Cortical atrophic changes. Brain atrophy in childhood

Brain atrophy - a decrease in the size of each cell, a decrease in their number. The process is expressed by the deterioration or complete degradation of the functions of the organ. Regardless of the location of atrophic tissues in patients, cognitive abilities decrease, but very rarely completely disappear (cognition of new information). In most cases, there are neurological disorders (somatic diseases central nervous system), neurotic (mental) pathologies are expressed in a quarter of cases, and mixed ones are also found.

Cerebral atrophy of the brain is characterized by an acceleration of destruction and a slowdown in the development of new cells, so the disease is known for a slow but constantly progressive course.

Causes

The activity of the nervous system is not fully understood, therefore, not all causes of atrophic processes in tissues are known. There is a version that degenerative processes in cells with cerebral atrophy are possible under the influence of hereditary factors. In some cases, their onset is provoked by harmful effects.

Reasons laid down in the period intrauterine development:

Abnormal genes that are inherited.
Chromosome mutations.
Infections.

Acquired Causes:

Intoxication of the body, continuing for a long time.
Severe or prolonged brain infections.
Radiation (usually provokes minor dystrophic changes).
Smoking.
Alcoholism.
Addiction.
Impact chemical substances(at home or at work).
Brain injury, accompanied by edema, hematomas, circulatory disorders.
cysts.
Neoplasms.

Congenital predisposition to atrophy is considered a prevailing factor, compared with acquired causes. They can activate the development of genetically embedded anomalies. Acquired atrophic processes in the brain account for no more than 5%, the remaining cases are associated with congenital pathologies.

Diagnostics

Main methods:

MRI- creation of images of sections of parts of an organ (in this case brain). The person is laid down on the couch, takes the position recommended by the instructor. The device starts up and the results of the scan are displayed on the display. Gives information about chemical structure fabrics. Pathological conditions are viewed visually on the image.
CT— layer-by-layer study of the organ. Helps to identify physical state substances. In diseases, the doctor determines changes in the density of the object.
EFFECT- creation of a three-dimensional image of the internal structure of the distribution of radionuclides by emitting photons when a patient is placed in a gamma camera.
PAT- study of the human brain by registering a pair of gamma quanta, for the formation of which a radiopharmaceutical (radioactive drug) is first introduced into the body.
MR spectroscopy– review of metabolic processes, analysis of biochemical changes in tissues.

Additional ways to diagnose brain atrophy:

UZDG (ultrasound dopplerography) - detection of pathologies of blood vessels and arteries of the brain. The person is on the couch. The gel is applied to the neck. The picture of the vessels is compiled according to the information received by the sensor, which is carried out at the location of the vessels.
TKDG (transcranial dopplerography)- a more advanced method for studying the vessels and arteries responsible for the blood supply to the brain. Particular attention is paid to the brachiocephalic arteries.
Thoracic angiography- Diagnosis of the state of blood vessels after the introduction of X-ray contrast agents. Required for condition assessment thoracic aorta. There is direct and indirect methods. Direct involves the introduction of a catheter through the cubital or femoral vein. The indirect method involves the installation of a catheter through the femoral or subclavian artery.
Selective angiography- diagnostics by catheterization method of all vessels involved in the blood supply to the brain.
EEG- obtaining a graphic image of electrical oscillations with an electroencephalograph and comparing them with normal indicators to identify deviations in the process of neuronal metabolism.
evoked potential method- tracking of bioelectrical reactions of the brain to study the functions of the brain (somatosensory (touch, sense of temperature, pain, position of body parts in relation to each other), visual, auditory), changing or disappearing during atrophy.
Analysis of blood plasma.
Laboratory research cerebrospinal fluid (liquor).

Signs of brain atrophy on MRI images

When diagnosing cerebral atrophy in children and adults by MRI, common signs can be observed in a group or individually.

signs, cause of dementia:

Reduction of the temporal lobes of the brain.
Reducing the volume of the hippocampus, which is responsible for the formation of emotions, maintaining the mechanisms of short-term memory and its transition to long-term memory, which is necessary to maintain attention.
Expansion of the furrows of the cerebral cortex with involutive changes visible on it.
On the frontal, parietal and temporal lobes, a decrease in the subarachnoid space in the convexital (adjacent) surface is found.

Manifestations of cerebrovascular insufficiency (changes in cerebral vessels):

Destruction of boundaries between white and gray matter.
Postischemic microcysts (after microstrokes) — in most patients.
Macrocysts more than 5 mm in diameter in a smaller number of patients with brain atrophy.
Expansion of the lateral sulcus (delimits the temporal lobe of the brain from the frontal and parietal).
Involution of the structure of the cerebral cortex.

Degrees of the disease

Depending on the volume of the affected brain tissue, several degrees of atrophy are distinguished. They are taken into account during the examination in order to determine the severity of pathologies caused by degenerative processes, if necessary, to draw up rules of behavior and patient care for relatives.

Atrophy 1 degree

At first, the disease is invisible to either the patient or others. Anxiety of the patient or his environment may appear due to other pathology, which directly or indirectly affects the processes of atrophy of brain cells. Depending on the localization of the process: cortical atrophy or damage to subcortical structures, different changes will be visible.

With the development of moderate atrophy, dizziness, headaches begin, the course and frequency of which gradually worsen. The development of the disease at this stage can often be slowed down. Based on the indications of MRI, the doctor can choose the necessary methods of therapy.

Atrophy 2nd degree

Clinical manifestations of defects in thinking, speech and physical activity are constantly growing. Depending on the defeat of certain structures, specific processes are inhibited and degraded.

Due to brain atrophy, irreversible changes in motor skills, as well as in coordination of movements and gait, can occur, for example, with degeneration of the cerebellum. Thinking, memory and intelligence also suffer. Outwardly, the character, manners of a person can change. In the last stages of atrophy, patients lose the ability to use familiar things, such as Toothbrush cutlery (require hand feeding).

Symptoms

Scroll Common symptoms of brain atrophy:

Simplification of thinking, decrease in analytical abilities.
Speech changes. It becomes more measured, poor, indistinct.
Decreased memory up to its complete loss.
Decreased motor skills.

Symptoms depending on the atrophied area:

Violations breathing.
Cardiovascular pathology.
Crashes in digestive tract.
Absence protective reflexes.
Violations muscle tone.
Deterioration movement coordination.
Violations metabolic processes.
Wrong thermoregulation.
Loss of part or all reflexes.

Natural brain atrophy in old age

atrophy of the brain physiological phenomenon usually begins moderately between the ages of 40 and 60. Symptoms may appear around age 70. A brain that has undergone aging for every 10 years, on average, decreases by 1-2%.

American scientists believe that aging begins under the influence of the lateral and third ventricles of the brain that increase every year. At the age of 65 the ventricles grow by about 0.95 ml each year.

Also, in many people, due to age-related changes, the subarachnoid space (the cavity between the membranes of the brain with cerebrospinal fluid) also increases. From 40 years old the volume of CSF (cerebrospinal fluid) increases by 1 ml. By the age of 90, it can become 40 ml more than the primary value.

As people age, the hemispheres of the brain shrink. Possible dynamic reducing their volume by 0.23% per year. frontal lobe loses up to 0.55%. temporal lobes getting smaller by 0.28%. Occipital and parietal are shrinking by 0.30% per year.

Brain atrophy predetermines the development of various forms dementia (dementia). 7% people over 65 years of age, the development of this pathology is observed. In people over the age of 80, dementia is much more common.

Signs of senile atrophy of the brain

Age changes increase gradually. They begin with harmless signs, but as they progress, they make a person inferior. First, there are changes in a person's character. Active become passive A sociable, emotional — sluggish and indifferent, withdrawn.

The person begins to use poorer speech. Lexicon More is shrinking. Sometimes cultural patients swear with swear words, which may also indicate not a deterioration in character, but progressive atrophy of the brain.

Speech defects — external manifestations thought disorders. Patients are unable to think broadly. All thoughts are tritely simple, and actions are primitive. Such people do not evaluate their behavior from the outside, they commit illogical actions. All mental activity is reduced to the implementation of the simplest things. (regardless of their relevance), that with the progression of the disease can be replaced by a complete lack of activity.

Motor activity in atrophy of the brain, as well as its cortex, always suffers, sometimes even to the point of complete immobility. Motility impairments are especially visible, so patients with brain atrophy unable to do difficult work neither mental nor physical. The first signs are often expressed by the deterioration of handwriting.

Alcoholic brain atrophy

Signs of even the initial stages of brain atrophy expressed very clearly because the first manifestation encephalopathy, expressed in abrupt change the nature and mood of a person to be depressive, sometimes with a suicidal bias. Violations appear due to insufficient blood supply to the brain and its increasing dystrophy.

Under the influence of alcohol, neurons of various parts of the brain (and spinal cord) with the subsequent formation of accumulations of decay products around the affected vessels. Neuronal damage is expressed by several processes: shrivelling, moving, or lysing(dissolution).

Symptoms gradually increase and worsen. Pathology begins with encephalopathy and delirium (stupefaction, delirium), later death is possible.

In the process of brain atrophy with the constant use of alcohol, vascular sclerosis. Deposits form around the brown pigment and iron-containing hemosiderin. Such changes lead to hemorrhages (bleeding in the brain) and cyst formation in the vascular plexuses.

Separately allocated Makiyafawa-Bignami Syndrome, the manifestation of which is the central necrosis of the corpus callosum with the appearance of edema. The disease is accompanied by hemorrhages in the brain and demyelination (destruction of the myelin layer of the nerve fibers of the nervous system).

Cortical atrophy of the brain substance

If the neurons of the knee of the corpus callosum or the anterior part of the posterior cerebellar peduncle are damaged, a hemiplegia (paralysis of half of the body). The posterior parts of the substance of the cerebral cortex, when damaged, lose their control functions, so symptoms that spread to the floor of the body are possible:

Hemianesthesia (loss of skin sensation).
Hemianopsia (inability to see objects when looking in a certain direction, loss of right or left visual fields).
Different muscle groups move differently however, no muscle weakness is observed.
Also one side of the body may lose sensation completely.

multisystem atrophy

Degeneration of various neurons is called multisystem atrophy or Shy-Drager syndrome. The disease causes disturbances in various body systems.
It starts with primary signs:

Akinetic rigid syndrome(movements are rare and inhibited with slight muscle tension).
Cerebellar ataxia(violations of gait, stability, possible violations in the performance of voluntary movements of the limbs).
Urinary problems.

The progression of the disease brings new symptoms:

parkinsonism (slowness of movement, small writing with round, uneven letters).
Cerebellar dysfunction (persistent lack of coordination of movements, the inability to constantly maintain balance, frequent falls).
orthostatic hypotension (V vertical position a person suffers a sharp drop in pressure due to the inability of the vessels to maintain it, expressed in dizziness and fainting).
Sweating disorders.
Urinary incontinence or vice versa inability to urinate at the certain time.
Constipation.
Impotence in men.
Dry skin and mucous membranes.
Speech and eating disorders (swallowing) due to paralysis vocal cords.
Double vision.
Loud breathing during sleep. Possible: shortness of breath, snoring, stridor (whistling).
sleep disorders, in particular apnea (cessation of breathing for a few seconds or minutes, followed by awakening), rapid eye movements.
cognitive degradation (inhibition of the ability to learn new things).

Granular atrophy of the brain

The disease is very rare. It is characterized by such clinical signs:

Strokes . They flow into acute form. Always accompanied by paralysis (inability to make voluntary movements), hemiparesis (complete or partial loss of strength in half of the body).
Aphasia disorders (aphasia). Speech disorders. They occur when the part of the cerebral cortex responsible for speech is damaged, as well as the nearest subcortical structures.
Dementia. Dementia gradually increases, mental retardation may appear. A person loses previously acquired knowledge, poorly perceives new ones.

Often diagnosed in old age, but can begin at any age. With granular atrophy appear and progress cerebrovascular disorders. First of all, damage to the arterioles is observed.

When diagnosed (conducting an MRI), the surface of the cerebral cortex changes the external structure to a bumpy one, becoming as if strewn with grains (granules).

Left hemisphere

Appear speech disorders. Developing motor aphasia: speech sounds slowly, with the application of great efforts of the patient, in some cases all words are made up of individual sounds, sometimes they are illegible.

Logical thinking noticeably degrades. The patient develops a state of constant depression (one of the primary signs of atrophy of the left hemisphere in the temporal region).

Visible images are not fully captured by vision, but are composed of separate fragments. A person cannot read, the handwriting changes, becomes unrecognizable and sloppy. Analytical thinking is gradually disappearing, incoming information is not analyzed, not logically perceived. A person does not remember dates, does not orient himself in them, also does not perceive numbers, the ability to count is lost.

Due to incorrect perception and processing of incoming information mnemonic processes are disrupted(memory is lost). A person perceives what is said in his presence as fragments of phrases or even individual words, so a distorted meaning reaches him.

In severe cases, atrophy of the left hemisphere of the brain causes partial or complete paralysis right side body. First, motor activity is disturbed, and then loss of sensitivity and a decrease in muscle tone increase.

frontal lobes

get worse mnemonic processes (ability to remember), also noticeable degradation (simplification) thinking. Decreased intelligence.

The initial stage is expressed in character change:

The person becomes more secretive, but expresses simplistic thoughts.
Gradually separates from others.
Does illogical things.
Set to meaningless goals.

Phrases and actions are repeated every day. Life passes as if according to a pre-written (quite primitive and the same for every day) scenario. All speech is reduced to simple sentences. Patients lose most vocabulary, therefore express thoughts and needs in monosyllables.

If atrophy of the frontal lobes of the brain occurs with Alzheimer's disease, then the processes of memorization and thinking suffer the most. A person's personality and character are preserved much better than, for example, with Pick's disease therefore, human adequacy can be expected in most cases.

Cerebellum

Come to the fore changes in muscle tone, and ataxia (inconsistency of movements). A person loses dexterity, stability when walking and standing, motor skills may be disturbed to the point of impossibility to perform any work. A person may lose the ability to self-service.
Movement disorders in atrophic changes in the cerebellum have some features:

Before the end of the action appears intentional trembling (imperceptible at rest and manifested in movement, its amplitude is rather low)
Arms and legs become more angular instead of the usual fluency.
All actions (speech and movement) are slowing down.
scanned speech (words are pronounced in syllables, and pronunciation is slow).

In addition to movement disorders, cerebellar atrophy is characterized by nonspecific symptoms: headaches, frequent attacks nausea and vomiting, the person may be drowsy, and hearing loss is also noted.

The progression of atrophy adds new symptoms:

intracranial hypertension (high blood pressure).
Ophthalmoplegia (paralysis of the muscles of the eyes). With atrophy of the cerebellum, it occurs due to paralysis of the cranial (oculomotor) nerves.
Areflexia (loss of reflexes).
Enuresis (urinary incontinence during sleep).
nystagmus (eye movements of high frequency, not controlled by the patient).

Brain atrophy in newborns

The onset of cerebral atrophy in infants is often influenced by hydrocephalus, in the people a dropsy. With this pathology an increase in the amount of cerebrospinal fluid, serving as a protective shell of the brain, but in the case of an increase squeezing him.

During intrauterine development, such a pathology is detected by the method ultrasound. Hydrocephalus can develop due to disorders in the formation of the nervous system. The process is influenced intrauterine infections, such as herpes, cytomegaly (a disease of the salivary glands, in adults it is minimally manifested).

Congenital causes of hydrocephalus developmental defects. matter birth trauma moderate or severe, in which the infant has a cerebral hemorrhage with the subsequent development of meningitis.

Children with cerebral atrophy months of life are spent in intensive care. In some cases, it is allowed to stay at home in the pauses between courses of treatment, round-the-clock monitoring by neurologists. Further children need a long rehabilitation.

Therapeutic methods, developmental activities, positive emotions can make possible or accelerate the processes taking on certain functions by healthy parts of the brain to replace the work of atrophied ones. The prognosis for complete recovery is usually poor.

Treatment

There is no way to restore atrophied brain cells. You can only relatively slow down the course of atrophy. All treatments are aimed at relief or relief of symptoms, appearing in the process of degradation of various parts of the brain.

Patients need a calm environment around. Extremely I wish they were at home. Hospitalization is undertaken in extreme cases. All of them are due to the lack of the ability to provide proper patient care.

Hospitalization or residence in a boarding school for the disabled is practiced for patients with obvious severe mental disorders, inadequacy, mental retardation. It is also possible to transfer the patient to a specialized institution if it is impossible to provide permanent care.

It is desirable to create conditions for a person with brain atrophy, suggesting activity, healthy lifestyle. Sleep or long rest during the daytime (overwhelming) time of day is not required. If possible the sick person is involved in daily household chores, other work or vigorous activity, entertainment.

Psychotropic drugs in the treatment of cerebral atrophy are undesirable, however, their relative necessity is revealed in the manifestations excited state, increased irritability or vice versa apathy to varying degrees.

The only way to treat brain atrophy in modern medicine is slowing down the destruction of neurons, cells. Scientists have found the effectiveness of this in such groups of drugs:

Vascular drugs (Cavinton).
Nootropics - stimulators of brain functions (Ceraxon).
Metabolic drugs - means to improve metabolic processes.
Vitamin B6 helps maintain proper fiber structure nervous tissue.

Symptomatic treatment stops signs of atrophy for a certain time, the following are effective:

Antidepressants - stop the depressed state and some disorders of brain function.
sedatives - deposition of signs of disorders of the nervous system.
tranquilizers — psychotropic drugs, help to temporarily remove anxiety state, calm a person, remove muscle tension, stop convulsions. They have a hypnotic or vice versa activating effect.

Prevention of brain atrophy

Exact methods to prevent the occurrence of this pathology have not been identified. It is only possible to delay this process, not to create additional conditions for the appearance of destructive processes in the brain.

Required compliance with the rules:

Timely treatment of any diseases in the body, directly or indirectly affecting the brain.
Passing examinations to detect pathologies.
Alternating monotonous work and life with active recreation and sports.
Balanced diet with a minimum percentage of harmful substances.
Do not neglect the necessary rest.
Preventing the development of atherosclerosis cerebral vessels. For this you need: control over body weight, rejection of fatty foods, treatment of pathologies of the endocrine system (hormone release) and metabolism, all kinds of obstacles to excessive obesity.

Need to exclude risk factors, which, in their excess, lead to atrophy of the brain tissue. Required:

quit smoke.
Refuse alcohol and drugs.
Remove (if possible) everything factors that depress immune system.
To not allow psycho-emotional stress, respond moderately to stress.

Practice shows that people with an active, cheerful attitude more often than others live to old age without signs of common pathologies associated with brain atrophy.

The destruction of cells and their connections with complete dysfunction is called brain atrophy. Subatrophy of the brain is called a partial local loss of brain function. With a disease such as cerebral atrophy of the brain, life expectancy does not change, since neurons die off gradually and, according to statistics, in most cases death occurs from other diseases. However, this disease is characterized by progression, leading the patient to dementia (acquired dementia).

As a rule, cerebral atrophy of the brain makes itself felt after the 45-year age threshold, but studies have established cases of earlier manifestation. Cerebral atrophy of the brain of the head occurs as a result of exposure to a large number of various causes, one of which is the natural aging of organs. The main reason is genetic predisposition.

At the same time, there are many other possible factors that contribute to the further death of cells:

intoxication, frequent and excessive use of alcohol, gradually damaging the cerebral cortex;
drugs and exposure to adverse environmental conditions (for work and in the place of residence);
brain injury with hematomas, edema, hemodynamic disorders, neoplasms;
neurological ailments ( poor circulation and provision of tissues with oxygen, ischemia, etc.);
persistent lack of desire for mental development and work throughout life, increasing the risk of developing the disease.

An unfavorable outcome is a severe impairment of brain functions, accompanied by Parkinson's, Alzheimer's, Pick's and others, insanity.

Destruction of the frontal part of the cerebral cortex entails the first signs of cerebral atrophy associated with changes in behavior, complication of control over conventional manipulations and other symptoms.

Atrophic changes may also be accompanied by:

immunodeficiency (lack of vitamins B1, B3 and folic acid, HIV);
deterioration of metabolism;
mental disorders;
severe renal failure;
infectious diseases (meningitis, encephalitis);
amyotrophic and multiple sclerosis;
neurosyphilis;
leukoencephalopathy;
spinocerebral degenerative processes;
hydrocephalus;
anoxia and traumatic brain injury;
brain abscesses, subdural, intracerebral and epidural hematomas and intracranial tumors;
vascular disorders;
chronic alcoholism.

The severity of the lesion is determined by the types of pathology:

Cortical - the death of the frontal, and then other areas of the cortex, the consequences of which are senile dementia and Alzheimer's disease.
Multisystem - neurodegeneration with the capture of many departments (cerebellum, trunk, basal ganglia, spinal areas).
Posterior - damage to the occipital lobe caused by neurodegenerative plaques (a variant of the course of Alzheimer's disease).

Symptoms

Atrophic brain damage first manifests itself in barely noticeable changes: a person indulges in apathy and indifference, his aspirations disappear and lethargy appears, memory deteriorates. Old skills are lost and new ones are hard to acquire. Often there is a strong deviation from moral norms, irritability and conflict increase, sharp mood swings, depression occur.

The following symptoms are also observed:

impoverishment of the lexicon - a protracted selection of the right words to express ordinary realities;
decline brain activity;
the disappearance of self-criticism, the ability to comprehend;
sensitivity disorders, erectile dysfunction;
motor impairment;
parkinsonism.

Cognitive functions continue to deteriorate along with well-being. The ability to distinguish objects and use them is reduced. A "mirror" syndrome is detected, in which the patient involuntarily repeats other people's behavioral habits. Gradually almost stops mental activity and complete incapacity sets in (the stage of insanity), the personality disintegrates.

Specific symptoms in cerebral atrophy of the brain of the head depend on the involvement of various sites. For example, damage to the frontal lobes negatively affects behavior and intelligence, while damage to the cerebellum affects motor skills, gait, speech, and handwriting. If the nerve connecting pathways are damaged, vegetative disorders may occur.

Atrophic processes in newborns

Brain atrophy is also observed in children. In this case, negative changes in tissues are associated with prolonged hypoxia. Since children's brain structures require a greater blood supply than adults to develop, small anomalies lead to serious consequences.

The causes of cerebral atrophy can be genetic, conflicting Rh factors of the mother and fetus, intrauterine developmental abnormalities and neuroinfection. Consequences are usually detected after the first year of life.

The necrosis of neurons leads to cystic formations and hydrocephalus. Such a complication of cerebral atrophy as retarded development is also common. How long they live with cerebral and cortical atrophy of the brain depends on the severity of the pathology - this is an ambiguous question.

Diagnosis and treatment

The presence of brain pathology is determined by a single procedure instrumental diagnostics. In case of an inaccurate result and the need to clarify the degree of damage, several methods are prescribed. There are the following methods:

CT (computed tomography), which helps to identify vascular anomalies, neoplasms that impede blood flow. One of the most informative is multispiral CT, which detects even the first signs of cerebral atrophy of the brain.
MRI (magnetic resonance imaging) not only detects the early stages of brain disorders, but also monitors the progress of the disease, including cerebral atrophy.

Treatment of brain atrophy is aimed at eliminating symptoms and combating the spread of necrosis. Early symptoms do not involve medication (elimination of bad habits and negative factors, proper nutrition works well).

Does not exist therapeutic methods, reversing the process of necrosis, therefore, all efforts are directed to improving the patient's condition, slowing down the necrosis of brain cells and mitigating the manifestations of the disease.

For therapy use:

Psychotropic drugs that help cope with psychoemotional disorders (antidepressants, sedatives and mild tranquilizers).
Medicines to stimulate hematopoietic functions and improve blood circulation, which contributes to the saturation of tissues with oxygen and, therefore, slows down death (Trental).
Nootropics that also improve blood circulation and metabolism, but also have a good effect on mental activity (Piracetam, Cerebrolysin).
Antihypertensive drugs. Among the factors provoking necrosis is hypertension. Normalization of pressure does not allow rapid progression of changes.
Diuretics in the presence of hydrocephalus.
Antiplatelet agents for increased thrombosis.
Statins (to normalize fat metabolism) in atherosclerosis.
Antioxidants that stimulate regeneration and metabolism, to some extent opposing atrophic processes.
Non-steroidal anti-inflammatory drugs, often used to relieve headaches. There is a clear need for understanding and active participation of loved ones in the rehabilitation of a patient with cerebral atrophy.

fresh air and walks;
methodical physical activity and massage in the absence of contraindications;
communication, avoiding leaving the patient alone;
self-care habits, even if symptoms progress.

A good atmosphere, a positive attitude, and the elimination of stress have a beneficial effect on the well-being of a patient with cerebral atrophy and stop the development of the disease.

Brain atrophy is not characterized by a positive prognosis, because it is an incurable disease that always ends in death, and there is only a difference in its duration. dying off nerve cells does not stop when running.

To the most hazards include hereditary causes of brain pathology, leading to lethal outcome in a matter of years. With vascular pathology, the course of the disease can reach 10-20 years.

Video

Brain atrophy is a chronic pathological process, which results in a progressive decrease in the number of nerve cells due to their death, as well as a decrease in volume, mass and, as a result, the functionality of the central nervous system.

In the vast majority of cases, the death of brain cells is a secondary condition, which is a consequence of pathological process that prevents proper nutrition and functioning of brain neurons.

Atherosclerotic lesion of cerebral vessels. The death of brain cells begins when atherosclerotic deposits, causing narrowing of the lumen blood vessels, cause a decrease in the trophism of neurons, and subsequently, as the disease progresses, their death. The process is disseminated. Brain atrophy caused by atherosclerotic vascular disease is one of the special cases of ischemic atrophy.
Chronic intoxication effects. The death of brain nerve cells in this form of the disease is caused by the harmful effects of toxic substances on them. Alcohol, drugs, some of the pharmaceuticals, nicotine. The clearest examples of this group of diseases can be considered alcoholic and narcotic encephalopathy, when atrophic changes in the brain are represented by smoothing of the relief of the convolutions and a decrease in the thickness of the cortex of the hemispheres, as well as subcortical formations.
Residual phenomena of traumatic brain injury. Hypotrophy and atrophy of the brain long-term effect head injuries are usually local. The death of nerve cells occurs in the damaged area of the brain; in their place, cystic formations, glial foci or scars subsequently form. Such atrophy is called post-traumatic.
Chronic cerebrovascular insufficiency. The most common causes of this condition are an atherosclerotic process that reduces the patency of cerebral vessels; arterial hypertension and age decline elasticity of the vessels of the cerebral capillary bed.
Degenerative diseases of the nervous tissue. These include Parkinson's disease, Alzheimer's disease, Pick's disease, cerebral degeneration with Lewy bodies, and others. To date, there is no single answer about the causes of the development of this group of diseases. These diseases have a common feature in the form of gradually developing atrophy of various parts of the brain, are diagnosed in elderly patients and in total account for about 70 percent of cases. senile dementia.
intracranial hypertension. Compression of the brain substance with a long-term increase in intracranial pressure can lead to atrophic changes in the substance of the brain. Cases of secondary malnutrition and atrophy of the brain in children with a congenital form of hydrocephalus can serve as a good example.
genetic predisposition. To date, clinicians are aware of several dozen genetically determined diseases, one of the features of which are atrophic changes in the brain substance. One example is Huntington's chorea.

Classification

Given the prevalence of the atrophic process, the following types of cerebral atrophy are distinguished:

Cortical atrophy is characterized by the death of neurons in the cortical substance of the brain, which is observed when arterial hypertension, atherosclerosis, intoxications and forms the basis of the so-called age-related changes in the nervous tissue. With a predominant lesion of the nervous tissue, cortical atrophy causes the formation of the so-called frontal syndrome.
Multifocal atrophy. According to this scenario, events develop in degenerative as well as genetically determined conditions. In this case, along with neurons, cells of the brain stem, cerebellar tissue, and basal ganglia atrophy. Affects the pathological process and white matter. Due to the extensive lesion, this type of cerebral atrophy is characterized by the multiplicity and severity of symptoms. Dementia reaches an extreme degree, balance and coordination disorders, parkinsonism and autonomic disorders are very pronounced.
Limited atrophy of the brain (local). More often it is the result of a traumatic brain injury or stroke. The leading manifestations are focal symptoms, the specificity of which depends on the area and degree of damage to the nervous tissue.
diffuse atrophy. Its causes are dyscirculatory disorders or neurodegenerative diseases. The brain tissue in this case is evenly affected.

Manifestations

As it progresses, the pathological process goes through several stages

stage of minimal change. A patient with such a pathology is able to work, the usual activities do not cause him any difficulties. Signs of atrophy at this stage are often attributed to age-related changes and are limited to a slight decrease in cognitive functionality. From time to time, a decrease in memory is noticeable, some difficulties in solving complex problems. Changes in gait, episodes of dizziness and headaches are possible. Psychoemotional deviations are expressed in a decrease in affective background, tearfulness, irritability. There are no restrictions on life activity with atrophy of the brain of the 1st degree.
At the stage of moderate atrophy, aggravation of symptoms is observed. Now a sick person needs prompts in solving complex problems, demonstrates a progressive violation of behavioral reactions (up to the loss of the ability to control their actions). Increasing discoordination movement disorders; social adjustment suffers.
Severe cerebral atrophy of the brain is characterized by the progression of symptoms, the rate of which depends on the number of dying nerve cells. There are gross violations of motor skills and the psyche up to dementia. Memory disorders progress, reaching the forgetting of the names and purpose of objects. Vegetative functions are also disturbed, urination and swallowing disorders are typical. A sick person in a state of dementia is not socially adapted, loses the ability to self-service, needs constant monitoring and care.

Except common manifestations, brain atrophy is accompanied by specific symptoms depending on the intensity and position of the pathological process.

frontal area syndrome

Atrophy of the frontal lobes of the brain manifests itself in the form of the following symptom complex:

reduced ability to self-control;
gradual extinction of spontaneous and creative activity;
severe irritability;
selfish character traits appear or become aggravated;
a sick person is prone to impulsiveness, affective breakdowns, rudeness;
decrease in intelligence and memory, not reaching the level of dementia;
tendency to apathy and lack of desire;
hypersexuality, primitive jokes.

Cerebellar atrophy

Atrophy of the cerebellum of the brain is accompanied by the following symptoms:

severe motor and speech disorders;
loss of ability to write;
cranialgia;
nausea and vomiting;
hearing disorder;
visual failures.

Subatrophy of the brain

So it is customary to call the borderline state, accompanied by a partial loss of the functions of a certain area of the medulla. Subatrophy of the brain is a stage at which it is still possible to stop the progression of the pathological process. The appearance of one or more symptoms is a signal that a person needs a detailed examination, including a neurological examination and an examination of intellectual functions. Delayed diagnosis will lead to the progression of the pathology and the development of atrophy of the brain substance.

Characteristic manifestations of subatrophic changes:

somewhat delayed reactions;
small violations fine motor skills;
transient episodic memory disorders.

Brain atrophy in childhood

Brain atrophy in newborns is usually associated with the following pathological conditions:

hydrocephalus;
congenital malformations of brain ontogenesis;
oxygen starvation of neurons as a result of neonatal hypoxia.

Factors that can lead to these pathologies:

influence on the fetus during its development of ionizing radiation;
the action of certain groups of medicines;
a woman's use of alcohol or drugs during pregnancy;
hereditary predisposition;
infectious factor (both before and after the birth of a child);
complications of pregnancy and childbirth, birth trauma.

The children's brain is very plastic and has a greater reserve than that of adults for restoring its normal functions. In cases of severe damage, oxygen starvation of cerebral neurons leads to rather serious consequences (cerebral palsy, mental retardation).

Diagnostics

For visualization, it is advisable to use the method of magnetic resonance imaging. This technique allows us to determine with a high degree of accuracy the location of the focus of atrophy, the degree of its prevalence, the structure and size of the atrophied area. MRI makes it possible both to detect the disease at the very initial stages, when the nervous tissue is just beginning to atrophy, and to observe the process in dynamics, tracking the rate of its progression.
Testing aimed at identifying intellectual-mnestic disorders (the method involves contact between the patient and the doctor, therefore it is applicable to adults).

Treatment

Atrophic diseases of the brain are characterized, as a rule, by a steadily progressive course. Means capable of completely stopping the process of atrophy have not been created to date.
Treatment of brain atrophy is carried out in two main areas:

Therapy of the underlying disease that led to the onset of the pathological process ( antihypertensive therapy with arterial hypertension, statins with atherosclerosis of blood vessels). With alcoholic etiology of the pathology we are considering, the patient needs to give up the bad habit in order to avoid the progression of atrophy. The patient should be explained what it is and that such a condition is irreversible.
Symptomatic therapy that minimizes the manifestations of the disease. Mood swings help level psychoactive compounds, vasoactive drugs improve hemodynamics and trophism of the nervous tissue.

Treatment of brain atrophy should be started at the earliest possible stage in order to slow down the pathological process as early as possible and as few neurons atrophy as possible. How long a person lives in a conscious state will depend on this, because atrophy of the cerebral cortex can relatively quickly lead to dementia.

With atrophic changes in the brain, treatment is optimally carried out in the patient's usual environment - at home. However, for cases where relatives who live with the patient cannot cope, hospitalization in specialized institutions is indicated.

Factors positively affecting the patient's condition

The progression of degenerative phenomena is successfully resisted by a rational day regimen, good nutrition, dosed physical activity. A healthy lifestyle is a universal tool that helps to increase life expectancy, as they say, in your right mind.
Complete exclusion of toxic factors of influence. This is especially true for toxic encephalopathy. Having determined how to treat the pathology, the attending physician must convince the patient to exclude all harmful factors.
Background antihypertensive therapy. Nervous tissue atrophies gradually, so the sooner antihypertensive therapy is prescribed, the longer the patient will be able to live on early stages degeneration.
Healthy food. A balanced diet helps to avoid many metabolic abnormalities (especially lipid balance).
intellectual activity. This condition is mandatory because it stimulates nerve cells to action.

Brain atrophy is a process of gradual death of cerebral cells and destruction of interneuronal connections. The pathological process can spread to the cerebral cortex or subcortical structures. Despite the cause of the pathological process and the treatment used, the prognosis for recovery is not entirely favorable. Atrophy can affect any functional area of the gray matter, leading to impaired cognitive abilities, sensory and motor disorders.

ICD-10 code

G31.0 Limited cerebral atrophy

Epidemiology

Most of reported cases are among the elderly, namely women. The onset of the disease can start after 55 years and after a couple of decades lead to complete dementia.

Causes of brain atrophy

Brain atrophy is a serious pathology that occurs as a result of age-related degenerative processes, a genetic mutation, the presence concomitant pathology or exposure to radiation. In some cases, one factor may come to the fore, and the rest are only a background for the development of this pathology.

The basis for the development of atrophy is a decrease in the volume and mass of the brain with age. However, one should not think that the disease concerns only senile age. There is brain atrophy in babies, including newborns.

Almost all scientists unanimously argue that the cause of atrophy lies in heredity, when there are failures in the transmission of genetic information. surrounding negative factors are considered a background effect that can accelerate the process of this pathology.

Causes of congenital brain atrophy imply the presence of a genetic anomaly of hereditary origin, a mutation in the chromosomes, or an infectious process during pregnancy. Most often this concerns a viral etiology, but bacterial is also often observed.

From the group of acquired predisposing factors, it is necessary to single out intoxications of a chronic course, especially Negative influence alcohol, infectious processes in the brain, both acute and chronic, traumatic injury brain and exposure to ionizing radiation.

Of course, acquired causes can come to the fore only in 5% of all cases, since in the remaining 95% they are a provoking factor against the background of manifestations of a genetic mutation. Despite the focality of the process at the beginning of the disease, the entire encephalon is gradually affected with the development of dementia and dementia.

At the moment, it is not possible to describe pathogenetically all the processes that take place in the brain during atrophy, since the nervous system itself and its functionality have not been fully studied. However, some information is still known, especially about manifestations of atrophy involving certain structures.

Symptoms of brain atrophy

As a result of age-related changes in the encephalon, as well as other organs, processes of reverse development occur. This is due to the acceleration of destruction and slowing down of cell regeneration. Thus, the symptoms of brain atrophy gradually increase in severity depending on the area of the lesion.

At the beginning of the disease, a person becomes less active, indifference, lethargy appear, and the personality itself changes. Sometimes there is an ignorance of moral behavior and actions.

Then there is a decrease in vocabulary, which ultimately leads to the presence of primitive expressions. Thinking loses its productivity, the ability to criticize behavior and think about actions is lost. In relation to motor activity, motor skills deteriorate, which leads to a change in handwriting and a deterioration in semantic expression.

Symptoms of brain atrophy may affect memory, thinking, and other cognitive functions. Thus, a person may stop recognizing objects and forget how they are used. Such a person needs constant monitoring in order to avoid unforeseen emergencies. Problems with orientation in space occur due to memory impairment.

Such a person cannot adequately assess the attitude of the surrounding people towards him and is often suggestible. In the future, with the progression of the pathological process, there is a complete moral and physical degradation of the personality due to the onset of insanity.

Brain atrophy 1 degree

Degenerative changes in the brain become more active with age, however, under the influence of concomitant additional factors, thinking disorders can develop much faster. Depending on the activity of the process, its severity and the severity of clinical manifestations, it is customary to distinguish several degrees of the disease.

Brain atrophy of the 1st degree is observed on initial stage diseases when there is a minimum level of pathological abnormalities in the functioning of the encephalon. In addition, one should take into account where the disease is initially localized - in the cortex or subcortical structures. The first manifestations of atrophy that can be seen from the side depend on this.

At the initial stage, atrophy may have absolutely no clinical symptoms. Perhaps the appearance of human anxiety due to the presence of another comorbidity that directly or indirectly affects the functioning of the encephalon. Then, periodic dizziness and headaches may appear, which gradually become more frequent and intense.

If a person at this stage consult a doctor, then grade 1 brain atrophy under the influence of drugs slows down its progression and there may be no symptoms. With age, it is necessary to adjust therapeutic therapy, selecting other drugs and dosages. With their help, you can slow down the growth and emergence of new clinical manifestations.

Brain atrophy grade 2

The clinical picture and the presence of certain symptoms depend on the degree of brain damage, in particular on damaged structures. The 2nd degree of pathology usually already has some manifestations, due to which the presence of pathological processes can be suspected.

The onset of the disease can be manifested exclusively by dizziness, headache, or even manifestations of another concomitant illness, which affects the work of the encephalon. However, in the absence of therapeutic measures, this pathology continues to destroy structures and increase clinical manifestations.

So, to periodic dizziness, a deterioration in mental capabilities and the ability to analyze is added. In addition, the level of critical thinking decreases and self-esteem of actions and actions is lost. speech function. In the future, most often, changes in speech, handwriting increase, as well as old habits are lost and new ones appear.

Brain atrophy of the 2nd degree, as it progresses, causes a deterioration in fine motor skills, when the fingers cease to “obey” the person, which leads to the impossibility of performing any work involving the fingers. Coordination of movements also suffers, as a result of which gait and other activities slow down.

Thinking, memory and other cognitive functions gradually worsen. There is a loss of skills in the use of objects familiar to daily use, for example, a TV remote control, a comb or a toothbrush. Sometimes you can notice a person copying the behavior and manners of other people, which is due to the loss of independence in thinking and movements.

Forms

Atrophy of the frontal lobes of the brain

In some diseases, at the first stage, atrophy of the frontal lobes of the brain is observed, followed by progression and spread of the pathological process. This applies to Pick's disease and Alzheimer's.

Pick's disease is characterized by a destructive lesion mainly of neurons in the frontal and temporal regions, which causes the appearance of certain clinical signs. With their help, the doctor can suspect the disease and, using instrumental methods to make the correct diagnosis.

Clinically, damage to these areas of the encephalon is manifested by a change in personality in the form of a deterioration in thinking and the process of memorization. In addition, from the onset of the disease, a decrease in intellectual abilities. There is a degradation of a person as a person, which is expressed in the angularity of character, secrecy, alienation from the surrounding people.

Motor activity and phrases become pretentious and may be repeated in a pattern. Due to the decrease in vocabulary, there is a frequent repetition of the same information in the course of a conversation or after a while. Speech becomes primitive with the use of monosyllabic phrases.

Atrophy of the frontal lobes of the brain in Alzheimer's disease is slightly different from Pick's pathology, since in this case there is a greater deterioration in the process of remembering and thinking. As for the personal qualities of a person, they suffer a little later.

Atrophy of the cerebellum

Dystrophic lesions can begin with the cerebellum, moreover, without involving pathways in the process. Ataxia and changes in muscle tone come to the fore, despite the fact that the causes of development and the prognosis are more similar to damage to the neurons of the hemispheres.

Atrophy of the cerebellum of the brain can be manifested by the loss of a person's ability to self-service. Damage to the cerebellum is characterized by disorders in the combined functioning of skeletal muscles, coordination of movements and maintenance of balance.

Disorders of motor activity due to pathology of the cerebellum have several features. So, a person loses the smoothness of his arms and legs when performing movements, intentional trembling appears, which is noted at the end of a motor act, handwriting changes, speech and movements become slower, and chanted speech occurs.

Atrophy of the cerebellum of the brain can be characterized by an increase in dizziness, an increase in headaches, the appearance of nausea, vomiting, drowsiness and disorders auditory function. Intracranial pressure increases, ophthalmoplegia may occur due to paralysis of the cranial nerves, which are responsible for the innervation of the eye, areflexia, enuresis and nystagmus, when the pupil performs involuntary rhythmic oscillations.

Atrophy of the brain substance

The destructive process in neurons can occur during physiological process due to age-related changes after 60 years or pathological - as a result of any disease. Atrophy of the substance of the brain is characterized by the gradual destruction of the nervous tissue with a decrease in the volume and mass of gray matter.

Physiological destruction is noted in all people in old age, but the course of which can only be slightly exerted by a medicinal effect, slowing down destructive processes. With regard to pathological atrophy due to the negative impact harmful factors or another disease, then it is necessary to act on the cause of atrophy in order to stop or slow down the destruction of neurons.

Atrophy of the substance of the brain, in particular white matter, may develop as a result of various diseases or age-related changes. It is worth highlighting individual clinical manifestations of pathology.

So, with the destruction of the neurons of the knee, hemiplegia appears, which is a paralysis of the muscles of half of the body. The same symptoms are observed when the anterior portion of the posterior leg is damaged.

Destruction of the posterior area is characterized by a change in sensitivity in half of the areas of the body (hemianesthesia, hemianopsia and hemiataxy). The defeat of the substance can also cause a complete loss of sensitivity on one side of the body.

Mental disorders are possible in the form of a lack of recognition of objects, the performance of purposeful actions and the appearance of pseudobulbar signs. The progression of this pathology leads to disorders of speech function, swallowing and the occurrence of pyramidal symptoms.

Cortical atrophy of the brain

Due to age-related changes or as a result of a disease that affects the encephalon, the development of such a pathological process as cortical atrophy of the brain is possible. Most often, the frontal parts are affected, but the spread of destruction to other areas and structures of the gray matter is not excluded.

The disease begins imperceptibly and slowly begins to progress, and the increase in symptoms is noted after a few years. With age and in the absence of treatment, the pathological process actively destroys neurons, which ultimately leads to dementia.

Cortical atrophy of the brain mainly occurs in people after 60 years of age, but in some cases, destructive processes are observed even at an earlier age due to the congenital genesis of development due to a genetic predisposition.

The defeat of the two hemispheres of cortical atrophy occurs in Alzheimer's disease or in other words, senile dementia. The pronounced form of the disease leads to complete dementia, while small destructive foci do not have a significant negative impact on the mental capabilities of a person.

The severity of clinical symptoms depends on the location and severity of damage to the subcortical structures or cortex. In addition, the rate of progression and the prevalence of the destructive process should be taken into account.

Multisystem atrophy of the brain

Degenerative processes underlie the development of Shy-Drager syndrome (multisystem atrophy). As a result of the destruction of neurons in some areas of the gray matter, disturbances in motor activity occur, and control over autonomic functions is lost, for example, blood pressure or the process of urination.

Symptomatically, the disease is so diverse that, for a start, some combinations of manifestations can be distinguished. Thus, the pathological process is expressed autonomic dysfunctions, in the form of parkinsonian syndrome with the development of hypertension with trembling and slowing of motor activity, as well as in the form of ataxia - unsteady walking and impaired coordination.

The initial stage of the disease is manifested by an akinetic-rigid syndrome, which is characterized by slow movements and has some symptoms of Parkinson's disease. In addition, there are problems with coordination and genitourinary system. In men, the first manifestation may be erectile dysfunction, when there is no ability to achieve and maintain an erection.

As for the urinary system, it is worth noting urinary incontinence. In some cases, the first sign of pathology may be sudden falls of a person throughout the year.

With further development, multisystem atrophy of the brain acquires new symptoms that can be divided into 3 groups. The first is parkinsonism, which manifests itself in slow awkward movements and changes in handwriting. The second group includes urinary retention, urinary incontinence, impotence, constipation and paralysis of the vocal cords. And finally, the third - consists of dysfunction of the cerebellum, which is characterized by difficulty in coordination, loss of a sense of prostration, dizziness and fainting.

In addition to cognitive impairment, other symptoms are possible, such as dry mouth, dry skin, changes in sweating, snoring, shortness of breath during sleep, and double vision.

Diffuse atrophy of the brain

Physiological or pathological processes in the body, in particular, in the encephalon, can trigger the degeneration of neurons. Diffuse atrophy of the brain can occur as a result of age-related changes, genetic predisposition, or under the influence of provoking factors. These include infectious diseases, trauma, intoxication, diseases of other organs, as well as the negative impact of the environment.

Due to the destruction of nerve cells, there is a decrease in brain activity, the ability of critical thinking and control over one's actions is lost. In old age, a person sometimes changes behavior that is not always clear to others.

The onset of the disease can be localized in different areas, which causes certain symptoms. As other structures are involved in the pathological process, new clinical signs appear. Thus, the healthy parts of the gray matter are gradually affected, which ultimately leads to dementia and loss of personality.

Diffuse atrophy of the brain is initially characterized by the appearance of symptoms similar to cortical atrophy of the cerebellum, when gait is disturbed and spatial sensation is lost. In the future, there are more manifestations, as the disease gradually covers new areas of gray matter.

Atrophy of the left hemisphere of the brain

Each section of the encephalon is responsible for a specific function, therefore, when it is damaged, a person loses the ability to perform something, either physically or mentally.

The pathological process in the left hemisphere causes the appearance of speech disorders, such as motor aphasia. With the progression of the disease, speech may consist of separate words. In addition, suffering logical thinking and a depressive state develops, especially if the atrophy is localized mostly in the temporal region.

Atrophy of the left hemisphere of the brain leads to the lack of perception of the full image, the surrounding objects are perceived separately. Parallel to this, a person's ability to read is impaired, handwriting changes. Thus, analytical thinking suffers, the ability to think logically, analyze incoming information and manipulate dates and numbers is lost.

A person cannot correctly perceive and process information consistently, which leads to the inability to remember it. The speech addressed to such a person is perceived separately by sentences and even words, as a result of which there is no adequate reaction to the appeal.

Severe atrophy of the left hemisphere of the brain can cause complete or partial paralysis of the right side with impaired motor activity due to changes in muscle tone and sensory perception.

Mixed brain atrophy

Cerebral disorders can occur as a result of age-related changes, under the influence of a genetic factor or concomitant pathology. Mixed brain atrophy is a process of gradual death of neurons and their connections, in which the cortex and subcortical structures suffer.

Degeneration of the nervous tissue occurs mostly in women over 55 years of age. As a result of atrophy, dementia develops, and that significantly worsens the quality of life. With age, the volume and mass of the brain decrease due to the gradual destruction of neurons.

The pathological process can be observed in childhood when it comes to the genetic pathway of disease transmission. In addition, there are comorbidities and environmental factors, such as radiation.

Mixed brain atrophy covers the functional areas of the encephalon, which are responsible for controlling motor and mental activity, planning, analysis, and also criticizing one's behavior and thoughts.

The initial stage of the disease is characterized by the appearance of lethargy, apathy and a decrease in activity. In some cases, immoral behavior is observed, as a person gradually loses self-criticism and control over actions.

In the future, there is a decrease in the quantitative and qualitative composition of the vocabulary, the ability of productive thinking, self-criticism and understanding of behavior are lost, and motor skills deteriorate, which leads to a change in handwriting. Further, a person ceases to recognize objects familiar to him, and eventually insanity sets in, when there is practically a degradation of the personality.

Atrophy of the parenchyma of the brain

The causes of parenchyma damage are age-related changes, the presence of concomitant pathology that directly or indirectly affects the encephalon, genetic and harmful environmental factors.

Atrophy of the brain parenchyma can be observed due to insufficient nutrition of neurons, since it is the parenchyma that is most sensitive to hypoxia and insufficient intake of nutrients. As a result, cells decrease in size due to compaction of the cytoplasm, nucleus and destruction of cytoplasmic structures.

In addition to a qualitative change in neurons, cells can disappear altogether, reducing the volume of the organ. Thus, atrophy of the brain parenchyma gradually leads to a decrease in the weight of the brain. Clinically, damage to the parenchyma can be manifested by impaired sensitivity in certain areas of the body, impaired cognitive function, loss of self-criticism and control over behavior and speech function.

The course of atrophy steadily leads to the degradation of the personality and ends in death. With the help of medicines, you can try to slow down the development of the pathological process and support the functioning of other organs and systems. Also used symptomatic therapy to alleviate the human condition.

spinal cord atrophy

Reflexively, the spinal cord can carry out motor and autonomic reflexes. Motor nerve cells innervate the muscular system of the body, including the diaphragm and intercostal muscles.

In addition, there are sympathetic and parasympathetic centers that are responsible for the innervation of the heart, blood vessels, digestive organs and other structures. For example, in the thoracic segment is the center of the expansion of the pupil and the sympathetic centers of innervation of the heart. The sacral region has parasympathetic centers responsible for the functionality of the urinary and reproductive systems.

Atrophy of the spinal cord, depending on the localization of destruction, can manifest itself as a violation of sensitivity - with the destruction of neurons of the posterior roots, or motor activity - of the anterior roots. As a result of the gradual damage to individual segments of the spinal cord, there are violations of the functionality of the organ that is innervated at this level.

So, the disappearance of the knee reflex occurs due to the destruction of neurons at the level of 2-3 lumbar segment, plantar - 5 lumbar, and the violation of contraction abdominal muscles observed with atrophy of nerve cells of 8-12 thoracic segments. Especially dangerous is the destruction of neurons at the level of the 3-4th cervical segment, where the motor center of innervation of the diaphragm is located, which threatens human life.

Alcoholic brain atrophy

The most sensitive organ to alcohol is the encephalon. Under the influence of alcohol, there is a change in the metabolism in neurons, resulting in the formation of alcohol dependence.

Initially, the development of alcoholic encephalopathy is observed, due to pathological processes in different areas of the brain, membranes, cerebrospinal fluid and vascular systems.

Under the influence of alcohol, the cells of the subcortical structures and the cortex are affected. In the brain stem and spinal cord, fiber destruction is noted. Dead neurons form islands around the affected vessels with accumulations of decay products. In some neurons, the processes of wrinkling, displacement and lysis of the nucleus.

Alcoholic atrophy of the brain causes a gradual increase in symptoms, which begins with alcoholic delirium and encephalopathy, and ends in death.

In addition, there is sclerosis of the vessels with deposition around the brown pigment and hemosiderin, as a result of hemorrhages, and the presence of cysts in the vascular plexuses. Possible hemorrhages in the trunk of the encephalon, ischemic changes and degeneration of neurons.

It is worth highlighting the Makiyafawa-Bignami syndrome, which occurs as a result of frequent use alcohol in in large numbers. Morphologically, central necrosis of the corpus callosum, its swelling, as well as demyelination and hemorrhages are revealed.

Brain atrophy in children

Infrequently, brain atrophy occurs in children, but this absolutely does not mean that it cannot develop in the presence of any neurological pathology. This fact, neurologists must take into account and prevent the development of this pathology in the early stages.

To make a diagnosis, they use a survey of complaints, the stages of the onset of symptoms, their duration, as well as the severity and progression. In children, atrophy can develop after initial stage formation of the nervous system.

Brain atrophy in children at the first stage may not have clinical manifestations, which complicates the diagnosis, because parents from the outside do not notice the deviation, and the destruction process has already started. In this case, magnetic resonance imaging will help, thanks to which the encephalon is examined in layers, and pathological foci are detected.

As the disease progresses, children become nervous, irritable, conflicts with peers occur, which leads to the solitude of the baby. Further, depending on the activity of the pathological process, cognitive and physical impairments can be attached. Treatment is aimed at slowing down the progression of this pathology, maximizing the elimination of its symptoms and maintaining the functioning of other organs and systems.

Brain atrophy in newborns

Most often, brain atrophy in newborns is caused by hydrocephalus or dropsy of the brain. It is manifested by an increased amount of cerebrospinal fluid, due to which the encephalon is protected from damage.

There are many reasons for the development of dropsy. It can form during pregnancy, when the fetus grows and develops, and is diagnosed using ultrasound. In addition, various failures in the laying and development of the nervous system or intrauterine infections in the form of herpes or cytomegaly can become the cause.

Also, dropsy and, accordingly, brain atrophy in newborns can occur due to malformations of the brain or spinal cord, birth injuries, accompanied by hemorrhage and meningitis.

Such a baby should be located in intensive care unit, as it needs the control of neuropathologists and resuscitators. There is no effective treatment yet, so gradually this pathology leads to serious violations functioning of organs and systems due to their inferior development.

Diagnosis of brain atrophy

When the first symptoms of the disease appear, you should consult a doctor for diagnosis and selection effective treatment. At the first contact with the patient, it is necessary to find out about the complaints that bother, the time of their occurrence and the presence of an already known chronic pathology.

Further, the diagnosis of brain atrophy consists in the use of X-ray examination, due to which the encephalon is examined in layers to detect additional formations (hematomas, tumors), as well as foci with structural changes. For this purpose, magnetic resonance imaging can be used.

In the case of age-related changes, the treatment of brain atrophy consists in the use of drugs, providing complete care for a person, eliminating annoying factors and protecting from problems.

A person needs the support of loved ones, and therefore, when the first signs of this pathology appear, you should not immediately send a relative to a nursing home. It is desirable to carry out medication course to maintain the functioning of the encephalon and eliminate the symptoms of the disease.

For therapeutic purposes, antidepressants, sedatives, including tranquilizers, are widely used, thanks to which a person relaxes and does not react so painfully to what is happening. He should be in a familiar environment, engage in daily activities and preferably sleep during the day.

Effective treatment in our time has not yet been developed, since it is very difficult to deal with the destruction of neurons. The only way to slow down the pathological process is to use vascular preparations that improve cerebral circulation (Cavinton), nootropics (Ceraxon) and metabolic drugs. As a vitamin therapy, it is recommended to use group B to maintain the structure of nerve fibers.

Of course, with the help of drugs it is possible to slow down the progression of the disease, but not for long.

Treatment of spinal cord atrophy

The destruction of neurons in both the brain and spinal cord has no pathogenetic therapy, since it is extremely difficult to deal with genetic, age and other causative factors. When exposed to a negative external factor, you can try to eliminate it, if there is a concomitant pathology that contributed to the destruction of neurons, its activity should be reduced.

The treatment of spinal cord atrophy is mostly based on the attitude of the surrounding close people, since it is impossible to stop the pathological process and, in the end, a person may remain disabled. Good attitude, care and familiar environment are the best that a relative can do.

Concerning drug therapy, then the treatment of spinal cord atrophy consists in the use of B vitamins, neurotropic and vascular drugs. Depending on the cause of this pathology, the first step is to eliminate or reduce the influence of the damaging factor.

Prevention

In view of the fact that the pathological process is almost impossible to prevent or stop, the prevention of brain atrophy can only consist in following some recommendations that can be used to delay the onset of this pathology in the case of age-related genesis or to stop it a little - in other cases.

Preventive methods are timely treatment chronic concomitant human pathology, since exacerbation of diseases can provoke the development of this pathology. In addition, it is necessary to regularly undergo preventive examinations to identify new diseases and their treatment.

In addition, the prevention of brain atrophy includes maintaining an active lifestyle, proper nutrition and good rest. With age, atrophic processes can be observed in all organs, in particular in the gray matter. Their frequent cause is atherosclerosis of cerebral vessels.

As a result, it is recommended to adhere to certain recommendations to slow down the process of vascular damage by atherosclerotic deposits. To do this, it is necessary to control body weight, treat diseases of the endocrine system, metabolism, which contribute to obesity.

You should also fight high blood pressure, give up alcohol and smoking, strengthen the immune system and avoid psycho-emotional overstrain.

Forecast

Depending on the part of the brain that has undergone the most destruction, the prognosis and rate of development of the pathological process should be considered. For example, with Pick's disease, destruction of neurons in the frontal and temporal regions is noted, as a result of which personality changes first appear (thinking and memory worsen).

The progression of the disease is observed very quickly, as a result - the degradation of the personality. Speech and physical activity take on a pretentious tone, and the impoverishment of the vocabulary contributes to the use of monosyllabic phrases.

As for Alzheimer's disease, memory impairment is most pronounced here, but personal qualities do not suffer much even with 2 degrees of severity. This is due more to the breaks in interneuronal connections than to the death of neurons.

Despite the presence of the disease, the prognosis of brain atrophy is always unfavorable, as it slowly or quickly leads to the onset of dementia and death of a person. The only difference is the duration of the pathological process, and the outcome is the same in all cases.

It is important to know!

The causes and pathogenesis of facial hemiatrophy have not been established. Facial hemiatrophy often develops with a lesion trigeminal nerve and autonomic innervation disorders, which may be genetically determined, progressive hemiatrophy may be the cause of scleroderma striae.

Cortical atrophy of the brain is a devastating, irreversible change that most often affects people between the ages of 50 and 55, although there are cases of cortical atrophy in newborn babies. Pathological disorders, as a rule, manifest themselves in the frontal lobes of the brain, which are responsible for the process of thinking, human behavior, and control. The disease proceeds slowly with a gradual increase in the main symptoms, which eventually leads to the onset and development of senile dementia.

The main factor that leads to the appearance of brain atrophy in 95% of cases is a genetic predisposition. With age, there is a decrease in the volume and mass of the brain. Most of all, this pathology is manifested in older women. The situation can be aggravated by provoking external factors. Mutations in chromosomes, infectious processes during childbearing can lead to congenital atrophy of the brain in a newborn. The main reasons for the development of the disease include:

hereditary predisposition.
Maternal diseases that are transmitted to the fetus through the placenta, trauma during childbirth, hypoxia.
Poor blood supply to the brain due to changes in the vessels and a decrease in their throughput.
Insufficient mental load, as a result of which the brain atrophies.
The influence of alcohol, narcotic and medicinal substances, which adversely affects the cortex and subcortical formations of the brain. Radiation exposure.
Chronic anemia, which leads to insufficient saturation of brain cells with oxygen, which ultimately leads to the occurrence of ischemia and atrophy.
Injuries, including those resulting from neurosurgical intervention, lead to squeezing of blood vessels that affect brain tissue, which can cause atrophy. Slow development of neoplasms that also compress blood vessels.
Acute and chronic infectious diseases brain.

The factors that contribute to the development of pathology include: excessive smoking, chronic arterial hypotension, the use of vasoconstrictor drugs, chronic alcoholism.

It is important to note that cortical atrophy of the brain is a change in the nervous tissue of the brain after its normal formation. The primary underdevelopment of the central nervous system during fetal development cannot be considered atrophy.

The development of pathology in the cerebral cortex in people in old age very often depends on the level of their mental load in their youth. People who think a lot, are engaged in intellectual work, are less at risk of developing senile dementia.

Clinical manifestations and diagnosis of the disease

Symptoms of cortical atrophy of the brain directly depend on the degree, site of the lesion and the prevalence of the pathology. Cortical cerebral atrophy has five stages of development of the destructive process with its own characteristic features. It is also important to consider where exactly the harmful changes occur - in the cortex or in the subcortical zones. The first manifestations of the main signs of the disease depend on this. Depending on the age external factors pathological changes can develop faster. The disease has the following stages of development:

Cortical cerebral atrophy of the 1st degree, as a rule, proceeds without any symptoms. From time to time, the head hurts, weakness, dizziness appear. This stage of the disease develops very quickly and passes into the next.
The second stage of the pathology is characterized by the fact that a person becomes irritable, cannot calmly perceive criticism, conflicts with the environment, while easily losing the thread of communication. Memory deteriorates, handwriting may change, old habits are forgotten and new ones are acquired. At the second stage of the development of atrophy, one can notice a violation in the coordination of movements, changes in gait. The patient may begin to copy other people, as his independence in thinking and movements is lost. The second stage should alert loved ones and relatives and encourage them to seek help from a specialist.
Loss of control over behavior, sharp outbursts of anger, despondency - characteristics the third stage of the destructive process. Loss of basic self-care skills.
In the last stages of the disease, a person reacts inadequately to the world around him, loses awareness of what is happening, and does not show any emotions.

A person in the last stage of the pathology is often dangerous to society, and therefore such people can be isolated in a psychiatric or neurological clinic. The most famous pathology of the cerebral cortex is bihemispheric cortical atrophy (destructive changes occur simultaneously in both hemispheres). This disease is better known as Alzheimer's disease. Another type of atrophic diseases of the brain tissue is Pick's disease, in which thinning of the cerebral cortex is observed. Its main symptoms include: inability to concentrate, increased distractibility, gluttony, hypersexuality. Pathology develops slowly, but steadily progresses. Unlike Alzheimer's disease, Pick's disease, detected early in its development, is treatable.

It is possible to diagnose pathological changes in the cerebral cortex, its degree of damage with the help of additional studies, as well as computer or magnetic resonance therapy, the indications for which are the main symptoms of a possible disease. Dopplerography of the vessels of the neck and brain, cognitive tests (to determine the stage of pathology) are also performed. To detect neoplasms, foci with structural changes, the patient undergoes x-ray examinations. The most accurate way of diagnosing today is magnetic resonance therapy, which allows not only to detect pathological changes in the brain tissue in the early stages of the disease, but also to monitor them in dynamics.

Methods for the treatment of atrophic pathology of the brain

Cortical atrophy of the brain is not completely curable. The most important thing is to stop the progression of the pathology, which at a young age can be done with greater success than in the elderly. Atrophy therapy, depending on the situation, can be carried out with the help of such medicines:

nootropics are used to improve the nutrition of brain cells. In addition, these drugs contribute to the normalization of the thinking process;
the action of antioxidants is aimed at improving metabolism, slowing down the process of atrophy, counteracting free radicals oxygen;
drugs to improve blood microcirculation.

In addition, if a person suffers from headaches, he is prescribed to take analgesics or anti-inflammatory nonsteroidal drugs. At hyperexcitability, irritation, insomnia, sedative medication is indicated. It is very important to support the relatives of the patient, their help and understanding. It is undesirable for the patient to change the usual way of life, it is necessary to create the most calm and familiar environment for the person. Walking is very important fresh air, feasible physical exercise. Daytime sleep for a person with atrophic pathology of the brain is undesirable. If the doctor permits, the patient may be prescribed a course of therapeutic massage to improve the patient's blood flow. If necessary, the treating specialist may prescribe sedatives. medicines, antidepressants, tranquilizers. In cases where relatives are not able to cope with the patient on their own, with his aggressive behavior there are specialized nursing homes and boarding schools for patients with impaired brain function.

The prognosis of people with cortical atrophy of the brain is far from rosy. The disease, one way or another, progresses slowly or rapidly, leads to irreversible changes in the cerebral cortex, degradation of the personality, which ultimately leads to death. The main factors that can stop the development of pathology in a patient are:

positive psycho-emotional mood, complete absence of stressful situations;
eating healthy food;
complete rejection of harmful habits for the body, such as smoking, alcohol, taking drugs;
blood pressure control;
daily walks, moderate physical activity.

The role of nutrition in the treatment of disease

Proper nutrition is very important for maintaining the normal functioning of the brain, saturating its cells with all the necessary vitamins and minerals. A person diagnosed with cortical atrophy of the brain must necessarily introduce omega acids, unsaturated fats, and fat-soluble vitamins into his diet. It is necessary to remove all fatty, fried, smoked, flour. The use of walnuts, fruits and vegetables has a good effect on brain nutrition. You should include dishes from fatty varieties of fish in your diet. Proper nutrition, a healthy lifestyle will be able to stop the death of nerve cells, will enable the patient to lead their usual life.

Treatment of pathology with the help of traditional medicine

Brain atrophy is characterized by irreversible processes in the body that cannot be cured. However, with the help folk methods it is possible to stop the pace of development of pathological processes, to improve the patient's well-being. With great success in the treatment of cerebral atrophy are used herbal teas and tinctures. Here best options such fees:

Take oregano, horsetail, motherwort and nettle in equal proportions. Pour boiling water in a thermos and insist overnight. Take 3 times a day;
Tincture of young rye and chickweed, steamed with boiling water, can be drunk after meals in any quantity. This tea is very helpful after an injury.
Tincture of viburnum, wild rose and barberry, steamed with boiling water and infused for 8 hours, is taken instead of tea in unlimited quantities, it is possible with honey.

Very important for every person are preventive examinations, careful attitude to one's health, strict implementation of the recommendations of specialists and the attending physician. This will help save good health and live many more years of happy and fulfilling life.