Diffuse brain changes: what does it mean?

The brain is the supreme center of regulation of all processes that occur in the human body. It is its complex structure and peculiarities 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 best affect the performance of this important organ that controls the work of all other components of the living organism. Although even here it is important to take into account that in different age periods in the brain regularly occur qualitative and quantitative changes that are physiologically conditioned and do not imply pathology. But how to understand what the changes in brain matter and its activity are associated with, and is it worth worrying about?

The human brain

When people say that man is the supreme being on Earth, they do not mean that he is stronger and more powerful than the rest of the animal kingdom. In a fight with large and predatory animals, the power advantage is often not at all on the side of man. But thanks to the complex structure of the brain and the processes of analyzing and synthesizing information in it, we make decisions that help us stand up to opponents many times stronger.

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

It would seem that the brains of humans and higher animals have a similar structure and function 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, a person can control this process and even correct it.

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

The main cells of the brain - neurons - have an amazing property of transmitting information from the environment from receptors located throughout the body to the brain and spinal cord. This is possible due to bioelectric impulses generated by neuron bodies, which travel long distances in a fraction of a 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 centers represent a certain code that is transmitted along nerve fibers consisting of neuron outgrowths and decoded by the brain as a guide to action. It is these impulses that man has learned to record with the help of special equipment (electroencephalographs). By studying the passage of impulses through different parts of the CNS it is possible to judge the functioning of the brain, i.e. Its bioelectrical activity.

Local or focal changes in the substance of the brain or its cortex cause disorders of individual organs and systems, depending on the location of the lesion. The functions of vision, hearing, sensitivity of limited areas of the body or organs may be affected, there may be problems with coordination of movements, etc. The basis of serious CNS dysfunction is usually diffuse changes in the brain, i.e. Widespread disorders with a blurred localization, when not a particular area of the brain is disturbed, but its work as a whole, as an organized system.

The human brain has undergone various changes in the course of evolution, so there are older and newer formations in its composition. The youngest part of the brain is considered to be its cortex, which performs more responsible functions, increasingly distinguishing humans from animals, providing conscious actions. It is clear that both local and diffuse changes in the cerebral cortex, significantly affect the well-being of a person, his cognitive abilities (which is especially important in childhood, when the concepts of the surrounding world are still being formed), performance. [1]

When considering the role of the cerebral cortex, we should not overlook the functions performed by 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 analysis and synthesis of sensitive information transmitted to the brain by receptors.

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

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

Causes of the diffuse changes in the brain:

The causes of diffuse changes in nerve conduction of the brain in adults can be considered as organic brain lesions of medium and severe degree, when more than 20% of brain tissue is affected, which entails various disorders of nervous activity and neuropsychiatric disorders. The risk factors of organic brain pathologies - a concept that combines a number of disorders, which are characterized by dystrophic changes in brain matter with impaired neuronal conduction, are considered to be acquired brain defects associated with:

• craniocerebral traumas, which can be of varying severity, so the bioelectrical conduction disturbance caused by them may have different nature, intensity and duration (cranial and brain injuries can be characterized by both local and diffuse changes in the brain matter), [2]
• various intoxications (here it depends on the nature of toxins and poisons, and the duration of their impact on the body),
• radiation that disrupts metabolic processes in brain tissue and causes brain cells to die,
• Brain hypoxia (the brain is one of the first to feel the lack of oxygen and the longer it experiences oxygen deprivation, the stronger and more persistent will be the damage to nerve cells),
• inflammatory processes in the tissues and membranes of the brain, which in most cases are infectious in nature (meningitis, encephalitis, meningoencephalitis, which often occur as a complication 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 cerebral vessels, such as atherosclerosis)
• degenerative diseases (we wrote about them above).

One should not exclude such disorders that seemingly have nothing to do with the brain, although, according to statistics, they rarely lead to serious brain disorders. 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 to the brain, is reduced. In this case, the brain will also lack oxygen, as in hypoxia caused by asphyxiation, but to a lesser extent, so the changes in brain matter and activity will be less pronounced (mild).

Metabolic disorders in the body, avitaminosis, endocrine gland disorders lead to increasing brain starvation, and sleep deprivation (lack of normal rest) leads to brain fatigue. Not surprisingly, people with such problems may also have unstable bioelectrical activity of the brain and reversible decline in intellectual abilities, although there may be no changes on ultrasound or brain imaging.

Changes in the bioelectrical activity of the brain of a regulatory nature imply functional disorders and are usually associated with dysfunction of medial structures controlling brain activity, as a result of which excitation or inhibition may prevail in the CNS. Such structures include the pituitary gland, hypothalamus, epiphysis, cerebellum. It is not necessarily that dystrophic or degenerative changes will be diagnosed in the brain matter.

Pathogenesis

We have already noted that our brain undergoes different changes in different age periods. And it is scientifically explainable, because with the formation of higher mental functions the brain activity changes. It develops due to creation of multiple conditionally-reflexive connections, formed in the process of life activity of CNS, starting from the birth of a person and till his death. It is on the formation of such useful connections that help the brain to work more actively and quickly make the right decisions, and the learning process is based. Based on the teachings of I.P. Pavlov on higher nervous activity (HNA), the saying "live and learn forever" 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 brain reactions. When they are repeated frequently, a dynamic stereotype is formed that facilitates the work of the brain.

When the bioelectrical activity (BEA) of the brain is disturbed, its analytical and synthetic work becomes more complicated. The developed stereotypes are slowly lost, and new ones are not formed. Reacting to each new and even already known stimulus (and there are a lot of them around and inside our organism), the CNS has to work hard, constantly analyzing the situation and making decisions, which 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 a given situation without straining the brain. If bioelectrical conduction is disturbed, even such a simple task will cause tension in the brain, which entails its rapid fatigue, reduction of physical and intellectual activity.

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

Diffuse changes in brain tissue are considered to be such common processes that are associated with qualitative and quantitative reorganization of cellular structures of the organ. This can be brain edema or blood circulation disorder in its tissues causing cell death, scar formation due to trauma and tumor processes compressing brain vessels and again leading to ischemia of large areas of brain matter. Such changes affect both the functionality 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, as well as brain radiography and tomography, can be provoked by trauma or infection, as well as vascular diseases, tumor processes in the brain, nutritional disorders of nervous tissue (hypoxia, anemia, etc.). They are characteristic of hereditary degenerative diseases provoked by gene mutations (neurofibromatosis types 1 and 2, Louis-Bar syndrome, tuberous sclerosis) and neurodegenerative pathologies associated with metabolic disorders (dementia, multisystem atrophy, Parkinson's disease, Wilson's and Farah's diseases). [3]

Changes in the structure of brain tissue are reflected in its ability to generate and conduct nerve impulses. Diffuse changes in the brain (qualitative and quantitative), identified 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 influence on the neuropsychiatric development of the child only in combination with the analysis of bioelectrical conduction indices in brain neurons. Mild changes can be both a variant of the norm and an indicator of persistent or developing pathological disorders. Some of them are detected immediately after birth, others - at a later age. [4]

Symptoms of the diffuse changes in the brain:

Diffuse brain changes and its BEA is not a diagnosis, but only the result of an examination that helps to understand whether there is pathology and to determine the diagnosis. It cannot be considered separately from other manifestations of the disease and those processes that happened to the 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 overworked or against the background of a severe nervous shock, brain activity decreases.

However, changes in brain structures determined on ultrasound and tomograms are a more specific concept that narrows the range of possible diagnoses. However, when it is not a local, but a diffuse lesion (vague, without clear boundaries, when there is one large focus with indistinct boundaries or many such indistinct ones throughout the brain), it is impossible to say unambiguously what caused it and what it may turn out to be.

Diffuse change in the brain stem structures, which include the medulla oblongata, which is a continuation of the spinal cord, the varicose vein, the midbrain, sometimes including the cerebellum (the center for regulation of muscle tone, balance, coordination of movements) and the medulla oblongata. Through all these structures passes the reticular formation, which contains many nerve centers responsible for vital functions of the body: chewing, swallowing, breathing, digestion, heartbeat, etc. Crowning the brain stem is the limbic system, responsible for human emotions. A diffuse change is said to occur when it is not possible to specify 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 parts are involved in the pathological process. A person's appetite, heart rhythm, breathing, swallowing, blood pressure (if the reticular formation is involved in the process), ataxia and atonia (impaired coordination of movement and decreased muscle tone in cerebellar lesions) may develop. When the intermediate brain (thalamus, hypothalamus, pituitary gland, epiphysis) is affected, sleep disorders, biorhythm disorders, endocrine gland disorders, decreased intellectual capacity, rapid fatigue, auditory and visual disorders may appear. Sexual dysfunction may occur.

When talking about functional damage, it is usually possible to identify the focus of the disease, i.e. The brain structure that has malfunctioned, already from the symptoms. Diffuse brain changes are accompanied by dysfunction of several structures involved in the pathological process, so it may seem that the symptoms are unrelated.

Diffuse dystrophic changes in the brain are accompanied by changes in its bioelectric activity, resulting in impaired processing of information. If the brain activity is increased, a person is quickly fatigued, attention span decreases, mood swings, seizure syndrome may occur and epilepsy may develop. If BEA is reduced, a person slower performs the usual work, loses interest in previous hobbies and surroundings, there is a decrease in intellectual level. Decreased self-esteem can be observed in both cases, especially when it comes to adolescents and young people who know their potential. Headaches are possible in both cases, but they are diagnosed more often with increased BEA.

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

Atherosclerosis of cerebral vessels, which itself is the cause of diffuse changes and possible strokes, can be determined multiple foci with impaired blood supply to the brain due to narrowing of its vessels. Cholesterol plaques on the walls of the vessels prevent the flow of blood and violate their elasticity. This may cause headaches, spikes in blood pressure and intracranial pressure, double vision, dizziness, and other symptoms depending on which parts of the brain are more affected by oxygen deficiency.

In epilepsy, diffuse changes in the brain may not be present, but such a symptom as seizures is always present. Organic changes in brain structures cause epilepsy when a focus of neuronal hyperexcitability is formed at the site of swelling caused by an infectious or traumatic process, which does not fully recover even after the swelling subsides.

Disorders of metabolic processes and hormonal regulation can be considered as signs of disorganization of bioelectrical activity of the brain. 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, their loss, changes in the appearance and clarity of the skin, increased brittleness of nails, stool disorders. Not always such symptomatology speaks of brain diseases, but in combination with headaches, memory impairment, temperature fluctuations, etc., it should make you think.

Some patients complain of decreased libido, while in others uncontrollable sexual arousal predominates. The latter is more common in patients with irritative lesions and is associated with irritation of the neurons responsible for sexual function (neurons are not damaged but are constantly in an excited state). Another cause of sexual dysfunction may be an imbalance of the hormonal background (the CNS, and in particular the pituitary gland, is also responsible for its regulation).

Many people report weight fluctuations, even when appetite is intact. In brain injuries, there is often a decrease in appetite. But for progressive dementia is more characterized by insatiability, a person feels that he constantly does not finish, eating worse than others, the feeling of satiety comes only when there is no more room in the stomach. Vomiting attacks are not uncommon in both categories of patients.

Neurotic reactions in diffuse BEA changes of the brain 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 avitaminosis, but by insufficient regulation of the immune system. That is why it does not fully perform its 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 nerve centers is disturbed, shortness of breath, arrhythmias, chills, bone and muscle weakness may occur for no good reason. In this case, organic damage to the brain entails functional disorders, when the organ is healthy but does not work properly.

The fact is that the regulation of our organism, including metabolic processes, occurs through the transmission of bioelectric impulses about the state of homeostasis (internal environment of the organism) to the CNS. The brain processes this information in detail and through the same impulses going from neuron to neuron, triggers or inhibits certain processes. Thanks to central regulation, the constancy of such a complex biological system as the human body is ensured.

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

As we can see, determining the presence of structural changes in the human brain is still not enough to make a definitive diagnosis. Analysis of the patient's complaints helps the doctor to determine the localization of the damaged structures and the available consequences, and dynamic studies and the study of anamnesis make it possible to understand the nature of the disorder (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 to perform their functions of the various organs of our body largely depends on the performance of the brain. Any changes in the brain sooner or later affect our well-being, and this in turn leads to a decrease in the ability to work, deterioration of mood and general condition. The more pronounced are structural and functional changes in the brain, the more they affect the well-being and behavior of a person.

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

Many people somehow treat a contusion or concussion resulting from a brain injury superficially. [7] It is believed that a certain amount of time of complete rest is enough to restore the functionality of damaged brain structures. In reality, it's not that simple, especially if you ignore the injury altogether and continue to go to work. After all, the result of trauma can become and hemorrhages in the brain when vessels rupture (for example, in atherosclerosis, which a person may not have suspected, the brain vessels become less strong and can easily burst at impact), and increased neuronal activity, provoking spasms and seizures, and disruption of the work of individual brain structures. All this may not remind of itself for some time, and then it may lead to stroke, cerebral thrombosis, epilepsy, etc.

Prolonged course of the 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. In this case, it is almost impossible to restore the brain tissue, returning it to its original properties in this case. Children with prolonged meningitis or encephalitis have persistent disorders of psycho-physical development, and in adults there is a decline in intelligence and impaired motor function.

Some degenerative processes in the brain (especially those of hereditary nature) cannot be stopped even if diagnosed early. But it is possible to slow down the process in most cases. And the earlier treatment is started, the more time for a more or less full-fledged existence remains for a person. And nothing is more valuable than human life, which, alas, is fleeting, so it is important to enjoy every moment of it.

Diagnostics of the diffuse changes in the brain:

Diffuse changes in the brain and its bioelectrical conduction do not remind of themselves immediately, so a person may not even suspect pathology. But those who monitor their health, immediately notice changes in mood, memory impairment, rapid fatigue, increased sensitivity to natural changes, which resemble the first signs of brain dysfunction. Perhaps such symptoms have trivial causes, such as vitamin deficiency, but if it affects the brain, it is worth taking certain measures.

In addition, how can you know what the symptoms are related to, if you do not consult a doctor. Even if a person has suffered a brain injury, it does not necessarily have to have a serious impact on brain function, it may be due to infection or intoxication, and the past trauma has only created the basis for a predisposition to brain disease. [8]

Since the symptoms play an important role in the diagnosis, the doctor will always ask the patient about his well-being. Interest in possible injuries, intoxications and infections is also not accidental, because not always the problem can be seen with 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 provoked 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 general and biochemical blood tests. Hypoxia can be caused by a low content of red blood cells and hemoglobin, increased blood viscosity, which slows down the speed of its flow through the vessels and contributes to the formation of blood clots.

We know that the symptoms of organic brain damage can vary considerably depending on which structures are involved and how serious the situation is. In addition, the deterioration is not always directly related to brain damage. So 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, there is irradiation of irritation, when under the influence of a tumor or other irritant, one neuron transmits irritation (excitation) to another. Usually, by removing the object of irritation, normal brain function can be restored.

What the 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 detected by ultrasound (ultrasound) and tomography (computerized or magnetic resonance). [9] X-ray of the skull is less informative because it reflects the state of soft tissues worse, but it can also provide some information.

In case of suspected atherosclerosis and cerebral ischemia, angiography, i.e. Examination of cerebral vessels and assessment of blood flow in them, helps to confirm the diagnosis. In the case of irritative changes, brain imaging is most relevant, although ultrasound can also detect pathologic thickening.

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

Differential diagnosis in diffuse brain changes is of great value and is based on the analysis of available information: the results of laboratory and instrumental tests, information obtained from the patient and due to the study of anamnesis. 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 diagnosis. It is very important due to the fact that different diseases, in which the structure and functioning of the brain is altered, require different treatment approaches. The difference is evident if we consider the therapy of vascular and degenerative diseases, congenital (difficult to correct) and acquired.

Especially important is such differentiation in the examination of young children, because it determines the direction of not only therapeutic, but also corrective and developmental work with the child.

What do ultrasounds and encephalograms tell us?

Diffuse brain changes is a medical concept used in differential diagnosis to make a final verdict. But in itself it is not a diagnosis and does not even speak of pathology. Everything depends on the degree of severity of brain changes and which structures are affected.

Depending on the causes causing the disruption of the brain structure and its conduction, as well as the time of the lesion, the disorder of brain functionality may be persistent or progressive. In the case when the factor that affected brain activity or brain development has lost its relevance (ceased to act), but diffuse changes remain, we will talk about a persistent disorder of psychophysical development (of the type of oligophrenia, residual dementia, etc.). With timely professional treatment of inflammatory and oncologic diseases, the structure and activity of the brain can fully recover.

If diffuse changes in the brain are the result of active disease, it is likely that they will progress, spreading across the surface of the brain and into the depths. But to determine the likelihood of this, you need a definitive diagnosis, rather than just the presence of brain changes during an ultrasound scan.

Mild diffuse changes in the brain (its bioelectrical activity measured by an encephalograph) can also occur in healthy people. This may be due to fatigue, decreased blood sugar levels (lack of carbohydrates in food), lack of sleep, and general malaise. Brain function is reduced and a person quickly becomes tired even without heavy physical or mental exertion.

But sometimes this verdict is just the first swallow, especially if a person notes frequent headaches, dizziness, unexplained temperature fluctuations. Such moments need to pay special attention to those who had a head injury in the past. Sometimes its consequences remind of themselves after several months and years.

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

Diffuse changes in midbrain structures may be accompanied by changes in bioelectrical activity of varying degrees of severity. The symptoms that may be observed depend on which part of the brain is damaged and the degree of damage. With hypothalamic pathology, temperature fluctuations, appetite disorders and sleep-wake cycles, increased or decreased sex drive may be noted. If the pituitary gland is damaged, there may be disorders in the work of various glands of internal secretion (accordingly, symptoms of non-sugar diabetes, hypothyroidism, hyperprolactinemia appear), growth disorders in children, mental retardation, sexual disorders.

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

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

But if we talk about moderate changes in bioelectrical activity of the brain, then here the situation is even more ambiguous. Such a result in some cases is considered a variant of the norm, and in others indicates a pathological process. Everything depends on the individual characteristics of the human body, its well-being and the results of ultrasound or tomography.

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

Treatment of the diffuse changes in the brain:

The detection of diffuse changes in the brain during the 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 patient's body characteristics.

Thus, in atherosclerosis of blood vessels, a complex therapy is prescribed, which includes normalization of fat metabolism and optimization of the work of brain vessels. The first direction is provided by means of nicotinic acid, reducing the content of harmful cholesterol, fibrates, reducing the synthesis of own fats in the body, sequestrants of bile acids, statins, inhibiting the synthesis of cholesterol.

To improve blood supply to the brain, vasodilators, central-acting myorelaxants that relax the vasculature, angioprotectors, antiaggregants and anticoagulants that improve blood flow and prevent the formation of blood clots are prescribed.

Vitamin complexes play an important role. Particularly useful are B vitamins, which have a positive effect on the nervous system, antioxidants (vitamins A and E), polyunsaturated fatty acids, which reduce the level of bad cholesterol in the blood.

In atherosclerosis and cerebral ischemia, accompanied by increased arterial and intracranial pressure, memory loss and impaired concentration, doctors may also prescribe hypotensive drugs and nootropics (drugs that improve trophicity and brain function, resulting in some recovery of cognitive function). [10]

If the patency of the sclerosed vessel cannot be restored, surgical treatment is resorted to. The most popular method of intervention on cerebral vessels is carotid endarterectomy (dissection of the vessel and removal of cholesterol plaque).

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

In diseases caused by intoxication of the body (toxic encephalopathy), the first place is given to detoxification therapy, followed by restoration of the brain metabolic processes in it (nootropics, proivoconvulsants, neuroleptics, antidepressants, psychotherapy sessions).

If diffuse changes occur as a result of a brain injury, treatment should be based on the type of injury. The prescription of drug therapy should be based on the severity of the injury.

The main requirement of brain injury therapy is rest for a certain period of time (in case of mild concussion, this may even be sufficient for recovery). Corticosteroids and diuretic (diuretic) drugs are prescribed for traumatic inflammation and brain edema, as well as for its prevention.

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

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

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

Surgical treatment for brain injuries is performed only in cases of cranial crushing and compression of the brain, formation of hematomas.

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

Physiotherapeutic treatment in diffuse changes in the brain is prescribed with caution and takes into account the existing disorders. In vascular pathologies and associated dysfunction of the BEA of the brain are prescribed galvanization, drug electrophoresis (vasodilators and stimulants of cerebral circulation), ultratonotherapy, UHF and DMV therapy, ultraviolet irradiation, radon and coniferous baths, hydrotherapy. To improve the trophics of brain tissue in various diseases can be prescribed percutaneous electroneurostimulation, interference therapy. Diademo- and amplipulsterapiya, darsonvalization. Fighting motor disorders, which often develop against the background of organic or functional brain lesions, is conducted through massage, kinesotherapy, physical therapy, water procedures, swimming. Speech disorders often require work with a speech therapist.

In any case, the approach to the choice of physiotherapy procedures should be strictly individualized, taking into account concomitant pathologies, the patient's condition, age characteristics.

Drug therapy

Specific drugs used in diffuse changes in the brain are considered neuroprotectants. This is a large group of drugs, in which they are distinguished:

• medicines that improve the trophicity of brain tissue (nootropics),
• antioxidants with antihypoxic, anti-stress, anticonvulsant, anxiolytic (calming) effects,
• agents that stimulate cerebral blood flow,
• 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 be prescribed only as an auxiliary agent, since it does not have a pronounced therapeutic effect.

The drug is produced 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 at 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 convulsive syndrome, the dose should be increased 1.5-2 times.

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. Internally, the solution of piracetam is taken twice a day in 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 acute kidney failure, allergic reactions to the drug (as well as juices and essences), acute impairment of cerebral circulation (stroke). Children over 1 year of age are given the drug only by doctor's prescription.

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

"Mexidol" - a drug from the category of antioxidants with neuroprotective action. It is available in the form of tablets and solution for intravenous and intramuscular administration. The drug improves brain nutrition and respiration, as well as the qualitative characteristics of blood, normalizes behavior and sleep, restores disturbed autonomic 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 (not more than 800 mg per day). The duration of treatment with the drug can be up to 2 months.

The drug solution is administered in acute pathologies (in the form of injections and infusions). In strokes in the first 2-4 days, the drug is administered by infusion1 once a day for 200-300 mg. After which they switch to intramuscular administration (three times a day for 2 ampoules). The therapeutic course is 1.5-2 weeks.

In case of brain injuries and their consequences, the dose can be increased to 500 mg (frequency of administration up to 4 times a day). Duration of the course is the same.

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

Contraindications to the use of the drug are: acute renal failure, severe liver pathology, hypersensitivity to the drug, pregnancy and lactation. It is not used for the treatment of children.

Side effects are limited to headaches, reactions from the GI tract, allergic reactions, pressure fluctuations.

"Cinnarizin" - a drug that improves cerebral blood 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 the adult dose.

Contraindications to the use of the drug are, first of all, hypersensitivity 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 progressive dementia and Parkinson's disease.

Side effects of the drug can be described by such symptoms as increased fatigue, drowsiness, headaches and dizziness, disorders of the digestive system and liver function (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 to potassium and sodium ions, which provide bioelectrical potential. The drug that affects the action of such receptors, improving mental activity and eliminating motor disorders is "Memantine".

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 renal pathologies. Side effects of the drug are considered to be increased mental excitability, anxiety, fatigue, increased intracranial pressure, nausea.

Folk treatment

When we notice some deterioration of intellectual abilities without other suspicious symptoms, we do not hurry to consult a doctor, because today there is a lot of hyped synthetic and herbal remedies 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 it is possible to find out whether there are any or not only during professional diagnostics.

If diagnosis has shown that there are widespread changes in various brain structures and impaired functionality, one cannot rely on therapeutic drugs alone. 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 should be understood that folk remedies for organic brain diseases are powerless. They help to fight the consequences of the disease, but do not cure it. True, in brain injuries, when you need peace, you can take advantage of the property of some herbs to have a sedative effect. Such herbs include valerian, marjoram root, motherwort, ruta, hops, bluebells, mint. Treatment with herbs in this case will have a certain effect, but it can not always be considered sufficient.

Another thing is that such herbs help to normalize the neuropsychiatric state of patients, adjust 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 cerebral vessels. In such a diagnosis, herbal medicine (herbal collections) has a truly therapeutic effect.

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

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

Consumption of grapefruit reduces the risk of atherosclerosis and reduces its manifestations. Melon is also attributed to its antisclerotic effect.

Prevent cerebral vascular spasms and ischemic brain damage can be prevented with the help of melissa. It can be consumed fresh or taken as an infusion (1 tbsp. Dry herb per glass of boiling water).

Herbs such as lavender, plantain, nettle, succession, poplar and mulberry leaves are useful for reducing intracranial pressure and preventing cerebral hemorrhage.

It also helps to use a medicine that is an infusion of garlic and lemon (1 head of garlic and lemon grated, pour 700 ml of hot boiled water and insist 24 hours, take 4 times a day ¼ cup).

You can take herbs such as rosemary, sage, milkwort, St. John's wort, pol-pala (erva woolly), elecampane roots, hawthorn flowers, decoctions and baths of pine needles to improve brain function and cognitive function.

It is important to understand that folk treatment should be considered as symptomatic and prophylactic 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 peculiarities. Strictly speaking, in most cases we are not talking about treatment of diseases, but about rehabilitation of patients after a course of medication. Rehabilitation includes psychological help, physiotherapy sessions and homeopathic treatment aimed at restoring the functions lost as a result of the disease.

As for homeopathic remedies, their choice is largely conditioned by the diagnosis made in the hospital and the results of laboratory tests, ie, without consultation of a neurologist and examination here can not do without.

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

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

In CNS neoplasms most often prescribed: Arnica montana, Arsenicum album, Bufo rana, Helonias dioica, Hura brasilensis, Sulphuris, Tarentula hispanica, Taxus baccata and others.

Some homeopathic remedies do not require strict consideration of the constitutional and psychological features of the patient's body, as is customary in homeopathy. They can be prescribed by a neurologist. Such remedies include "Coenzyme Compositum", "Traumel C", "Engistol", "Polysponin", "Spaccuprel" and some other drugs sold in ordinary pharmacies.

Ginkgo biloba preparations have gained particular popularity as effective means to improve memory and brain activity in general. They are sold in pharmacies without a prescription and even in special sections of supermarkets. Such means can not be considered a cure for deep and pronounced diffuse changes in the brain, but they help in the rehabilitation period, after undergoing appropriate treatment, to restore intellectual capabilities and restore brain performance. In case of mild changes in the CNS, they will help to restore its performance even without special treatment.

Prevention

Prevention of diffuse brain lesions 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 affect the further development of the child.

Traumatic brain injuries, unlike neuroinfections, are not always preventable. Nevertheless, careful attention on the road, in everyday life and at work can in most cases avoid serious consequences. Getting behind the wheel, it is necessary to make sure that there are no traces of alcohol in the blood and drugs that can have a depressing effect on the CNS, during the trip should be as focused as possible and do not get distracted by unimportant stimuli.

Dementia in older age is a physiologically determined process of brain fatigue. It can be maintained by training (regular intellectual work, reading books, watching popular science films, solving logical problems). To delay the onset of dementia help; physical activity, a rational diet, taking multivitamin complexes, avoiding bad habits.

Forecast

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

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

Even diffuse axonal injuries in road traffic accidents, which are considered to be severe injuries, in many cases are accompanied by temporary disturbances of various CNS functions. Everything depends on the depth of the damage and the treatment performed.

In infectious-inflammatory diseases of the brain, everything depends on the timeliness of the initial 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 frequent causes of oligophrenia (mental retardation) acquired in the postnatal period, cerebral palsy, childhood dementia.

The worst prognosis for intellectual and motor abilities in progressive dementia and atrophic processes in the brain. It is usually not possible to stop such processes, it is possible only to slow them down with a properly designed treatment regimen.

Diffuse brain changes is a medical terminology that indicates the extent of diffuse structural and functional changes in the cortex, large hemispheres and medial structures of the brain. Doctors' attitude to these changes depends on what these changes are, whether they are linked to age periods and how they affect a person's well-being and self-actualization. All we have to do is to listen to their verdict and adhere to professional recommendations rather than hypothesize what is going on.