop during the prenatal period, and also appear during childbirth or immediately after it. Such lesions, which negatively affect the functioning of the nervous system, can cause serious complications and even disability.
What is perinatal CNS damage?
Perinatal Central Nervous System Damage, abbreviated as PCNSL, is a a whole series pathologies that are related to disruptions in the functioning of the brain and developmental anomalies in its structure. Observed similar deviations from the norm in children during the perinatal period, the time frame of which ranges from the 24th week of pregnancy to the first 7 days of life after birth, inclusive.
Currently, PPCNSL in newborns is a fairly common phenomenon. This diagnosis is established in 5-55% of children. The wide range of indicators is due to the fact that often lesions of the central nervous system this kind pass easily and quickly. Cases of severe forms of perinatal damage occur in 1-10% of children who were born on time. Premature babies are more susceptible to the disease.
Classification of the disease
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In modern medicine, it is customary to classify deviations in the normal functioning of the central nervous system in accordance with the reasons that caused this or that pathology. In this regard, each disorder has its own forms and symptoms. There are 4 main pathological types of central nervous system lesions:
- traumatic;
- dismetabolic;
- infectious;
- hypoxic genesis.
Perinatal lesions in the newborn
Perinatal lesions of the central nervous system are those that develop during the perinatal period, the main part of which occurs in the prenatal period. The risk of depression of the central nervous system in a child increases if during pregnancy a woman suffered:
- cytomegalovirus infection (we recommend reading:);
- toxoplasmosis;
- rubella;
- herpetic infection;
- syphilis.
The baby may receive intracranial trauma and injuries to the spinal cord or peripheral nervous system during childbirth, which can also cause perinatal lesions. Toxic effects on the fetus can disrupt metabolic processes and negatively affect brain activity.
Hypoxic-ischemic damage to the nervous system
Hypoxic-ischemic damage to the nervous system is one of the forms of perinatal pathology, which is caused by fetal hypoxia, that is, insufficient oxygen supply to the cells.
A manifestation of the hypoxic-ischemic form is cerebral ischemia, which has three degrees of severity:
- First. Accompanied by depression or stimulation of the central nervous system, which lasts up to a week after birth.
- Second. In addition to depression/excitation of the central nervous system that lasts more than 7 days, convulsions, increased intracranial pressure and autonomic-visceral disorders are added.
- Third. It is characterized by a severe convulsive state, dysfunction of the brain stem, and high intracranial pressure.
Disease of mixed origin
In addition to ischemic genesis, hypoxic lesions of the central nervous system can be caused by hemorrhages of non-traumatic origin (hemorrhagic). These include hemorrhages:
- intraventricular type 1, 2 and 3 degrees;
- subarachnoid primary type;
- into the substance of the brain.
Combination of ischemic and hemorrhagic forms, is called mixed. Its symptoms depend solely on the location of the hemorrhage and the severity.
Features of the diagnosis of PPCNSL
After giving birth to children mandatory examined by a neonatologist, assessing the degree of hypoxia. He may be the one to suspect perinatal lesion on changes in the condition of the newborn. The conclusion about the presence of pathology is confirmed or refuted in the first 1-2 months. During this entire time, the baby is under the supervision of doctors, namely a neurologist, pediatrician and an additional specialist with a narrow focus (if required). Deviations in the functioning of the nervous system require special attention in order to be able to correct them in time.
Forms and symptoms of the disease
Perinatal damage to the central nervous system of a newborn can occur in 3 different forms, each characterized by its own symptoms:
- light;
- average;
- heavy.
Knowing the symptoms that indicate inhibition of the central nervous system, you can make a diagnosis in the early stages and promptly treat the disease. The table below describes the symptoms that accompany the course of the disease for each of its forms:
PPCNS form Characteristic symptoms Lightweight
- high excitability of nerve reflexes;
- weak muscle tone;
- sliding squint;
- trembling of the chin, arms and legs;
- wandering movements of the eyeballs;
- nervous movements.
Average
- lack of emotions;
- weak muscle tone;
- paralysis;
- convulsions;
- increased sensitivity;
- spontaneous motor activity of the eyes.
Heavy
- convulsions;
- renal failure;
- disruptions in bowel function;
- problems with the cardiovascular system;
- impaired functioning of the respiratory system.
Reasons for development
Very often, the cause of the development of PPCNS is fetal hypoxia during the prenatal period.
Among the reasons leading to perinatal damage to the central nervous system in an infant, it is worth noting four main ones:
- Fetal hypoxia during the intrauterine period. This deviation is due to a lack of oxygen entering the baby’s blood from the mother’s body. Provoking factors are harmful conditions work of a pregnant woman, bad habits such as smoking, past infectious diseases and previous abortions.
- Injuries caused during childbirth. If a woman is weak labor activity, or the baby is delayed in the pelvis.
- Violation metabolic processes. They can be caused by toxic components that enter the body of a pregnant woman along with cigarettes, alcoholic drinks, narcotic substances and potent medications.
- Viral and bacterial infections that entered the mother's body during pregnancy, abbreviated as IUI - intrauterine infections.
Consequences of the disease
In most cases, by the time the child is one year old, almost all the symptoms accompanying damage to the nervous system have passed. Unfortunately, this does not mean at all that the disease has receded. Usually after such an illness there are always complications and unpleasant consequences.
After undergoing PCNSL, parents may experience child hyperactivity
Among them are:
- Hyperactivity. This syndrome characterized by aggressiveness, tantrums, learning difficulties and memory problems.
- Developmental delay. This applies to both physical and speech and mental development.
- Cerebroasthenic syndrome. It is characterized by the child's dependence on weather conditions, mood swings, restless sleep.
The most serious consequences of inhibition of the central nervous system, which lead to disability of the baby, are considered:
- epilepsy;
- cerebral palsy;
- hydrocephalus (we recommend reading:).
Risk group
The widespread diagnosis of perinatal damage to the nervous system in a newborn is due to many factors and conditions affecting the intrauterine development of the fetus and the birth of the baby.
In pregnant women who had healthy image life, and the child was born at term, the probability of PPCNS is sharply reduced to 1.5-10%.
To the group increased risk, which is 50%, includes kids:
- with breech presentation;
- premature or, conversely, post-term;
- with a high birth weight exceeding 4 kg.
It is also essential hereditary factor. However, it is difficult to predict exactly what may cause CNS depression in a child and depends more on the situation as a whole.
Diagnostics
Any disturbances in brain activity are difficult to diagnose early stage. Babies are diagnosed with perinatal damage to the central nervous system during the first months of life, based on the presence of problems with their motor and speech apparatus, and also taking into account violations mental functions. Closer to the year, the specialist should already specify the type of disease or refute the previously made conclusion.
Disturbances in the functioning of the nervous system represent serious danger for the health and development of the child, so it is important to diagnose the problem in time in order to carry out proper treatment. If a newborn baby behaves uncharacteristically and the first symptoms of illness appear, parents must take him to the doctor. First, he performs an examination, but such a procedure alone may not be enough for an accurate diagnosis. Only integrated approach will help identify the disease.
If there is the slightest suspicion that a child is developing PPCNS, it is necessary to immediately show a doctor
For this reason, the following clinical and laboratory tests are usually additionally prescribed:
- neurosonography (we recommend reading:);
- CT – computed tomography or MRI – magnetic resonance imaging of the brain;
- Ultrasound - ultrasound diagnostics;
- X-ray examination;
- echoencephalography (EchoES), rheoencephalography (REG) or electroencephalography (EEG) - methods of functional diagnostics (we recommend reading:);
- Consultative examination by an ophthalmologist, speech therapist and psychologist.
Treatment methods depending on symptoms
Treatment of any pathologies of the central nervous system in newborns must be carried out in the first months of life, since at this stage almost all processes are reversible, and impaired brain functions can be completely restored.
In the first months of life, PCNSL is easily treatable
For this purpose, appropriate drug therapy, which allows:
- improve nutrition of nerve cells;
- stimulate blood circulation;
- normalize muscle tone;
- normalize metabolic processes;
- relieve your baby from seizures;
- relieve swelling of the brain and lungs;
- increase or decrease intracranial pressure.
When the child’s condition stabilizes, in combination with medications carry out physiotherapy or osteopathy. The therapeutic and rehabilitation course is developed individually for each case.
Intracranial hypertension
Syndrome intracranial hypertension manifests itself as an increase in comparison with the norm, swelling of the large fontanel and divergence of the sutures of the skull (we recommend reading:). The child is also nervous and easily excitable. When similar symptoms The baby is prescribed diuretics and undergoes dehydration therapy. In order to reduce the likelihood of hemorrhages, it is recommended to take a course of Lidaz.
Plus they make special ones for the baby gymnastic exercises which help reduce intracranial pressure. Sometimes they resort to acupuncture and manual therapy to correct the outflow of fluid.
IN complex treatment PPCNS must include general strengthening gymnastic exercises
Movement disorders
When diagnosing movement disorder syndrome, treatment consists of a series of measures aimed at eliminating the problem:
- Drug therapy. Drugs such as Galantamine, Dibazol, Alizin, Proserin are prescribed.
- Massage and physical therapy. For children under one year old, a minimum of 4 courses of such procedures are required, each of which consists of approximately 20 sessions with specially selected exercises. They are selected depending on what is subject to deviations: walking, sitting or crawling. Massage and exercise therapy are carried out using ointments.
- Osteopathy. It consists of performing a massage of internal organs and influencing necessary points bodies.
- Reflexology. It has proven itself to be the most effective method. Its help is resorted to in cases where SDN leads to a delay in the maturation and development of the nervous system.
Increased neuro-reflex excitability
One of the possible manifestations of perinatal lesions in acute phase is increased neuro-reflex excitability.
Relating to mild form the course of the pathology, it is characterized by:
- decreased or increased muscle tone;
- extinction of reflexes;
- superficial sleep;
- causeless shaking of the chin.
Massage with electrophoresis helps restore muscle tone. In addition, drug therapy is carried out, and treatment can be prescribed using pulsed currents and special baths.
Epileptic syndrome
For epileptic syndrome characterized by periodic epileptic seizures, which are accompanied by convulsions, which are shudders and twitching of the upper and lower extremities and head. The main goal of therapy in this case is to get rid of the convulsive state.
Finlepsin is prescribed if the child has convulsive syndrome
A course of the following medications is usually prescribed:
- Difenin;
- Radodorm;
- Seduxen;
- Finlepsin;
- Phenobarbital.
Minimal brain dysfunction
Minimal brain dysfunction, better known as attention deficit hyperactivity disorder, is a mild form of neurological disorders. Treatment with medications is mainly aimed at eliminating specific manifestations, while methods of physical influence, namely massage or exercise, are capable of more high efficiency correct the pathological condition of the child.
Recovery period
The recovery period plays an important role in the full recovery of the baby.
At the rehabilitation stage during the first year of life, the main focus is not drug therapy, but all kinds of procedures that help activate those functions that have been impaired and restore normal operation CNS.
These include:
- electrophoresis with medications;
- therapeutic ultrasound;
- physical therapy and gymnastics;
- acupuncture;
- swimming lessons;
- impulse currents;
- massage;
- balneotherapy;
- thermal procedures;
- pedagogical methods of correction;
- therapy through music.
In addition, parents must create certain living conditions for their child with PPCNS:
Perinatal damage to the central nervous system (PPNSS) of a child occurs at the most critical stage of development, namely from the 7th month to the first week of a newborn’s life.
This pathology occurs in the womb, during childbirth or in the first days of the baby’s life.
What is PPCNS
There are many varieties, each of which has quite extensive characteristics, but in in this case We are faced with the task of figuring out what it is - PPCNSL in newborns and how terrible such a diagnosis is. 
First of all, it should be understood that this is not a specific, but a collective term. It implies various abnormalities in the functioning of the nervous system that arose due to intrauterine and birth pathologies and leading to perinatal encephalopathy.
We can talk about PPCNSL if the baby has a history of deviations in mental, physical and speech development before he reaches one year of age.
For a long time it was believed that with this disease changes in the nervous system would remain permanent, however modern medicine emphasizes that the brain small child has enormous compensatory potential and can successfully restore its functions even with moderate severity currents
Important! The pathology in severe form threatens the child’s life, as without treatment it causes irreversible damage to the central nervous system.
Often, perinatal damage to the central nervous system occurs in premature infants due to the fact that the functioning of the nervous system directly depends on body weight. 
How often can babies have
According to statistics, from 5 to 55% of babies are diagnosed with PPCNS immediately after birth. Often the disease occurs in a mild and even barely noticeable form, which is why such a difference is recorded.
Among children born on time, approximately 10% have a severe degree of pathology, and in children who were born in a hurry, the disease is detected in 70% of cases.
Severity
There are three degrees of severity of the disease, each of which differs in its manifestations and further prognosis:
- A mild degree is accompanied by twitching of the baby’s chin, and he has weak reflexes. Muscle tone can be either slightly increased or decreased. The functioning of the nervous system may fluctuate due to depression nervous processes and until they are excited.
- Medium degree: inhibition of nervous system processes dominates over their excitation. The child is restless, anxious, with convulsive activity. Functioning of the heart, kidneys and digestive tract insufficient and problematic;
- Severe: the child is practically non-viable and requires resuscitation. He has serious violations in the functioning of the heart and lungs.
Causes and risk groups
All causes of this disease can be divided into four categories.
CNS damage due to hypoxia ( oxygen starvation) fruit. This is the most frequently occurring category. The reasons become various diseases expectant mother in the perinatal period, low or high water levels, multiple pregnancy.
Acute hypoxia can also occur during childbirth due to premature detachment placenta, which causes disturbances in the uteroplacental circulation. In some cases, this option is explained by compression of the baby's head as it passes through the birth canal.
Naturally, the severity of damage to the central nervous system directly depends on the duration of oxygen starvation. If the lack of oxygen has chronic form, the baby’s capillaries in the brain stop growing, and their permeability increases.
Did you know? During fetal development, the number of cellsin the fetusincreases by 250 thousand every minute. And by 9 months, the child’s brain already has more than 10 million cells.
During childbirth, asphyxia occurs due to severe disturbances in the functioning of the cardiovascular and respiratory systems. 
The second category is lesions caused by trauma. Trauma to the nervous system occurs mechanically and possibly both during childbirth and during the first few hours after birth.
Such lesions may occur when used by obstetricians during childbirth. special tools, which help to expand or protect the perineum from tears, bring out the head or rotate it.
Staying for too long birth canal and strong compression during pushing also injure the baby's brain and spinal cord.
The third category includes metabolic disorders in the baby. They usually arise in the womb and directly depend on the mother and what she consumes. The child may experience nicotine, alcohol and drug syndromes.
Hypoxia is also caused by toxins that appear in the mother’s body during illness or as a result of taking medications. 
The fourth category is fetal infection. The virus infects the central nervous system and causes disruption of the nervous system. How the damage occurs and what its consequences are depends on the type of virus and the overall severity of the disease.
The risk group for PPCNS primarily includes newborns whose mothers are under 18 years of age and over 30, their activities are associated with hazardous production, they have bad habits and genetic diseases.
Pregnant women with renal failure, heart defects, hypertension, endocrine disorders, extragenital diseases and anemia are also at risk. These also include pregnant women who have been diagnosed with frequent medical and spontaneous infertility or infertility.
How it manifests and develops
During the course of the disease, three periods are distinguished: acute (from the prenatal period until the first month after birth), recovery (from the second month to one year, and in premature babies up to two years) and outcome of the disease. Each period has its own specific symptoms. 
In the acute period, the baby may experience:
- Hydrocephalus (hydrosis of the brain), due to which the baby’s head becomes enlarged, and the fontanel pulsates and protrudes above the surface of the skull;
- Convulsions of both limbs and the whole body.
- Vegetative-visceral syndrome due to impaired vascular tone;
- Inhibition of the nervous processes of the central nervous system, due to which basic reflexes and motor activity are significantly reduced;
- Muscular dystonia can be either depression or stimulation of the central nervous system (the baby often cries for no reason, his chin trembles nervously, sleep is intermittent and inconsistent). This condition is observed when mild degree diseases;
- Comatose state, when the baby falls into a coma. The most severe form of the disease. The activity of the central nervous system is extremely depressed. The child is in intensive care.
But things get worse very quickly. The child has delays in psycho-speech development, which is natural with such a disease. He later masters various motor skills, such as holding the head, crawling, sitting, walking. He also begins to speak later than his peers. The outcome of the disease becomes clear by the time the child turns one year old.
Even if the treatment was successful, the baby may have developmental delays, hyperactivity and cerebroasthenic syndrome, due to which the baby becomes weather dependent, hysterical, gets tired quickly, sleeps poorly and is often anxious.Did you know? From the moment of birth, a baby's brain grows three times larger every year compared to the previous year. But in old age the picture is the opposite: every year the weight of the brain decreases by one gram.
Diagnostics
Signs of PPCNSL can be noticed even in the maternity hospital, during an examination by a neonatologist. Based on the clinical picture, the doctor suggests a diagnosis. 
Further, after the baby leaves the maternity hospital, his condition will be monitored by a neurologist who can prescribe the following diagnostic methods:
- Brain ultrasound (neurosonography) can only be performed in the first year of life. The bones of the skull are too dense and ultrasound radiation cannot penetrate through them, so in infants the procedure is performed through a still open fontanel. This diagnostic method is simple and safe for the child.
- CT (computed tomography) and MRI (magnetic resonance imaging) are the most informative way to look into the baby’s brain. It is resorted to if the ultrasound turned out to be uninformative, and the symptoms are moderate to severe. Tomography gives very detailed information. However, for the procedure to be successful, the child must lie still in the scanner, and since this is not possible in the case of an infant, special drugs may be administered.
- EEG (electroencephalography) allows you to assess the functionality and condition of the brain vessels, but the procedure must be carried out several times (for comparison);
- Dopplerography allows you to evaluate blood flow in the vessels of the brain.
Treatment and rehabilitation measures
If PPCNS is detected immediately after birth, then the baby’s rehabilitation is carried out immediately. In the acute period, doctors relieve cerebral edema, eliminate and prevent seizures.
With the help of special vitamins they reduce permeability vascular walls, give medications to improve myocardial contractions, level out the metabolism of nerve tissues and create a gentle lifestyle for the baby.
During the recovery period, treatment depends on the symptoms of PPCNS that appear in newborns.
IN common child Stimulating therapy is provided, which provokes the growth of brain capillaries, improves nutrition and restoration of damaged areas. 
Forecast
Even if the baby was treated correctly and on time, perinatal damage to the central nervous system will leave its marks forever. With a mild degree of the disease, such consequences will be some delay in development and impulsiveness of the baby on the one hand, as well as lethargy, apathy, anxiety and sleep disorders on the other.
A severe form of PPCNSL in newborns has the same consequences: the child may develop hydrocephalus (hydropy) of the brain, cerebral palsy and epilepsy.
In general, approximately 30% of children recover completely, 40% of children have impairments in the functionality of the nervous system, and another 30% have organic impairments. Sometimes death occurs.
Important! To prevent the onset of such a serious disease, a pregnant woman must undergo all routine examinations, avoid stress, infections, and eliminate bad habits from her life.
Prevention measures
Primary prevention is available in the form of a healthy lifestyle for the expectant mother. 
In addition, doctors must provide competent help in childbirth.
Secondary prevention consists of caring for the newborn baby and preventing perinatal damage to the central nervous system. He must be regularly observed by a doctor and undergo tests. With mother's milk, the baby should receive all the substances necessary for growth.
PPCNS is a severe pathology of the intrauterine development of a child, which affects the functioning of the central nervous system. Often the disease has consequences, even with successful treatment.
Therefore, the best thing you can do for your baby is to lead a healthy lifestyle to prevent the occurrence of perinatal damage to the central nervous system.
The human brain is a complex organ that is responsible for transmitting nerve impulses all systems human body. Any disturbance in its functioning indicates the presence of problems in its development. One of the reasons may be perinatal damage to the central nervous system, as well as residual organic damage to the central nervous system. But, first things first...
So, damage to the nervous system, as stated earlier, is divided into:
- Perinatal.
- Organic.
Perinatal lesion of the central nervous system (PPCNS), what is it? PPCNS is a pathology that affects unborn babies, that is, disorders begin to form during the development of the fetus in the womb. Such a disease may develop in one of three subperiods, into which the perinatal period of the baby’s development is actually divided:
- antenatal (occurs after 28 weeks of fetal formation);
- intrapartum (immediately at the moment of birth);
- neonatal or postnatal (the first seven days of a baby's life).
This pathology is not always a death sentence.
Fetal hypoxia is one of the causes of PCPNS
Regarding organic damage, then this disease is typical not only for newborns and children early age, but can also be observed in adults, and the main reason for the development of the disease is changes occurring in the structure of brain cells.
There are three degrees of severity of the disease:
- lung;
- average;
- heavy.
Reasons
Since these two subspecies have different names, accordingly, the reasons for their occurrence differ. However, in newborns the cause may be the same. 
Perinatal
Thus, perinatal damage mainly occurs as a result of asphyxia (suffocation) of the baby, which subsequently leads to such consequences as damage to the central nervous system. However, asphyxia is not always the determining factor in the development of the disease. The risk of the disease increases if there is evidence that the expectant mother suffered diseases such as:
- cytomegalovirus;
- toxoplasmosis;
- rubella;
- herpetic lesion;
- syphilis.
There is a classification of causes contributing to this disease:
- hypoxic - ischemic (posthypoxic);
- traumatic;
- hypoxic - traumatic;
- hypoxic - hemorrhagic.
Hypoxic - ischemic
This reason is typical for the antenatal and internatal periods of a baby’s life. Occurs as a result of a one-time or systematic lack of oxygen in a child. This can happen due to the tone of the uterus, as a result of which the umbilical cord is compressed and the baby may not receive enough oxygen, but also some nutrients. Moreover, at the time of birth, there is often a possibility of the umbilical cord entangling around the neck, which inevitably leads to suffocation. In those children for whom this happened during childbirth, central nervous system disorders may be observed.
The mechanism of formation of hypoxic-ischemic damage
Traumatic
This factor includes all injuries that the baby could have received during childbirth, as well as during the neonatal period. As a rule, these are injuries to the neck, spine, and in particularly complex cases, injuries to the skull.
Hypoxic - traumatic
This factor includes a combination of reasons (this reason is also called mixed genesis), namely the suffocation of a baby during the antenatal or internatal period, as well as injuries received during the internatal period as a result of improper positioning of the fetus in the womb or unprofessional actions of doctors. This factor is much more serious than the first two, since the combination of reasons leads to more serious consequences. But, depending on the nature of asphyxia and injuries, it is also possible light form perinatal disorder.
Option of injury during childbirth
Hypoxic - hemorrhagic
This reason is one of the most serious and occurs at the time of birth. When, as a result of prolonged asphyxia, hemorrhage and impaired blood circulation in the brain occur. Possible consequences depending on location varying degrees gravity.
Organic
These violations are:
- acquired;
- congenital.
Congenital diseases arise at the stage of fetal development in the womb and the main reasons for the formation of this pathology are:
- maintaining an unhealthy lifestyle of a pregnant woman (smoking, drinking alcohol or using drugs);
- abuse of certain medications;
- infectious diseases suffered during pregnancy (rubella, sore throat, influenza, etc.);
- with a neuroinfection that was suffered during pregnancy (encephalitis, meningitis);
- exposure severe stress while carrying a child;
- exposure of the mother to radiation, toxic or chemical substances;
- hereditary predisposition to certain mental or neurological diseases;
- pathologies during pregnancy;
- availability expectant mother demyelinating disease of the nervous system;
- with HIV infection;
- acquired or residual disorders arise as a result of birth injuries.
Premature baby support
Symptoms
As a rule, only a neurologist can make a correct diagnosis, who will determine whether the child has PPCNS or an organic lesion of the nervous system. The symptoms of such ailments are similar in many ways, but there are also differences.
Thus, PPCNSL, depending on the severity, has the following symptoms:
Lightweight
- excessive excitability;
- weak muscle response to external stimuli;
- strabismus;
- tremor of the chin, limbs;
- chaotic movement of the eyeballs;
- nervous twitching.
Average
- lack of emotional manifestations;
- problems with stool;
- pale skin;
- paralysis or paresis of limbs;
- convulsive reflexes;
- excessive sensitivity to external stimuli;
- uncontrolled eye movements.
Heavy
- convulsive reflexes;
- renal failure;
- disturbances in the gastrointestinal tract;
- disruptions in the respiratory system;
- partial or complete loss of vision.
Perhaps the formation of a complex of disorders characteristic of childhood cerebral palsy(cerebral palsy)
In addition, depending on when the child was born (earlier due date or on time) clinical picture can be different.
Thus, when a baby is born ahead of schedule, convulsive reflexes and problems with the respiratory system may be observed; in addition, the presence of motor disorders in such children is considered a serious wake-up call for parents.
As for babies who were born exactly on time, the main symptoms may be: inhibition of motor activity, excessive excitability, convulsions, and in the future, possibly the development of clubfoot and even hydrocephalus.
In turn, the main clinical syndromes The residual organic lesions are as follows:
- excessive overwork, frequent fatigue;
- excessive irritability;
- manifestation of aggression;
- mental instability;
- frequent mood changes;
- decrease in intellectual level;
- emotional experiences;
- lethargy;
- speech disorders in adulthood;
- absent-mindedness, which manifests itself quite often.
It is possible that the patient may suffer from personality disorders, infantilism, the patient may exhibit symptoms that arise when mental retardation. The danger of such a disorder is that it can lead to disability and even death of the patient if not properly treated.
Diagnostics
Diagnostic measures for these disorders are carried out in order to find out the true cause of the development of a particular disease, since one examination by a neurologist will be enough for him to determine the presence of a disorder. An external examination will give the doctor the opportunity to understand that not everything is all right with the baby, after which he will definitely prescribe comprehensive diagnostics, which includes:
- electroencephalogram;
- rheoencephalogram;
- Ultrasound of the brain.
If PPCNS is present, the doctor, in addition to the above, prescribes other research methods, namely:
- Dopplerography of cerebral vessels;
- neurosonography;
- X-ray of the skull;
- X-ray of the spine;
- several options for brain tomography.
In addition, such a patient is required to undergo consultation with other specialists, in particular:
- ophthalmologist;
- speech therapist;
- psychologist.
Treatment
If one of the above ailments is detected, treatment must begin immediately, as there is a high probability of a complete cure.
If there is a severe form of the disease, the patient may be placed in the intensive care unit. This does not mean that the baby is in critical condition It’s just that this department has everything necessary to urgently improve the child’s condition. In particular, the patient may need:
- artificial ventilation;
- anticonvulsants;
- parenteral nutrition.
In addition, the following treatment is indicated:
- sedatives;
- psychotropic substances;
- nootropic drugs;
- antipsychotics;
- a complex of vitamins and minerals for natural support of a fragile body.
Among other things, if indicated, the child may be prescribed:
- massage;
- kinesitherapy;
- physiotherapy;
- reflexology;
- acupuncture.
More accurate data regarding the child’s condition will allow him to additionally prescribe a treatment option such as neurocorrection.
Neurocorrection is a complex treatment aimed at restoring lost functions of the brain or spinal cord. This treatment option is restorative.
The character of the formed negative consequences indicates what kind of neurocorrection is needed. It could be:
- classes with a speech therapist;
- psychological treatment (psychologist);
- contacting specialized institutions in the presence of dementia or factors indicating mental retardation.
Forecast and consequences
As a rule, the prognosis for mild and moderate lesions is quite favorable. Approximately 80% of patients completely get rid of the symptoms of the disease, and the remaining 20% may experience minor manifestations in the form of nervous tics or manifestations associated minor deviations, which can only be determined by an experienced doctor.
Regarding the severe degree of damage, as well as untimely treatment illness, the consequences can be much more serious, namely:
- neurasthenia;
- epilepsy;
- post-traumatic stress disorder;
- hysterical fits;
- complete or partial absence self-control;
- speech disorders;
- mental disorders;
- delays in brain development.
Such children find it more difficult to adapt to the world around them and have problems communicating with peers. Perhaps not only later, but also early development child.
Prevention
For the prevention of PPCNSL or residually - organic disorder nervous system must adhere to the following rules:
- during pregnancy, completely follow the doctor’s instructions;
- lead a healthy lifestyle;
- respond to the slightest disturbance on the part of the fetus;
- do not take any medications unless necessary;
- use C-section only according to indications, and not because it is easier (anesthesia can seriously harm the child);
- eat well and properly;
- do not overwork yourself;
- avoid stressful situations.
If you want to give birth healthy child, you should listen to the rules listed above, as this may save you several weeks in the future restless sleep, and your child will be grateful to you. Take care of your children!
