Post-traumatic encephalopathy is an insidious symptom that occurs as a consequence of brain injury. It can manifest itself months and even years after the direct impact. Post-traumatic encephalopathy of the brain manifests itself in behavioral changes, difficulties in self-care, problems of social adaptation and much more. The consequences of this pathology are dangerous in the difficulties of diagnosing and delaying the onset of symptoms.
Modern classification of pathology
In medicine, the syndrome of post-traumatic encephalopathy is understood as a complex of consequences of brain injuries. They lead to damage to the structure and disruption of the normal functioning of the brain. In accordance with the International Classification of Diseases (ICD 10), the symptoms of post-traumatic encephalopathy are classified asconsequences of traumatic brain injury (T90.5) or other specified diseases of the brain (G93.8). If cerebral edema develops against the background of this syndrome, it is assigned the code G91 - post-traumatic hydrocephalus.
Mechanism of development of pathology
On the degree of severity of post-traumatic encephalopathy of the brain affects only two factors - the severity of the injury received by the patient and the localization of brain damage. The mechanism of development of the pathological process includes:
- Primary damage to the nerve tissue of the brain at the time of injury.
- Development of puffiness and impaired blood supply in the lesion.
- As a result of compression of the ventricles of the brain, the circulation of cerebrospinal fluid (cerebral fluid) is disturbed.
- Damaged dead nerve cells are quickly replaced by connective tissue cells that form scar formations and adhesions.
- An abnormal immune response develops - nerve cells are perceived by the immune system as foreign.
Injury to the brain can be different
Let's give a general description of injuries that can lead to post-traumatic encephalopathies. Closed injuries can be as follows:
- The most common is concussion, which can occur when you hit your head or fall. The more severe the concussion, the longer the victim is unconscious. Sometimes this injury is accompanied by temporaryamnesia. Such injuries are accompanied by headaches, nausea, tinnitus and dizziness. In severe cases, the pulse may slow down, reflexes weaken.
- When a traumatic force is applied, a contusion of the brain develops. The lesion is more often localized at the site of injury, although it can also be located in the opposite part of the brain. Symptoms of injury include dizziness and pain, nausea and vomiting. In addition, there may be focal manifestations - loss of sensitivity, impaired facial expressions or speech.
- Compression is a disorder that occurs when bleeding and increased intracranial pressure. Symptoms may not appear immediately. The clinical picture is similar to previous types of injuries.
Open brain injuries require immediate medical attention, and are accompanied by both cerebral and focal symptoms.
Concussions and minor bruises are mild injuries. Moderate bruises and closed fractures of the skull are moderate injuries, and severe ones are compression, severe bruises, open fractures and gunshot wounds.
Risk groups
As the name implies, all people who have received a single or several consecutive head injuries of varying severity, both closed (concussions, bruises or compression) and open ones, fall into the risk group. Post-traumatic encephalopathy and diffuse damage to brain tissue in them can become a distant manifestation of the consequences of trauma. The main patients with this pathologybecome:
- Athletes in contact sports. And both professionals and amateurs.
- Participants in traffic accidents with injuries and head bruises.
- People who fall from a height are at risk. A child who falls out of a chair may also have symptoms of post-traumatic cerebral encephalopathy as a result of a head injury.
- All patients with head contusion with any objects and with gunshot wounds.
Treatment statistics show that 70-80% of patients with head injuries experience various disorders of the blood supply to the brain. At the same time, timely and adequate treatment helps to save the patient from serious consequences of injury.
Encephalopathy of the newborn
Separately, it should be said about post-traumatic encephalopathy of newborns. It occurs with fetal asphyxia during childbirth, during rapid labor, with various injuries of the fetal brain during the passage of the birth canal and surgical interventions.
Light encephalopathy in a child is characterized by a syndrome of increased excitability: restlessness, irritability, tearfulness, hypo- or hypertonic states.
Moderate severity is expressed in one or more neurological symptoms: convulsive or hydrocephalic symptoms, hypertension and movement disorders, impaired reflex activity and depression of the nervous system. The state of hypotonicity is replaced by hypertonicity of the muscular system,there is strabismus and marbling of the skin, a large fontanelle swollen. It should be noted that with encephalopathy, a complex of conditions is assessed. Single symptoms may occur in neurologically he althy infants. Severe stages of the pathology are characterized by a pre-coma or coma.
The tasks of neonatologists include diagnosing pathology, relief of symptoms of encephalopathy in a child and early drug therapy, including a complex of restorative and developmental procedures - massages, electrophoresis, swimming, gymnastics for infants.
Symptoms of pathology
Depending on the severity of the traumatic factor, symptoms of post-traumatic encephalopathy can be:
- Distractedness, fatigue and insomnia.
- Sudden displays of aggression.
- Disorders of cognitive functions - memory, thinking, speech.
- Asthenic manifestations - depression, anxiety, fears.
- Neurological disorders - headache, lack of coordination, increased blood pressure and vegetative dystonia.
- Swelling of the brain (hydrocephalus).
- Mental disorders and epileptic seizures.
Degrees of post-traumatic encephalopathy
The severity of this pathology in clinical neurology distinguishes three degrees.
- 1st degree of post-traumatic encephalopathy - there are morphological changes in the brain, which are detected only during instrumental examination. Clinical symptoms are minimal.
- 2nd degree - changes in the morphology of the tissues of the medulla, neurological symptoms are weak with a variable character.
- 3rd degree of post-traumatic encephalopathy is characterized by severe neurological clinical manifestations - dementia, problems in self-care, impaired coordination and mental changes.
When to see a doctor
Even when the patient seems to have fully recovered from the injury, after weeks, and sometimes months, alarming signs of the development of encephalopathy may appear. Namely:
- Headaches that do not go away after taking analgesics.
- Uncontrollable mood swings (emotional lability).
- Dizziness, especially during exercise.
- Pupillary twitches (nystagmus).
- Interrupted sleep or insomnia that cannot be corrected with sleeping pills.
- Depression and attention disorders. Deterioration of memory and intellectual activity.
- Epileptic seizures.
Diagnosis of pathology
The diagnosis of post-traumatic encephalopathy requires an integrated approach. The first stage of diagnosis is the analysis of the patient's history. After that, the doctor may prescribe an instrumental examination:
- MRI and CT. These studies make it possible to establish deepening of the furrows and areas of brain atrophy, expansion of the ventricles and subarachnoid space.
- Electroencephalography will reveal disorders of brain rhythms, the appearance of pathological waves and establish epileptic activity.
Treatment of post-traumatic encephalopathy of the brain
After establishing a diagnosis in clinical medicine, a set of measures is taken to achieve the main goals:
- Protection of nerve tissue from wound exposure.
- Restoration and normalization of blood circulation.
- Normalization of metabolic processes in brain tissues.
- Restoration of functions, including cognitive ones.
All patients who have suffered brain injuries of varying severity are subject to dispensary registration. Symptomatic treatment of post-traumatic encephalopathy includes drug therapy, exercise therapy, physiotherapy.
Conservative treatment
The most important thing is to eliminate the symptoms and consequences of pathology. The complex of drug treatment prescribed by a neurologist includes:
- Diuretics and analgesics - stop pain syndromes.
- Psychedelics and nootropics - relieve disorders of the psycho-emotional sphere and restore the metabolism of brain cells.
- B vitamins and neuroprotectors - protect nerve cells and normalize their work.
- Anti-epileptic drugs.
Additional Therapy
The doctor may prescribe physiotherapy for the patient - laser and reflexology. Therapeuticphysical education, massage and regular exposure to fresh air are an important aspect of the positive dynamics of the course of the disease.
In addition, it is important to stop smoking and drinking alcohol and switch to a he althy diet. Mental exercises have a positive effect on the brain - solving crosswords and logic puzzles.
Surgical intervention in this pathology is carried out only when the additional damage to brain tissue during the operation outweighs the possible consequences of non-intervention. In case of post-traumatic pathologies, it is carried out if it is necessary to restore blood circulation in the brain.
Treatment with folk methods
Folk remedies in this case can become exclusively auxiliary methods of therapy. When using them, it is very important to consult with the treating neurologist. A wide range of folk remedies is used to restore blood flow in the vessels of the brain. For this purpose, tinctures and balms from the Caucasian Dioscorea, propolis, red clover are used.
Good strengthens the blood vessels of the brain hawthorn. Both fresh and dried berries are used. They are used to make tinctures and teas.
Consequences and forecast
Prognosis of course and cure becomes clear within a year after the injury. Physical and neurological deficits in a patient depend on the severity of the encephalopathy and the location of the lesion. In each case, it is individual.
In itself, encephalopathy after an injury does not becomegrounds for disability. With mild to moderate traumatic brain injury, if the patient complies with all prescriptions of a medical regimen, physiological and social functions are most often completely restored. However, in severe cases, when there are problems in self-service and a significant decrease in working capacity, grounds for obtaining disability are selected on an individual basis for the patient. Post-traumatic encephalopathy can lead to the establishment of the patient of all disability groups, depending on the severity of the damage to the central nervous system.
Prevention of encephalopathy
Prevention of post-traumatic disorders of a neurological nature is the patient's careful adherence to the regimen of therapeutic measures and the implementation of rehabilitation therapy in full.
A prerequisite for positive dynamics and prevention of vascular disorders in the brain is a he althy lifestyle and proper nutrition. Giving up smoking, alcohol, drugs is a must for patients who have suffered brain injuries.
