Diffuse changes in the brain: 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 a person from animals, make him 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 a 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 determined and do not imply pathology. But how to understand what the changes in the brain substance and its activity are associated with, and is it worth worrying about this?

Human brain

When they say that man is the highest being on Earth, it is not meant that he is stronger and more powerful than the rest of the animal world. In a fight with large and predatory animals, the power advantage is often by no means on the side of a person. But thanks to the complex structure of the brain and the processes of analysis and synthesis of information taking place in it, we make decisions that help to resist 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 and allows him to solve emerging problems not only through flight or aggression, but also through the transformation of 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, a person can control this process and even correct it.

But what is the human brain? This is the main regulatory organ of the central nervous system (CNS), which provides 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 forward movement back.

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 thanks to the bioelectric impulses generated by the bodies of neurons, which propagate over long distances in a fraction of a second, so we almost instantly respond to any changes in the external world and the internal environment of our body.

Nerve impulses that form chains of foci of excitation and inhibition are a kind of code that is transmitted along nerve fibers, consisting of neuron processes, and deciphered by the brain as a guide to action. It is these impulses that a person has learned to fix with the help of special equipment (electroencephalographs). By examining the passage of impulses through different parts of the central nervous system, one can 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 disturbances in the functioning of individual organs and systems, depending on the location of the lesion. The functions of vision and hearing may suffer, the sensitivity of limited areas of the body or organs may be impaired, there may be problems with coordination of movements, etc. Severe CNS dysfunction is usually based on diffuse changes in the brain, i.e. Common disorders with blurred localization, when not a specific 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 process of evolution, therefore, it contains older and newer formations. The youngest part of the brain is considered to be its cortex, which performs more responsible functions, more and more distinguishing a person 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 concepts about the world around him are still being formed), and working capacity. [1]

Considering the role of the cerebral cortex, one should not miss the functions that perform subcortical formations. Important subcortical formations include the basal nuclei in the composition of the white matter of the cerebral hemispheres, which are responsible for our emotions and the transmission of motor impulses along the pathways (bundles of nerve fibers), which are the result of the analysis and synthesis of sensitive information transmitted to the brain by receptors.

Among the vital median structures of the brain, the following are considered: the medulla oblongata, midbrain, diencephalon (thalamus, pituitary gland, hypothalamus, epiphysis), pons varolii, reticular formation, organs of the limbic system 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 becomes its analytical and synthetic work, which is 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 of the diffuse changes in the brain:

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

• craniocerebral injuries, which can be of varying severity, so the violation of bioelectrical conduction caused by them can be of a different nature, intensity and duration (traumas of the skull and brain can be characterized by both local and diffuse changes in the medulla), [2]
• various intoxications (everything here depends both on the nature of toxins and poisons, and on the duration of their exposure to the body),
• radiation that disrupts metabolic processes in the brain tissues and causes the death of its cells,
• brain hypoxia (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 of an infectious 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 a widespread decrease in the diameter of cerebral vessels, such is vascular atherosclerosis)
• degenerative diseases (we wrote about them above).

We should not exclude such disorders that, it would seem, have nothing to do with the brain, although, according to statistics, they rarely lead to serious disorders of the brain. For example, a low level of hemoglobin 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 in hypoxia caused by suffocation, but to a lesser extent, so changes in the substance of the brain and its activity will be less pronounced (light).

Metabolic disorders in the body, beriberi, disorders of the endocrine glands lead to increasing starvation of the brain, and lack of sleep (lack of normal rest) leads to its overwork. Not surprisingly, people with these problems may also have erratic brain activity and a reversible decline in intellectual ability, although there may be no change on an ultrasound or brain scan.

Changes in the bioelectrical activity of the brain of a regulatory nature imply violations of the functional plan 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. These structures include the pituitary gland, hypothalamus, pineal gland, cerebellum. At the same time, dystrophic or degenerative changes will not necessarily be diagnosed in the medulla.

Pathogenesis

We have already noted that our brain undergoes various changes in different age periods. 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 that are formed in the course of the life of the central nervous system, from the birth of a person to 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 that the learning process is based. Based on the teachings of I.P. Pavlov about higher nervous activity (HNA), the saying “live for a century, learn for a century” takes on 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. With their frequent repetition, a dynamic stereotype is formed that facilitates the work of the brain.

In violation of the bioelectrical activity (BEA) of the brain, 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 a lot, 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 needed in this situation, without straining the brain. If bioelectrical conductivity is disturbed, even such a simple task will cause tension in the brain, which leads to its rapid fatigue, a decrease in physical and intellectual activity.

The more extensive the damage to the brain with impaired bioelectrical conduction, the more difficult it will be for a person to cope with his usual duties, the more difficult it will be to form new conditioned reflexes that ensure the development of a person, and the faster the previously acquired skills and abilities will be lost. Thus, the diagnoses of “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 disruption of the work of neurons.

Diffuse changes in the tissues of the brain are such common processes that are associated with a qualitative and quantitative restructuring of the cellular structures of the organ. This may be cerebral edema or impaired blood circulation in its tissues, causing cell death, scarring due to trauma and tumor processes that compress the brain vessels and again lead to ischemia of large areas of the brain substance. 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 the brain tissue, which are detected by ultrasound, as well as radiography and tomography of the brain, can be triggered by both trauma or infection, and vascular diseases, tumor processes in the brain, malnutrition of the 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, multiple system atrophy, Parkinson's disease, Wilson's and Farah's diseases). [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), identified in early childhood, can act as a distinctive feature of a person's individual development or be the result of pathological processes in the brain. Therefore, it is possible to judge their pathogenesis and influence on the neuropsychic development of a child only in combination with an analysis of bioelectrical conductivity indicators 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 the birth of a child, others at a later age. [4]

Symptoms of the diffuse changes in the brain:

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

Diffuse changes in brain biopotentials may be due to normal physiology. When a person falls asleep, they decrease, with overwork or against the background of a severe nervous shock, brain activity decreases.

But the changes in brain structures determined by ultrasound and tomography are already a more specific concept, narrowing the range of possible diagnoses. True, when we are talking not about a local, but a diffuse lesion (vague, without clear boundaries, when there is one large focus with blurred boundaries or many of the same fuzzy ones throughout the brain), it is impossible to say unequivocally what caused it and what it could turn into..

Diffuse changes in the brain stem structures, which include the medulla oblongata, which is a continuation of the spinal cord, the pons, the midbrain, sometimes the cerebellum (the center for regulating muscle tone, balance, coordination of movements) and the medulla oblongata are also included here. A reticular formation passes through all these structures, containing many nerve centers responsible for the vital functions of the body: chewing, swallowing, breathing, digestion, heartbeat, etc. Crowning the brainstem is the limbic system, which is responsible, among other things, for human emotions. A diffuse change is said to be 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 it all depends on which departments are involved in the pathological process. A person may have impaired appetite, heart rhythm, breathing, swallowing, blood pressure (if the reticular formation is involved in the process), develop ataxia and atony (impaired coordination of movement and decreased muscle tone with damage to the cerebellum). With damage to the diencephalon (thalamus, hypothalamus, pituitary gland, pineal gland), there are sleep disturbances, disruptions in biorhythms, disruption of the endocrine glands, decreased intellectual capabilities, fatigue, and hearing and visual disorders may appear. Possible violations of sexual function.

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

Diffuse dystrophic changes in the brain are accompanied by a change in its bioelectrical activity, as a result of which the processing of the information received is disrupted. With increased brain activity, a person experiences rapid fatigue, decreased attentiveness, sudden changes in mood, the appearance of a convulsive syndrome and the development of epilepsy. If BEA is reduced, a person performs his usual work more slowly, loses interest in his former hobbies and the environment, and a decrease in the intellectual level is noted. A decrease in 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 with increased BEA they are diagnosed more often.

Some pathologies develop as a result of moderate or severe widespread changes in the brain. Thus, in dementia, diffuse atrophic changes in the brain are noted, which are characterized by multiple foci, where the death of nerve cells is noted, which are practically not restored. The prevalence of the process also affects the symptoms, so a person has speech disorders, intellectual problems (first of all, 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]

With atherosclerosis of cerebral 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 blood vessels impede blood flow and disrupt their elasticity. In this case, headaches, jumps in arterial and intracranial pressure, double vision, dizziness, and other symptoms may occur, depending on which parts of the brain are more affected by oxygen deficiency.

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

Violations of metabolic processes and hormonal regulation can be considered as signs of disorganization of the bioelectrical activity of the brain. With the naked eye, such disorders in the body are not visible. But some symptoms can clearly point to them. It is worth paying attention to the deterioration of the hair condition, their loss, changes in the appearance and purity of the skin, increased fragility of nails, and stool disorders. Such symptoms do not always indicate brain diseases, but in combination with headaches, memory impairment, temperature fluctuations, etc. It should make you think.

Some patients complain of a decrease in sexual desire, while others are dominated by uncontrolled sexual arousal. The second is more characteristic of 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 in the hormonal background (the central nervous system, and in particular the pituitary gland, is also responsible for its regulation).

Many note fluctuations in weight, even in cases where appetite is not disturbed. With brain injuries, there is often a decrease in appetite. But for progressive dementia, insatiability is more characteristic, it seems to a person that he constantly does not eat up, eats worse than others, a feeling of fullness occurs only when there is no more space left in the stomach. In both categories of patients, attacks of vomiting are not uncommon.

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

In the brain stem there are nerve centers responsible for the regulation of breathing, heartbeat, body temperature, etc. If the function of the nerve nuclei is impaired, shortness of breath, arrhythmias, chills, aching in the bones and muscles can be felt without good reason. In this case, organic damage to the brain leads to functional disorders when the organ is healthy, but does not work properly.

The fact is that the regulation of the work of our body, including metabolic processes, occurs due to the transfer 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 the 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 bioelectric circuit of neurons, will suffer (something similar happens when the electrical circuit is broken, when the energy flow is interrupted). With diffuse brain lesions, there are a great many such disorders, therefore the clinical picture can be quite extensive and varied, although the patient himself does not understand the connection between the symptoms that appear from different organs and systems.

As you can see, determining the presence of structural changes in the human brain is still not enough to make a final diagnosis. An analysis of the patient's complaints helps the doctor determine the location of the damaged structures and the consequences, while dynamic studies and the study of the anamnesis make it possible to understand the nature of the violation (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 by 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, entails a decrease in working capacity, a deterioration in mood and general condition. The more pronounced 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 defects. It must be said that taking analgesics with 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 mystery, if not solved in time, which is possible only with a comprehensive examination, can give serious complications.

Many people are somehow superficial about a bruise or concussion, which is the result of a traumatic brain injury. [7]It is believed that a certain time of complete rest is sufficient to restore the functionality of damaged brain structures. It's really not that simple, especially if you ignore the injury altogether and keep going to work. But the result of an injury can also be hemorrhages in the brain during rupture of blood vessels (for example, with atherosclerosis, which a person might not be aware of, the vessels of the brain become less durable and can easily burst upon impact), and an increase in neuronal activity, provoking spasms and convulsions, and disruption of certain brain structures. All this may not remind of itself for some time, and then result in a stroke, thrombosis of cerebral vessels, epilepsy, etc.

The prolonged course of the inflammatory process in the brain, in addition to headaches, can have other consequences. A change in the structure of inflamed tissues, their compaction entails a violation of nerve conduction. At the same time, it is practically impossible to restore the brain tissue, returning it to its original properties. Children suffering from meningitis or encephalitis for a long time have persistent disorders of psycho-physical development, while adults have a decrease in intelligence and impaired motor functions.

Some degenerative processes in the brain (especially those that are hereditary) cannot be stopped even with their early diagnosis. But slowing down the process is possible in most cases. And the sooner treatment is started, the more time a person has for a more or less full-fledged 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 of the diffuse changes in the brain:

Diffuse changes in the brain and its bioelectrical conductivity do not immediately remind of themselves, so a person may not even suspect a pathology. But those who monitor their health immediately notice changes in mood, memory impairment, 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, certain measures should be taken.

In addition, how can you find out what the symptoms are associated with if you do not consult a doctor. Even if a person has suffered a traumatic brain injury, this will not necessarily leave a serious imprint on the functioning of the brain, perhaps the cause of the malaise lies in infection or intoxication, and the past 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 well-being. Interest in possible injuries, intoxications and infections is also not accidental, because the problem is far from always visible to the naked eye, and the presence of a bump 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 evaluate the qualitative and quantitative characteristics of the blood. The patient is prescribed a general and biochemical blood test. Hypoxia can be caused by a low content 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 the symptoms of organic brain lesions, depending on which structures are involved in the pathological process and how serious the situation is, can differ markedly. In addition, the deterioration of well-being is not always associated directly with brain damage. So a tumor in the brain or near it can irritate nearby neurons, and then we are talking about diffuse irritative changes in the brain. That is, irradiation of irritation takes place here, 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, you can restore the normal functioning of the brain.

What the doctor cannot see with the naked eye can be visualized through instrumental diagnostics. Diffuse changes in the brain parenchyma, i.e. Its cellular structures, allows you to determine ultrasound (ultrasound) and tomography (computer or magnetic resonance). [9] An X-ray of the skull is less informative, since it reflects the condition of the soft tissues worse, but it can also provide certain information.

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

Changes in the structure of the medulla usually entail a change in its electrical conductivity. To assess such disorders, an electroencephalogram (EEG) is prescribed. It is this study that helps to assess the performance of the brain, and taking into account diffuse changes and existing symptoms, determine the cause of the disease, give it a name, assess the severity and prescribe the 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 studies, information received from the patient and as a result of studying the anamnesis. The changes in the brain themselves do not yet imply a diagnosis, which means they 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 various diseases in which the structure and working capacity of the brain change require a different approach to treatment. The difference is obvious if we consider the therapy of vascular and degenerative diseases, congenital (hard to correct) and acquired.

Such differentiation is especially important when examining young children, because the direction of not only medical, but also correctional and developmental work with a child depends on this.

What do ultrasound and encephalogram say?

Diffuse changes in the brain 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. It all depends on the severity of brain changes and what structures it concerns.

Depending on the causes that cause a violation of the structure of the brain and its conduction, as well as the time of the lesion, the dysfunction of the brain can be persistent or progressive. In the event that the factor that influenced brain activity or brain development has lost its relevance (ceased to act), but diffuse changes remain, we will talk about a persistent violation of psychophysical development (such as oligophrenia, residual dementia, etc.). With timely professional treatment of inflammatory and oncological diseases, the structure and activity of the brain can be fully restored.

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

Mild diffuse changes in the brain (its bioelectrical activity measured by an encephalograph) can also be observed in healthy people. This may be due to overwork, low blood sugar (lack of carbohydrates in food), lack of sleep, general malaise. At the same time, the working capacity of the brain decreases and the 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 notes frequent headaches, dizziness, and inexplicable temperature fluctuations. Such moments should be paid special attention to those who have had a head injury in the past. Sometimes its consequences remind of themselves, after a few months and years.

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

Diffuse changes in the median structures of the brain may be accompanied by changes in bioelectrical activity of varying severity. Symptoms that can be observed in this case depend on which part of the brain is damaged and the degree of damage to it. With the pathology of the hypothalamus, temperature changes, disturbances in appetite and sleep-wake cycles, an increase or decrease in sexual desire can be noted. If the pituitary gland is damaged, there may be disturbances in the work of various endocrine glands (respectively, symptoms of diabetes insipidus, hypothyroidism, hyperprolactinemia appear), growth disorders in children, mental retardation, sexual disorders.

Moderate diffuse changes in the brain are likely to indicate the development of a pathological process. So, with dementia and atherosclerosis, everything starts with mild changes, which are subsequently aggravated, i.e. Moderate changes in the brain are just one of the stages 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, you need to track the process in dynamics in order to understand how persistent such changes can be. Such observations help to determine the effectiveness of the treatment.

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

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

Treatment of the diffuse changes in the brain:

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

So, with vascular atherosclerosis, complex therapy is prescribed, which includes the normalization of fat metabolism and optimization of the brain vessels. The first direction is provided by nicotinic acid, which reduces the content of harmful cholesterol, fibrates, which reduce the synthesis of its own fats in the body, bile acid sequestrants, statins, which inhibit the synthesis of cholesterol.

To improve the blood supply to the brain, vasodilators, centrally acting muscle relaxants that relax the choroid, angioprotectors, antiaggregants and anticoagulants that improve blood flow and prevent the formation of blood clots are prescribed.

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

With vascular atherosclerosis and cerebral ischemia, accompanied by an increase in arterial and intracranial pressure, memory loss and impaired concentration, doctors can also prescribe antihypertensive drugs and nootropics (drugs that improve trophism and brain function, 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 sclerotic vessel, surgical treatment is resorted to. The most popular method of intervention on the vessels of the brain is carotid endarterectomy (dissection of the vessel and removal of the cholesterol plaque).

With 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 use of drugs that increase the body's resistance to infections (interferons). Additionally, diuretics are prescribed (prevention of cerebral edema) and infusions of drugs that reduce intoxication of the body.

In diseases caused by intoxication of the body (toxic encephalopathy), detoxification therapy comes first, after which the brain's metabolic processes are restored (nootropics, anticonvulsants, antipsychotics, 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 appointment of drug therapy should be based on the severity of the injury.

The main requirement for the treatment of traumatic brain injury is rest for a certain time (with a slight concussion, this may even be enough for recovery). With traumatic inflammation and swelling of the brain, as well as for its prevention, corticosteroids and diuretic (diuretic) drugs are prescribed.

Further therapy is inherently the prevention of possible complications. Patients may be prescribed medications that improve cerebral circulation, drugs that stimulate metabolic processes in the brain, general tonic. Symptomatic treatment: analgesics for 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 DPT as a result of a blow or a sharp movement of the head), large and small hemorrhages, multiple ruptures of axons of neurons, along which nerve impulses pass, occur. Such injuries are always accompanied by severe organic brain damage. With axonal damage, the patient falls into a coma (the duration of the coma varies).

After leaving the coma, psychostimulating therapy and drug treatment are prescribed to restore brain trophism and blood circulation: nootropics, vascular drugs, anticholesterase drugs, medicinal neurotransmitters.

Surgical treatment for brain injuries is carried out only in case of crushing of the skull and compression of the brain, the formation of hematomas.

With 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 neuronal dysfunction), nootropics, neuroprotectors, immunomodulating agents, antipsychotics (antipsychotics), vitamins.

Physiotherapy treatment for diffuse changes in the brain is prescribed with caution and takes into account existing disorders. In case of vascular pathologies and associated dysfunction of the BEA of the brain, galvanization, drug electrophoresis (vasodilators and cerebrovascular stimulants), ultratonotherapy, UHF and UHF therapy, ultraviolet irradiation, radon and coniferous baths, hydrotherapy are prescribed. To improve the trophism of the brain tissue in various diseases, transcutaneous electrical nerve stimulation and interference therapy can be prescribed. Diademo- and amplipulse therapy, darsonvalization. The fight against motor 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 the choice of physiotherapy procedures should be strictly individual, taking into account concomitant pathologies, the patient's condition, age characteristics.

Medical therapy

Neuroprotectors are considered specific drugs used for diffuse changes in the brain. This is a large group of medicines, in which there are:

• drugs that improve the trophism of brain tissues (nootropics),
• antioxidants with antihypoxic, anti-stress, anticonvulsant, anxiolytic (calming) action,
• drugs 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 in order to improve cognitive functions, i.e. To combat the consequences of diffuse brain changes or to prevent them. With dementia, it can be prescribed only as an adjuvant, since it does not have a pronounced therapeutic effect.

The medicine is produced in the form of tablets, capsules, ampoules with a 20% solution administered intravenously by drip (up to 12 g per day for severe pathologies) or taken orally. The initial dose for internal administration of the drug is 4.8 g. It remains during the first week of treatment, after which it can be reduced to 2.4 g. Subsequently, the dosage can be halved. With 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. Inside, a solution of piracetam 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 for acute kidney failure, the presence of allergic reactions to the drug (as well as juices and essences), acute cerebrovascular accident (stroke). For children older than 1 year, medicine is given only as directed by a doctor.

Among the side effects of the drug, most often mentioned are an excited mental state, increased motor activity, imbalance, some decrease in attention, and sleep disturbances. There may also be reactions from the digestive system: abdominal pain, nausea, stool disorders. In some patients, the medicine causes headaches and dizziness, movement disorders (impaired automated movements), convulsions, tremors in the body and limbs, heart rhythm disturbances, sexual hyperactivity.

"Mexidol" is a drug from the category of antioxidants with a neuroprotective effect. Available in the form of tablets and solution for intravenous and intramuscular injection. The medicine improves the nutrition and breathing of the brain, as well as the qualitative characteristics of the blood, normalizes behavior and sleep, restores disturbed autonomic functions, thereby improving the patient's well-being.

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

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

In severe disorders of nerve conduction, the daily dose of the drug for intravenous administration is 300 mg for 2 weeks. Next, they switch to intramuscular administration of a 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. Do not apply to the treatment of children.

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

"Cinnarizine" is a drug that improves cerebral circulation and reduces severe 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, 25 mg each. 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 is, first of all, the increased sensitivity of the body to the components of the drug. It is not recommended for pregnant women and nursing mothers. With extreme caution prescribed for progressive dementia and Parkinson's disease.

Side effects of the drug can be described by symptoms such as 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 for potassium and sodium ions, which provide a bioelectrical potential. Memantine is a drug that affects the action of such receptors, improves mental activity and eliminates movement disorders.

Tablets are prescribed to be taken 1 time per day at the same time. Start with the minimum active dose (5 mg) and gradually bring it up 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 increased mental excitability, anxiety, fatigue, increased intracranial pressure, nausea.

Alternative Treatment

When we notice some deterioration in intellectual abilities without other suspicious symptoms, we are in no hurry to consult a doctor, because today there are a lot of advertised 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 to find out whether there are any or not, it is possible only during professional diagnostics.

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

It must be understood that alternative remedies for organic diseases of the brain are powerless. They help to fight the consequences of the disease, but do not cure it. True, with brain injuries, when rest is needed, you can use the property of some herbs to have a sedative effect. These herbs include valerian, marin root, motherwort, rue, hops, blue cyanosis, mint. Herbal treatment in this case will give a certain effect, but it can not 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 alternative recipes can be obtained with atherosclerosis of cerebral vessels. With such a diagnosis, herbal medicine (herbal preparations) 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, succession and a double dose of mint and hawthorn. 2 tablespoons of the crushed collection are poured into 0.5 liters of boiling water, kept for 2 hours, then filtered and taken three times a day, 60-70 ml each.

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

The use of grapefruit reduces the risk of atherosclerosis and reduces its manifestations. Anti-sclerotic action is also attributed to melon.

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

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

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

To improve the functioning of the brain and its cognitive functions, you can take herbs such as rosemary, sage, sweet clover, St.

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

Homeopathy

Homeopathy is a relatively young branch of non-traditional medicine, which, nevertheless, already has sufficient experience in the treatment and rehabilitation of patients with organic brain lesions. 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 medical care. 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. Without consulting a neurologist and examination is indispensable.

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

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

With neoplasms of the central nervous system, the following are most often prescribed: Arnica montana, Arsenicum album, Bufo rana, Helonias dioica, Hura brasilensis, Sulfuris, 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. These funds include "Coenzyme compositum", "Traumeel S", "Engistol", "Polysponin", "Spaskuprel" and some other drugs sold in conventional 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 departments of supermarkets. Such drugs cannot be considered as 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. With slight changes in the work of the central nervous system, they will help restore its performance even without special treatment.

Prevention

Prevention of diffuse brain lesions is, first of all, the prevention of infectious and inflammatory processes in the medulla 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. Nevertheless, care on the roads, at home and at work in most cases allows you to avoid serious consequences. When driving, you need to make sure that there are no traces of alcohol and drugs left in the blood that can have a depressing effect on the central nervous system, during the trip you need to be as focused as possible and not be distracted by minor stimuli.

Dementia in older age is a physiologically determined process of brain fatigue. You can maintain its performance with the help of training (regular intellectual work, reading books, watching popular science films, solving logical problems). Help delay the onset of dementia; physical activity, rational nutrition, taking multivitamin complexes, giving up 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, but on the degree of prevalence and depth of damage to brain structures.

Perhaps someone believes that local brain damage affects the human condition to a lesser extent. In fact, deep local damage can have much more irreversible consequences than mild or moderate diffuse ones.

Even diffuse axonal injuries in road traffic accidents, which are classified as severe injuries, are in many cases accompanied by temporary impairments of various CNS functions. It all depends on the depth of the damage and the treatment.

In infectious and inflammatory diseases of the brain, everything depends on the timeliness of the treatment started and the age of the patient. The prognosis in this case is ambiguous. It is most severe at an early age, as 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 of intellectual and motor abilities in progressive dementia and atrophic processes in the brain. It is usually not possible to stop such processes; it is only possible to slow them down with a properly constructed treatment regimen.

Diffuse changes in the brain is a medical terminology that indicates the degree of spread of structural and functional changes in the cortex, cerebral hemispheres and midline structures of the brain. The attitude of doctors towards them depends on what these changes are, whether they are tied to age periods and how they affect the well-being and self-realization of a person. We can only listen to their verdict and adhere to professional recommendations, and not put forward our own hypotheses of what is happening.