Diffuse brain changes: what does it mean?

The brain is the highest center of regulation of all processes that occur in the human body. It is its complex structure and features of functioning that distinguish humans from animals, make them smarter and more reasonable. It is clear that any local or diffuse changes in the brain may not have the best effect on the performance of this important organ that controls the work of all other components of the living organism. Although here it is important to take into account that at different age periods, qualitative and quantitative changes regularly occur in the brain, which are physiologically conditioned and do not imply pathology. But how can we understand what the changes in the brain matter and its activity are associated with, and is it worth worrying about this?

The human brain

When they say that man is the highest creature on Earth, it is not meant that he is stronger and more powerful than other representatives of the animal world. In a fight with large and predatory animals, the strength advantage is often not on the side of man. But thanks to the complex structure of the brain and the processes of analysis and synthesis of information that occur in it, we make decisions that help us resist opponents many times stronger.

While the behavior of animals is based on innate instincts and basic needs that allow them to survive and ensure the continuation of the species, humans are guided by reason, which gives them certain privileges and allows them to solve emerging problems not only by fleeing or aggression, but also by transforming the world.

It would seem that the brain of man and higher animals has a similar structure and functions on the basis of the same principles, but man has learned to control the development of his brain. Having studied the principles of its work, man can control this process and even correct it.

But what is the human brain? It is the main regulatory organ of the central nervous system (CNS), providing higher mental functions: perception, attention, thinking, memory, controlling the motor and emotional-volitional spheres. All these functions begin to form immediately after the birth of a child. Violation or underdevelopment of higher mental functions brings a person closer to animals, provides a progressive backward movement.

The main cells of the brain - neurons - have an amazing ability to transmit information from the environment from receptors located throughout the body to the brain and spinal cord. This is possible due to the bioelectric impulses generated by the bodies of neurons, which spread over large distances in a split second, so we react almost instantly to any changes in the external world and the internal environment of our body.

Nerve impulses that form chains of excitation and inhibition foci are a kind of code that is transmitted along nerve fibers consisting of neuron processes and is deciphered by the brain as a guide to action. It is these impulses that humans have learned to record using special equipment (electroencephalographs). By studying the passage of impulses through different parts of the central nervous system, one can judge the functioning of the brain, i.e. its bioelectric activity.

Local or focal changes in the brain substance or its cortex cause disruptions in the functioning of individual organs and systems depending on the location of the lesion. Vision and hearing functions may suffer, sensitivity of limited areas of the body or organs may be impaired, problems with coordination of movements are possible, etc. Severe dysfunction of the central nervous system is usually based on diffuse changes in the brain, i.e. widespread disorders with blurred localization, when not a specific area of the brain is disrupted, but its functioning as a whole, as an organized system.

The human brain has undergone various changes in the course of evolution, therefore its composition includes more ancient and new formations. The youngest part of the brain is considered to be its cortex, which performs more important functions, increasingly distinguishing humans from animals, ensuring conscious actions. It is clear that both local and diffuse changes in the cerebral cortex significantly affect a person’s well-being, their cognitive abilities (which is especially important in childhood, when concepts about the surrounding world are just being formed), and their ability to work. [ 1 ]

When considering the role of the cerebral cortex, we should not overlook the functions performed by the subcortical formations. Important subcortical formations include the basal nuclei in the white matter of the cerebral hemispheres, which are responsible for our emotions and the transmission of motor impulses along the conductive pathways (bundles of nerve fibers), which are the result of the analysis and synthesis of sensory information transmitted to the brain by receptors.

Among the vital midbrain structures are considered: the medulla oblongata, midbrain, diencephalon (thalamus, pituitary gland, hypothalamus, pineal gland), pons, reticular formation, limbic system organs with nerve centers located in them. These centers regulate the work of the organs of vision and hearing, the vestibular apparatus, the autonomic nervous system, coordination of movements, emotional reactions, etc.

The greater the depth of brain damage, the more difficult its analytical and synthetic work becomes, necessary for understanding the world and life in it. Thanks to the electroencephalographic method of research, it is possible to determine both the extent and depth of brain damage, which is reflected in the diagnosis.

Causes diffuse changes in the brain:

The causes of diffuse changes in the nerve conductivity of the brain in adults can be considered to be organic brain damage of moderate and severe degree, when more than 20% of the brain tissue is affected, which entails various disorders of nervous activity and neuropsychiatric disorders. Risk factors for organic pathologies of the brain - a concept that combines a number of disorders, which are characterized by dystrophic changes in the brain matter with a violation of neural conductivity, are considered to be acquired brain defects associated with:

• craniocerebral injuries, which can be of varying severity, so the disruption of bioelectrical conductivity caused by them can have a different nature, intensity and duration (craniocerebral and brain injuries can be characterized by both local and diffuse changes in the brain tissue), [ 2 ]
• various intoxications (here everything depends on both the nature of the toxins and poisons and the duration of their effect on the body),
• radiation that disrupts metabolic processes in brain tissue and causes the death of its cells,
• hypoxia of the brain (the brain is one of the first to feel a lack of oxygen and the longer it experiences oxygen starvation, the stronger and more persistent the damage to nerve cells will be),
• inflammatory processes in the tissues and membranes of the brain, which in most cases are infectious in nature (meningitis, encephalitis, meningoencephalitis, which often arise as a complication against the background of diseases of the nasopharynx due to the proximity of its organs to the brain),
• extensive circulatory disorders in the brain (vascular pathologies associated with widespread reduction in the diameter of the brain vessels, such as vascular atherosclerosis)
• degenerative diseases (we wrote about them above).

We should not exclude such disorders that seem to have nothing to do with the brain, although, according to statistics, they rarely lead to serious disorders of the brain. For example, low hemoglobin levels or anemia, in which the level of red blood cells and hemoglobin, which deliver oxygen to the tissues of the body, and in particular the brain, decreases. In this case, the brain will also experience a lack of oxygen, as with hypoxia caused by suffocation, but to a lesser extent, so changes in the brain matter and its activity will be less pronounced (mild).

Metabolic disorders in the body, vitamin deficiency, and endocrine gland dysfunction lead to increasing starvation of the brain, and lack of sleep (lack of normal rest) leads to its overfatigue. It is not surprising that people with such problems may also experience unstable bioelectrical activity of the brain and a reversible decrease in intellectual abilities, although there may be no changes on ultrasound or tomogram of the brain.

Changes in the bioelectric activity of the brain of a regulatory nature imply functional disturbances and are usually associated with dysfunction of the median structures that control brain activity, as a result of which excitation or inhibition may predominate in the CNS. Such structures include the pituitary gland, hypothalamus, pineal gland, and cerebellum. In this case, dystrophic or degenerative changes will not necessarily be diagnosed in the brain matter.

Pathogenesis

We have already noted that our brain undergoes various changes at different ages. And this is scientifically explainable, because with the formation of higher mental functions, the activity of the brain changes. It develops due to the creation of multiple conditioned reflex connections formed in the process of the life of the central nervous system, starting from the birth of a person until his death. The learning process is based on the formation of such useful connections that help the brain work more actively and quickly make the right decisions. Based on the teachings of I.P. Pavlov on higher nervous activity (HNA), the proverb "live and learn" acquires a clear meaning.

Conditioned reflex connections are formed due to the ability of neurons to transmit nerve impulses. Different combinations of impulses cause different reactions in the brain. When they are repeated frequently, a dynamic stereotype is formed, facilitating the work of the brain.

When the bioelectrical activity (BEA) of the brain is disrupted, its analytical and synthetic work becomes more complicated. The developed stereotypes are gradually lost, and new ones are not formed. Reacting to each new and even already known stimulus (and there are a great many of them around and inside our body), the central nervous system has to strain itself greatly, constantly analyzing the situation and making decisions that were previously carried out almost instinctively on the basis of formed stereotypes. For example, if we need to write something down, we instinctively start looking for a pen, pencil or chalk, paper, i.e. what is necessary in this situation, without straining the brain. If bioelectrical conductivity is disrupted, even such a simple task will cause tension in the brain, which entails its rapid fatigue, a decrease in physical and intellectual activity.

The more extensive the damage to the brain with disruption of bioelectric conductivity, the more difficult it will be for a person to cope with habitual duties, the more difficult it will be to form new conditioned reflexes that ensure human development, and the faster previously acquired skills and abilities will be lost. Thus, with a pronounced disruption of the work of neurons, the diagnoses of "dementia" (feeblemindedness, which often develops in old age, but is sometimes diagnosed even in children over 2 years old) and "oligophrenia", considered a congenital pathology that limits the possibilities of intellectual development, are associated.

Diffuse changes in brain tissue are considered to be such widespread processes that are associated with qualitative and quantitative restructuring of the organ's cellular structures. This may be cerebral edema or circulatory disorders in its tissues, causing cell death, cicatricial formations due to injuries and tumor processes that compress the brain vessels and again lead to ischemia of large areas of the brain matter. Such changes affect both the performance of nerve cells (the ability to generate electrical signals) and the ability to conduct nerve impulses from one neuron to another.

Diffuse changes in brain tissue, which are detected by ultrasound examination, as well as X-ray and tomography of the brain, can be caused by trauma or infection, as well as vascular diseases, tumor processes in the brain, and nutritional disorders of the nervous tissue (hypoxia, anemia, etc.). They are characteristic of hereditary degenerative diseases caused by gene mutations (neurofibromatosis types 1 and 2, Louis-Bar syndrome, tuberous sclerosis) and neurodegenerative pathologies associated with metabolic disorders (dementia, multiple system atrophy, Parkinson's disease, Wilson's disease and Fahr's disease). [ 3 ]

Changes in the structure of brain tissue affect its ability to generate and conduct nerve impulses. Diffuse changes in the brain (qualitative and quantitative), detected in early childhood, can act as a distinctive feature of individual human development or be a consequence of pathological processes in the brain. Therefore, it is possible to judge their pathogenesis and impact on the neuropsychic development of the child only in combination with an analysis of bioelectric conductivity indicators in the neurons of the brain. Mild changes can be both a normal variant and an indicator of persistent or developing pathological disorders. Some of them are detected immediately after the birth of the child, others - at a later age. [ 4 ]

Symptoms diffuse changes in the brain:

Diffuse changes in the brain and its BEA are not a diagnosis, but only a result of an examination that helps to understand whether there is a pathology and determine the diagnosis. It cannot be considered separately from other manifestations of the disease and the processes that occurred with a person before the changes in the brain began.

Diffuse changes in brain biopotentials can be caused by normal physiology. When a person falls asleep, they decrease, when overtired or against the background of a severe nervous shock, brain activity decreases.

But changes in brain structures determined by ultrasound and tomograms are a more specific concept, narrowing the range of possible diagnoses. However, when we are talking about not a local but a diffuse lesion (vague, without clear boundaries, when there is one large focus with unclear boundaries or many of the same unclear ones throughout the brain), it is impossible to say for sure what caused it and what it may lead to.

A diffuse change in the brain stem structures, which include the medulla oblongata, which is a continuation of the spinal cord, the pons, the midbrain, and sometimes the cerebellum (the center for regulating muscle tone, balance, and coordination of movements) and the medulla oblongata. The reticular formation passes through all of these structures, containing many nerve centers responsible for vital functions of the body: chewing, swallowing, breathing, digestion, heartbeat, etc. The brain stem is crowned by the limbic system, which is responsible, among other things, for human emotions. A diffuse change is said to occur when it is not possible to indicate exactly which part of the brain stem is damaged even after a comprehensive instrumental examination.

In such situations, the symptom complex is very heterogeneous, because everything depends on which departments are involved in the pathological process. A person may experience disturbances in appetite, heart rhythm, breathing, swallowing, blood pressure (if the reticular formation is involved in the process), ataxia and atony (impaired coordination of movement and decreased muscle tone when the cerebellum is affected) may develop. When the diencephalon (thalamus, hypothalamus, pituitary gland, pineal gland) is affected, sleep disorders, biorhythm failures, endocrine gland dysfunction, decreased intellectual capacity, rapid fatigue are observed, and hearing and visual disorders may appear. Sexual dysfunction is possible.

When talking about functional damage, it is usually possible to determine the source of the disease, i.e. the brain structure that has failed, by the symptoms alone. Diffuse brain changes are accompanied by dysfunction of several structures involved in the pathological process, so it may seem that the symptoms are not related to each other.

Diffuse dystrophic changes in the brain are accompanied by changes in its bioelectric activity, which results in disruption of the processing of received information. With increased brain activity, a person experiences rapid fatigue, decreased attentiveness, sudden changes in mood, and the possible occurrence of convulsive syndrome and the development of epilepsy. If the BEA is reduced, a person performs his usual work more slowly, loses interest in previous hobbies and the environment, and a decrease in the intellectual level is observed. A decrease in self-esteem can be observed in both cases, especially when it comes to teenagers and young people who know their potential. Headaches are possible in both cases, but with increased BEA they are diagnosed more often.

Some pathologies develop as a result of moderate or pronounced widespread changes in the brain. Thus, dementia is characterized by diffuse atrophic changes in the brain, which are characterized by multiple foci where the death of nerve cells is observed, which are practically not restored. The prevalence of the process affects the symptoms, so a person experiences speech disorders, intellectual problems (primarily memory and logical thinking suffer), and behavioral deviations. At the same time, the causes of dementia can be different: congenital pathologies, brain injuries, atherosclerosis, hypertension, etc. [ 5 ], [ 6 ]

In atherosclerosis of the brain vessels, which itself is the cause of diffuse changes and possible strokes, multiple foci with impaired blood supply to the brain due to narrowing of its vessels can be determined. Cholesterol plaques on the walls of the vessels impede blood flow and impair their elasticity. In this case, headaches, jumps in arterial and intracranial pressure, double vision, dizziness, and other symptoms can be observed depending on which areas of the brain suffer more from oxygen deficiency.

In epilepsy, diffuse changes in the brain may be absent, but such a symptom as seizures is always present. Organic changes in brain structures cause epilepsy when a focus of increased excitability of neurons is formed in the place of edema caused by an infectious or traumatic process, the work of which is not fully restored even after the edema subsides.

Metabolic and hormonal regulation disorders can be considered as signs of disorganization of the brain's bioelectric activity. Such disorders in the body are not visible to the naked eye. But some symptoms can clearly indicate them. It is worth paying attention to the deterioration of hair condition, hair loss, changes in the appearance and purity of the skin, increased fragility of nails, and bowel disorders. Such symptoms do not always indicate brain diseases, but in combination with headaches, memory loss, temperature fluctuations, etc., they should make you think.

Some patients complain of decreased sexual desire, while others experience uncontrollable sexual arousal. The latter is more typical for patients with irritative lesions and is associated with irritation of neurons responsible for sexual function (neurons are not damaged, but are constantly in an excited state). Another reason for sexual dysfunction may be hormonal imbalance (the central nervous system, and in particular the pituitary gland, are also responsible for its regulation).

Many people report weight fluctuations, even in cases where their appetite is not affected. In cases of brain injury, a decrease in appetite is often observed. But progressive dementia is more characterized by insatiability, a person feels like he is constantly undernourished, eats worse than others, and the feeling of satiety occurs only when there is no more room in the stomach. Both categories of patients often have bouts of vomiting.

Neurotic reactions in diffuse changes of the brain's BEA can also be explained by increased excitability of the central nervous system. And the tendency to colds in such patients is caused not by weakened immunity due to stress or vitamin deficiency, but by insufficient regulation of the immune system. That is why it does not fully perform a protective function, although it is capable of doing so.

The brain stem contains nerve centers responsible for regulating breathing, heartbeat, body temperature, etc. When the function of the nerve nuclei is impaired, shortness of breath, arrhythmia, chills, and aching in the bones and muscles without good reason may occur. In this case, organic brain damage entails functional disorders, when the organ is healthy but does not function properly.

The fact is that regulation of our body's work, including metabolic processes, occurs due to the transmission of bioelectric impulses about the state of homeostasis (the internal environment of the body) to the central nervous system. The brain processes this information in detail and, by means of the same impulses going from neuron to neuron, starts or slows down certain processes. Thanks to central regulation, the constancy of such a complex biological system as the human body is ensured.

If conductivity is disrupted in some link of such regulation, the organ, system or function whose action was provided by the damaged bioelectrical circuit of neurons will suffer (something similar happens when an electrical circuit is broken, when the energy flow is interrupted). In diffuse brain lesions, there are a great many such disorders, so the clinical picture can be quite extensive and varied, although the patient himself does not understand the connection between the symptoms appearing on the part of different organs and systems.

As we can see, determining the presence of structural changes in the human brain is not enough to make a final diagnosis. Analysis of the patient's complaints helps the doctor determine the localization of damaged structures and the existing consequences, and dynamic studies and anamnesis study make it possible to understand what nature the disorder has (temporary, persistent or progressive).

Complications and consequences

The presence of diffuse changes in the brain is a good reason to think about your health, because the ability of various organs of our body to perform their functions largely depends on the performance of the brain. Any changes in the brain sooner or later affect our well-being, and this in turn entails a decrease in working capacity, a deterioration in mood and general condition. The more pronounced the structural and functional changes in the brain, the more they affect a person's well-being and behavior.

The consequences of such changes depend on their severity and the measures a person takes to eliminate the defects. It must be said that taking analgesics for constant headaches, although it makes life easier, does not solve the problem. They can be taken without consulting a doctor, but the cause of the pain will remain a secret behind seven locks. But such a secret, if not solved in time, which is possible only with a comprehensive examination, can cause serious complications.

Many people treat a concussion or bruise, which is the result of a traumatic brain injury, somewhat superficially. [ 7 ] It is believed that a certain period of complete rest is enough to restore the functionality of damaged brain structures. In reality, everything is not so simple, especially if you ignore the injury and continue to go to work. But the result of the injury can be hemorrhages in the brain when blood vessels rupture (for example, with atherosclerosis, which a person might not suspect, the brain vessels become less durable and can easily burst upon impact), and increased neuronal activity, provoking spasms and convulsions, and disruption of individual brain structures. All this may not remind of itself for some time, and then result in a stroke, thrombosis of the brain vessels, epilepsy, etc.

A long-term inflammatory process in the brain, in addition to headaches, can have other consequences. Changes in the structure of inflamed tissues, their compaction entails a violation of nerve conduction. At the same time, it is almost impossible to restore brain tissue, returning its original properties, in this case. Children who have been ill with meningitis or encephalitis for a long time have persistent disorders of psycho-physical development, and adults experience a decrease in intelligence and impaired motor functions.

Some degenerative processes in the brain (especially those that are hereditary) cannot be stopped even with early diagnosis. But it is possible to slow down the process in most cases. And the sooner treatment is started, the more time a person has for a more or less full existence. But there is nothing more valuable than human life, which, alas, is fleeting, so it is important to enjoy every moment of it.

Diagnostics diffuse changes in the brain:

Diffuse changes in the brain and its bioelectric conductivity do not immediately make themselves known, so a person may not even suspect that they have a pathology. But those who monitor their health immediately notice changes in mood, memory loss, rapid fatigue, increased sensitivity to natural changes that resemble the first signs of brain dysfunction. Perhaps such symptoms have banal causes, for example, a lack of vitamins, but if it affects the brain, it is worth taking certain measures.

Besides, how can you find out what the symptoms are related to if you don’t consult a doctor. Even if a person has suffered a head injury, it doesn’t necessarily leave a serious mark on the brain’s functioning; perhaps the cause of the malaise is an infection or intoxication, and the previous injury only created the basis, caused a predisposition to brain disease. [ 8 ]

Since the existing symptoms play an important role in making a diagnosis, the doctor will definitely ask the patient about his health. Interest in possible injuries, intoxications and infections is also not accidental, because the problem is not always visible to the naked eye, and the presence of a lump on the head is not yet evidence of diffuse brain damage.

Since diffuse changes in the brain are often caused by hypoxia due to impaired cerebral circulation (the brain receives oxygen from the blood), it makes sense to immediately assess the qualitative and quantitative characteristics of the blood. The patient is prescribed a general and biochemical blood test. Hypoxia can be caused by low levels of red blood cells and hemoglobin, increased blood viscosity, which slows down the rate of its flow through the vessels and contributes to the formation of blood clots.

We know that symptoms of organic brain damage can differ significantly depending on which structures are involved in the pathological process and how serious the situation is. In addition, deterioration of health is not always directly related to brain damage. Thus, a tumor in the brain or near it can have an irritating effect on nearby neurons, and then we are talking about diffuse irritative changes in the brain. That is, here we have irradiation of irritation, when under the influence of a tumor or other irritating factor, one neuron transmits irritation (excitation) to another. Usually, by removing the object of irritation, normal brain function can be restored.

What a doctor cannot see with the naked eye can be visualized by instrumental diagnostics. Diffuse changes in the brain parenchyma, i.e. its cellular structures, can be determined by ultrasound (US) and tomography (computer or magnetic resonance). [ 9 ] X-rays of the skull are less informative, since they reflect the condition of soft tissues worse, but they can also provide certain information.

If atherosclerosis of the vessels and cerebral ischemia are suspected, angiography, i.e. examination of the brain vessels and assessment of blood flow in them, helps to confirm the diagnosis. In case of irritative changes, a brain tomogram is most relevant, although ultrasound can also detect pathological compactions.

Changes in the structure of the brain substance usually entail changes in its electrical conductivity. To assess such disorders, an electroencephalogram (EEG) is prescribed. This study helps to assess the brain's performance, and taking into account diffuse changes and existing symptoms, determine the cause of the disease, give it a name, assess its severity and prescribe appropriate treatment.

Differential diagnostics for diffuse changes in the brain is of great value and is based on the analysis of available information: the results of laboratory and instrumental studies, information obtained from the patient and as a result of studying the anamnesis. The changes in the brain themselves do not yet imply a diagnosis, and therefore cannot tell the doctor what treatment to prescribe.

An accurate diagnosis is the result of differential diagnostics. It is very important because different diseases that change the structure and performance of the brain require different approaches to treatment. The difference is obvious when considering the treatment of vascular and degenerative diseases, congenital (hard to correct) and acquired.

This differentiation is especially important when examining young children, because the direction of not only therapeutic, but also corrective and developmental work with the child depends on it.

What do ultrasound and encephalogram indicate?

Diffuse changes in the brain is a medical term used in differential diagnostics to make a final verdict. But in itself, it is not a diagnosis and does not even indicate a pathology. Everything depends on the degree of expression of the brain changes and what structures it concerns.

Depending on the causes of the disruption of the brain structure and its conductivity, as well as the time of damage, the disorder of brain functionality can be persistent or progressive. In the case where the factor that affected brain activity or brain development has lost its relevance (stopped acting), but diffuse changes remain, we are talking about a persistent disorder of psychophysical development (like oligophrenia, residual dementia, etc.). With timely professional treatment of inflammatory and oncological diseases, the structure and activity of the brain can be completely restored.

If diffuse changes in the brain are the result of an active disease, it is likely that they will progress, spreading over the surface of the brain and into the depths. But to determine the likelihood of this, an accurate diagnosis is needed, and not a statement of the fact of the presence of changes in the state of the brain during an ultrasound.

Mild diffuse changes in the brain (its bioelectrical activity measured by an encephalograph) can also be observed in healthy people. This can be due to overwork, decreased blood sugar levels (lack of carbohydrates in food), lack of sleep, general malaise. The brain's performance decreases and a person quickly gets tired even in the absence of great physical or mental stress.

But sometimes such a verdict is just the first sign, especially if a person notices frequent headaches, dizziness, unexplained temperature fluctuations. Those who have had a head injury in the past should pay special attention to such moments. Sometimes its consequences remind of themselves after several months and years.

Mild diffuse changes in the brain, poorly discernible during ultrasound diagnostics, may accompany disturbances in the functioning of the midbrain structures (hypothalamus, pituitary gland). Their dysfunction is more pronounced on the EEG and is recorded as a regulatory pathology.

Diffuse changes in the midbrain structures may be accompanied by changes in bioelectric activity of varying severity. The symptoms that may be observed depend on which part of the brain is damaged and the extent of its damage. In case of hypothalamus pathology, temperature changes, disturbances in appetite and sleep-wake cycles, and an increase or decrease in sexual desire may be observed. In case of damage to the pituitary gland, disturbances in the functioning of various endocrine glands may be observed (symptoms of diabetes insipidus, hypothyroidism, hyperprolactinemia appear accordingly), growth disorders in children, mental retardation, and sexual disorders.

Moderate diffuse changes in the brain are highly likely to indicate the development of a pathological process. Thus, with dementia and atherosclerosis, everything begins with mild changes that subsequently worsen, i.e. moderate changes in the brain are only one stage of the pathological process. But with oligophrenia in a child, which is a non-progressive pathology, the degree of brain change determines only the severity of the disorder and the possibility of their correction.

Such changes can also occur with brain injuries or inflammation. In this case, it is necessary to monitor the process dynamically to understand how persistent such changes can be. Such observations also help determine the effectiveness of the treatment.

But if we talk about moderate changes in the bioelectric activity of the brain, then the situation is even more ambiguous. In some cases, such a result is considered a normal variant, while in others it indicates a pathological process. Everything depends on the individual characteristics of the human body, his or her well-being and the results of ultrasound or tomography.

Expressed diffuse changes in the brain are definitely an unpleasant situation, which indicates severe damage to the brain and a decrease in its performance. Such changes are always accompanied by a violation of nerve conduction, which affects both the well-being and intellectual abilities of a person. Often they radically change a person's behavior, causing either isolation or aggression.

Treatment diffuse changes in the brain:

The detection of diffuse changes in the brain during examination is a reason to understand the causes of such changes. It is on this basis that the final diagnosis is made, after which the doctor prescribes the appropriate treatment. The therapeutic approach will depend on both the diagnosis and the characteristics of the patient's body.

Thus, in case of atherosclerosis of vessels, complex therapy is prescribed, including normalization of fat metabolism and optimization of the work of brain vessels. The first direction is provided by means of nicotinic acid, which reduces the content of harmful cholesterol, fibrates, which reduce the synthesis of the body's own fats, bile acid sequestrants, statins, which inhibit the synthesis of cholesterol.

To improve blood supply to the brain, vasodilators, central muscle relaxants that relax the vascular membrane, angioprotectors, antiplatelet agents and anticoagulants that improve blood flow and prevent blood clots are prescribed.

A large role is given to vitamin complexes. Especially useful are vitamins of group B, which have a positive effect on the functioning of the nervous system, antioxidants (vitamins A and E), polyunsaturated fatty acids, which reduce the level of bad cholesterol in the blood.

In cases of vascular atherosclerosis and cerebral ischemia, accompanied by increased arterial and intracranial pressure, decreased memory and impaired concentration, doctors can also prescribe antihypertensive drugs and nootropics (medicines that improve the trophism and function of the brain, as a result of which cognitive functions are restored to one degree or another). [ 10 ]

If it is not possible to restore the patency of a sclerosed vessel, surgical treatment is used. The most popular method of intervention on the vessels of the brain is considered to be carotid endarterectomy (dissection of the vessel and removal of the cholesterol plaque).

In case of inflammation of the brain and its membranes (meningitis, encephalitis, meningoencephalitis), the treatment will be completely different. Since infection plays a decisive role in the pathogenesis of such diseases, antibiotic therapy is mandatory, which is combined with the intake of drugs that increase the body's resistance to infections (interferons). Additionally, diuretics (prevention of cerebral edema) and infusions of drugs that reduce intoxication of the body are prescribed.

In diseases caused by intoxication of the body (toxic encephalopathy), detoxification therapy comes first, after which the brain's function and metabolic processes are restored (nootropics, anticonvulsants, neuroleptics, antidepressants, psychotherapy sessions).

If diffuse changes occur as a result of brain injury, treatment should be carried out depending on the type of injury. In this case, the prescription of drug therapy should be based on the severity of the injury.

The main requirement for the treatment of craniocerebral injuries is rest for a certain period of time (in the case of a mild concussion, this may even be enough for recovery). In the case of traumatic inflammation and cerebral edema, as well as for its prevention, corticosteroids and diuretics are prescribed.

Further therapy is essentially prevention of possible complications. Patients may be prescribed medications that improve cerebral circulation, drugs that stimulate metabolic processes in the brain, and general tonics. Symptomatic treatment: analgesics to relieve headaches, antiemetics (for nausea), sedatives, and sleeping pills.

In severe injuries with a violation of the integrity of the skull and diffuse axonal damage to the brain (often diagnosed in DBT as a result of a blow or sudden movement of the head), large and small hemorrhages, multiple ruptures of the axons of neurons, through which nerve impulses pass, occur. Such injuries are always accompanied by severe organic damage to the brain. In case of axonal damage, the patient falls into a coma (the duration of the coma varies).

After coming out of a coma, psychostimulant therapy and drug treatment are prescribed to restore brain trophism and blood circulation: nootropics, vascular drugs, anticholesterase agents, medicinal neurotransmitters.

Surgical treatment for brain injuries is carried out only in cases of skull crushing, brain compression, and hematoma formation.

In case of persistent and progressive dementia, the treatment regimen depends on the clinical manifestations of the disease, the presence of concomitant pathologies, and the individual characteristics of the patient's body. Patients are prescribed cholinergic drugs that improve the transmission of nerve impulses at the points of contact of neurons (synapses), drugs that interact with NMDA receptors (prevent neural dysfunction), nootropics, neuroprotectors, immunomodulatory agents, neuroleptics (antipsychotics), and vitamins.

Physiotherapeutic treatment for diffuse changes in the brain is prescribed with caution and takes into account existing disorders. In case of vascular pathologies and related dysfunction of the brain's BEA, galvanization, drug electrophoresis (vasodilators and stimulators of cerebral circulation), ultratonotherapy, UHF and UHF therapy, ultraviolet irradiation, radon and pine baths, and hydrotherapy are prescribed. To improve the trophism of brain tissue in various diseases, transcutaneous electrical neurostimulation, interference therapy, diadem and amplipulse therapy, darsonvalization can be prescribed. The fight against movement disorders, which often develop against the background of organic or functional brain damage, is carried out through massage, kinesitherapy, exercise therapy, water procedures, and swimming. Speech disorders often require work with a speech therapist.

In any case, the approach to choosing physiotherapeutic procedures should be strictly individual, taking into account concomitant pathologies, the patient’s condition, and age characteristics.

Drug therapy

Specific drugs used for diffuse changes in the brain are considered neuroprotectors. This is a large group of drugs, which include:

• drugs that improve brain tissue trophism (nootropics),
• antioxidants with antihypoxic, antistress, anticonvulsant, anxiolytic (calming) effects,
• agents that stimulate cerebral circulation,
• adaptogens

"Piracetam" is a well-known legal drug from the group of nootropics and psychostimulants, which is sold in pharmacies without a prescription. The drug is prescribed to improve cognitive functions, i.e. to combat the consequences of diffuse brain changes or to prevent them. In dementia, it can only be prescribed as an auxiliary agent, since it does not have a pronounced therapeutic effect.

The medicine is available in the form of tablets, capsules, ampoules with a 20% solution, administered intravenously by drip (up to 12 g per day in severe pathologies) or taken orally. The initial dose for internal administration of the drug is 4.8 g. It is maintained during the first week of treatment, after which it can be reduced to 2.4 g. Subsequently, the dosage can be halved. In case of convulsive syndrome, the dose should be increased 1.5-2 times.

The tablets are taken 2-3 times a day, dividing the daily dose into 2-3 parts. Infusion treatment is carried out twice a day in high doses. Inside, piracetam solution is taken twice a day, 1.5 ampoules. The duration of treatment depends on the diagnosis, the patient's condition, the severity of brain dysfunction.

The drug is not prescribed in case of acute renal failure, allergic reactions to the drug (as well as juices and essences), acute cerebrovascular accident (stroke). Children over 1 year of age are given the drug only as prescribed by a doctor.

The most frequently mentioned side effects of the drug are an excited mental state, increased motor activity, instability, some decrease in attention, and sleep disorders. Reactions from the digestive organs are also possible: abdominal pain, nausea, bowel disorders. In some patients, the drug causes headaches and dizziness, movement disorders (disorders of automatic movements), convulsions, tremors in the body and limbs, heart rhythm disorders, and sexual hyperactivity.

"Mexidol" is a drug from the category of antioxidants with neuroprotective action. It is produced in the form of tablets and a solution for intravenous and intramuscular administration. The drug improves the nutrition and respiration of the brain, as well as the qualitative characteristics of the blood, normalizes behavior and sleep, restores impaired vegetative functions, thereby improving the patient's well-being.

The drug in tablets is prescribed in a dosage of 125-250 mg three times a day (no more than 800 mg per day). The duration of treatment with the drug can reach 2 months.

The drug solution is prescribed for acute pathologies (in the form of injections and infusions). In case of strokes, the drug is administered by infusion once a day at 200-300 mg in the first 2-4 days. After that, they switch to intramuscular administration (three times a day, 2 ampoules). The therapeutic course is 1.5-2 weeks.

In case of craniocerebral trauma and its consequences, the dose can be increased to 500 mg (frequency of administration up to 4 times a day). The duration of the course is the same.

In severe cases of nerve conduction disorders, the daily dose of the drug for intravenous administration is 300 mg for 2 weeks. Then switch to intramuscular administration of a maintenance dose (100 mg).

Contraindications to the use of the drug are: acute renal failure, severe liver pathologies, hypersensitivity to the drug, pregnancy and lactation. Do not use to treat children.

Side effects are limited to headaches, gastrointestinal reactions, allergic reactions, and pressure fluctuations.

"Cinnarizine" is a drug that improves cerebral circulation and reduces the severity of cerebrovascular symptoms: vascular headaches, tinnitus, decreased memory and attention, impaired balance and coordination of movements.

Tablets are prescribed to patients over 12 years of age three times a day at 25 mg. In severe cases, the dose may be increased. The pediatric dose is usually half that of an adult.

Contraindications to the use of the drug are, first of all, increased sensitivity of the body to the components of the drug. It is not recommended to prescribe it to pregnant women and nursing mothers. It is prescribed with special caution in case of progressive dementia and Parkinson's disease.

Side effects of the drug can be described by symptoms such as increased fatigue, drowsiness, headaches and dizziness, digestive system and liver disorders (jaundice), weight gain, hypotension, hyperhidrosis, allergic reactions, movement disorders.

In the treatment of dementia, the drugs of choice are acetylcholinesterase inhibitors and NMDA antagonists. NMDA receptors regulate the permeability of cell membranes for potassium and sodium ions, which provide bioelectric potential. The drug that affects the action of such receptors, improves mental activity and eliminates motor disorders is "Memantine".

The tablets are prescribed to be taken once a day at the same time. Start with the minimum active dose (5 mg) and gradually increase it to 20 mg over 3 weeks.

The drug is not prescribed only in case of individual intolerance and severe kidney pathologies. Side effects of the drug are considered to be increased mental excitability, anxiety, fatigue, increased intracranial pressure, nausea.

Folk remedies

When we notice some deterioration of intellectual abilities without other suspicious symptoms, we do not rush to consult a doctor, because today there are a lot of advertised synthetic and herbal products that stimulate cognitive functions. In principle, if a person does not have serious diffuse changes in the brain, such a solution to the problem is quite logical. But you can find out whether there are any or not only during professional diagnostics.

If diagnostics have shown that there are widespread changes in various brain structures and a disruption of their functionality, one cannot rely only on medicinal potions. Fruit and vegetable salads and natural juices can to some extent satisfy the body's need for vitamins, but therapy cannot be limited to this.

It is important to understand that folk remedies are powerless against organic brain diseases. They help fight the consequences of the disease, but do not cure it. However, in case of brain injuries, when rest is needed, you can use the property of some herbs to have a sedative effect. Such herbs include valerian, peony, motherwort, rue, hops, blue cornflower, mint. Herbal treatment in this case will have a certain effect, but it cannot always be considered sufficient.

Another thing is that such herbs help to normalize the neuropsychic state of patients, improve sleep, reduce the excitability of the nervous system, and thus make it possible to reduce the dosage of some prescribed drugs.

The greatest benefit from folk recipes can be obtained with atherosclerosis of the cerebral vessels. With such a diagnosis, herbal medicine (herbal infusions) has a truly therapeutic effect.

So, to normalize lipid metabolism, you can take a collection consisting of equal parts of kidney tea, birch leaves, St. John's wort, string and a double dose of mint and hawthorn. 2 spoons of the crushed collection are poured with 0.5 liters of boiling water, kept for 2 hours, then filtered and taken three times a day, 60-70 ml.

It is believed that freshly squeezed natural vegetable juices can be used to cleanse the blood vessels of the brain from cholesterol plaques: pumpkin, beetroot, potato, carrot, as well as celery and cabbage juices. Juices or their mixtures should be consumed in the amount of 1-2 glasses per day, taking into account contraindications.

Eating grapefruit reduces the risk of developing atherosclerosis and reduces its manifestations. Melon is also credited with an anti-sclerotic effect.

You can prevent spasms of the brain vessels and its ischemic damage with the help of lemon balm. It can be consumed fresh or taken as an infusion (1 tablespoon of dry herb per glass of boiling water).

To reduce intracranial pressure and prevent cerebral hemorrhages, herbs such as lavender, plantain, nettle, succession, poplar and mulberry leaves are useful.

Taking a medicine that is an infusion of garlic and lemon also helps (grate 1 head of garlic and lemon, pour 700 ml of hot boiled water and leave for 24 hours, take 4 times a day, ¼ cup).

To improve brain function and cognitive function, you can take herbs such as rosemary, sage, sweet clover, St. John's wort, pol-pala (wool erva), elecampane roots, hawthorn flowers, decoctions and baths of pine needles.

It is important to understand that folk treatment should be considered symptomatic and preventive in most diseases in which diffuse changes in the brain are detected. It can be used as part of complex therapy, but not as an independent treatment.

Homeopathy

Homeopathy is a relatively young branch of alternative medicine, which, however, already has sufficient experience in the treatment and rehabilitation of patients with organic brain damage. As in classical medicine, approaches to the treatment of various diseases in homeopathy have their own characteristics. Strictly speaking, in most cases we are not talking about the treatment of diseases, but about the rehabilitation of patients after a course of drug treatment. Rehabilitation includes psychological assistance, physiotherapy sessions and homeopathic treatment aimed at restoring functions lost as a result of the disease.

As for homeopathic medicines, their choice is largely determined by the diagnosis made in the hospital and the results of laboratory tests, i.e. you cannot do without a consultation with a neurologist and an examination.

In case of atrophic changes in brain cells, the drugs of choice will be: Agaricus muscarius, Calcarea carbonica, Capsicum annuum, Selenium metallicum, Tellurium metallicum, etc.

For inflammatory diseases of the brain substance and its membranes the following are indicated: Aconitum napellus, Apis mellifica, Ferrum jodatum, Gelsemium sempervirens, Rhus toxicodendron, Veratrum album and other nosodes.

For neoplasms of the central nervous system, the following are most often prescribed: Arnica montana, Arsenicum album, Bufo rana, Helonias dioica, Hura brasilensis, Sulphuris, Tarentula hispanica, Taxus baccata, etc.

Some homeopathic preparations do not require strict consideration of the constitutional and psychological characteristics of the patient's body, as is customary in homeopathy. They can be prescribed by a neurologist. Such drugs include "Coenzyme compositum", "Traumeel C", "Engistol", "Polysponin", "Spascuprel" and some other drugs sold in regular pharmacies.

Ginkgo biloba preparations have gained particular popularity as effective means for improving memory and brain activity in general. They are sold in pharmacies without a prescription and even in special sections of supermarkets. Such products cannot be considered as a medicine for deep and pronounced diffuse changes in the brain, but they help in the rehabilitation period, after undergoing appropriate treatment, to restore intellectual abilities and restore brain performance. With mild changes in the functioning of the central nervous system, they will help restore its performance even without special treatment.

Prevention

Prevention of diffuse brain damage is, first of all, prevention of infectious and inflammatory processes in the brain substance and its membranes, i.e. timely seeking help and treatment of respiratory infections, inflammatory diseases of the nasopharynx, ears and eyes. This is especially important in childhood, because such diseases leave an imprint on the further development of the child.

Traumatic brain damage, unlike neuroinfections, is not always possible to prevent. However, being attentive on the roads, at home and at work in most cases allows you to avoid serious consequences. When getting behind the wheel, you need to make sure that there are no traces of alcohol or drugs in your blood that can have a depressing effect on the central nervous system, and during the trip you need to be as focused as possible and not be distracted by unimportant irritants.

Dementia in old age is a physiologically conditioned process of brain fatigue. Its performance can be maintained by training (regular intellectual work, reading books, watching popular science films, solving logical problems). Physical activity, rational nutrition, taking multivitamin complexes, and giving up bad habits help to delay the onset of dementia.

Forecast

Changes in the state of various brain structures and its bioelectric activity can be diagnosed in various pathologies. But the prognosis of such diseases depends not so much on the diagnosis as on the extent and depth of damage to brain structures.

Some may think that localized brain damage has less of an impact on a person's condition. In fact, deep localized damage can have far more irreversible consequences than mild or moderate diffuse damage.

Even diffuse axonal damage in road accidents, which are considered severe injuries, are often accompanied by temporary impairments of various CNS functions. Everything depends on the depth of the damage and the treatment provided.

In infectious and inflammatory diseases of the brain, everything depends on the timeliness of the treatment and the age of the patient. The prognosis in this case is ambiguous. It is most severe at an early age, since it is fraught with irreversible intellectual impairment. Meningoencephalitis, as a complication of nasopharyngeal infections, is considered one of the most common causes of oligophrenia (mental retardation) acquired in the postnatal period, cerebral palsy, and childhood dementia.

The worst prognosis for intellectual and motor abilities is with progressive dementia and atrophic processes in the brain. It is usually impossible to stop such processes, they can only be slowed down with a properly constructed treatment plan.

Diffuse changes in the brain is medical terminology that indicates the extent of the spread of structural and functional changes in the cortex, cerebral hemispheres and midbrain structures. The attitude of doctors to these changes depends on what these changes are, whether they are tied to age periods and how they affect a person’s well-being and self-realization. All we can do is listen to their verdict and adhere to professional recommendations, rather than put forward our own hypotheses about what is happening.