Post-traumatic encephalopathy is an insidious symptom that occurs as a consequence of brain injury. It can manifest itself after months and even years after a direct hit. Post-traumatic brain encephalopathy 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, post-traumatic encephalopathy syndrome is understood to mean the complex consequences of brain injuries. They lead to damage to the structure and disruption of the normal functioning of the brain. According to the International Classification of Diseases (ICD 10), the symptoms of post-traumatic encephalopathy are attributed to the consequences of traumatic brain injury (T90.5) or to other specified diseases of the brain (G93.8). In the case of the development of cerebral edema against the background of this syndrome, he is assigned the code G91 - post-traumatic hydrocephalus.
The mechanism of development of pathology
Only two factors affect the severity of post-traumatic brain encephalopathy - the severity of the patient’s injury and the localization of brain damage. The development mechanism of the pathological process includes:
- Primary damage to the nerve tissue of the brain at the time of injury.
- The development of swelling 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 disrupted.
- 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.
Brain Injury May Be Different
We give a general description of injuries that can lead to post-traumatic encephalopathies. Closed injuries may include the following:
- The most common is a concussion, which can occur when you hit your head or fall. The heavier the concussion, the longer the victim is unconscious. Sometimes such an injury is accompanied by temporary amnesia. Such injuries are accompanied by headaches, nausea, tinnitus and dizziness. In severe cases, the pulse may slow down, reflexes may weaken.
- When a traumatic force is applied, a brain injury develops. The lesion is often localized at the site of the injury, although it can also be located in the opposite part of the brain. Symptoms of trauma 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 with 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 slight bruises are mild injuries. Bruises of moderate severity and closed fractures of the skull are moderate injuries, and severe ones are pressure, severe bruises, open fractures and gunshot wounds.
Risk groups
As the name implies, all people who have sustained a single or several consecutive head injuries of varying severity, both closed (concussions, bruises or compression) and open, fall into the risk group. Post-traumatic encephalopathy and diffuse damage to brain tissue in them can be a distant manifestation of the effects of trauma. The main patients with this pathology are:
- Contact sports athletes. And both professionals and amateurs.
- Participants in traffic accidents who received injuries and head injuries.
- At risk are people who have fallen from a height. A child falling from a stool may also have symptoms of post-traumatic brain encephalopathy as a result of a head injury.
- All patients with a bruised head with any objects and with gunshot wounds.
Medical statistics suggest that 70-80% of patients who have received head injuries experience various disorders of the blood supply to the brain. At the same time, timely and adequate treatment helps save the patient from the serious consequences of injury.
Encephalopathy of the Newborn
Separately, it should be said about post-traumatic encephalopathy of the newborn. It occurs with fetal asphyxiation during childbirth, during rapid childbirth, with various injuries to the fetal brain during passage through the birth canal and surgical interventions.
Mild encephalopathy in a child is characterized by a syndrome of increased excitability: anxiety, irritability, tearfulness, hypo- or hypertonic conditions.
The moderate severity is expressed in one or more neurological symptoms: convulsive or hydrocephalic symptoms, hypertension and motor disorders, impaired reflex activity and depression of the nervous system. The state of hypotension is replaced by hypertonicity of the muscular system, strabismus and marbling of the skin, and a large fontanel are swollen. It should be noted that with encephalopathy, a complex of conditions is evaluated. Single symptoms may occur in neurologically healthy infants. Severe stages of the pathology are characterized by a precomatous state or coma.
The tasks of neonatologists include the diagnosis of pathology, the relief of the symptoms of encephalopathy in a child and early drug therapy, which includes a set of rehabilitation 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 may include:
- Absent-mindedness, fatigue and insomnia.
- Sudden manifestations of aggression.
- Disorders of cognitive functions - memory, thinking, speech.
- Asthenic manifestations - depression, anxiety, fears.
- Neurological disorders - headache, impaired coordination, increased blood pressure and vegetovascular dystonia.
- Cerebral edema (hydrocephalus).
- Mental disorders and epileptic seizures.
Degrees of post-traumatic encephalopathy
The severity of this pathology in clinical neurology distinguish three degrees.
- 1st degree of post-traumatic encephalopathy - there are morphological changes in the brain that are detected only by instrumental examination. Clinical symptoms are minimal.
- 2nd degree - changes in the morphology of brain tissue, neurological symptoms are weak with a variable nature.
- The 3rd degree of post-traumatic encephalopathy is characterized by pronounced neurological clinical manifestations - dementia, problems in self-care, impaired coordination and mental changes.
When to see a doctor
Even when it seems to the patient that he has fully recovered from the injury, after weeks, and sometimes months, there may be alarming signs of the development of encephalopathy. Namely:
- Headaches that do not go away after taking analgesics.
- Uncontrolled mood swings (emotional lability).
- Dizziness, especially during physical exertion.
- Twitching of the pupils (nystagmus).
- Intermittent sleep or insomnia that cannot be corrected with sleeping pills.
- Depression and impaired attention. Deterioration of memory and intellectual activity.
- Epileptic seizures.
Pathology diagnostics
The diagnosis of post-traumatic encephalopathy requires an integrated approach. The first step in the diagnosis is to analyze the patient’s history. After which, the doctor can prescribe an instrumental examination:
- MRI and CT. These studies allow us to establish deepening of the furrows and areas of brain atrophy, expansion of the ventricles and subarachnoid space.
- Electroencephalography will reveal disorders of the rhythms of the brain, the appearance of pathological waves and establish epileptic activity.
Treatment of post-traumatic brain encephalopathy
After the diagnosis is established in clinical medicine, a set of measures is carried out aimed at achieving the main goals:
- Protection of nerve tissue from wound exposure.
- Recovery and normalization of blood circulation.
- Normalization of metabolic processes in brain tissue.
- Recovery of functions, including cognitive ones.
All patients who have suffered brain injuries of varying severity are subject to medical examination. Symptomatic treatment of post-traumatic encephalopathy includes drug therapy, physiotherapy exercises, physiotherapeutic procedures.
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.
- Antiepileptic drugs.
Adjunctive therapy
The doctor can prescribe physiotherapy to the patient - laser and reflexology. Physiotherapy exercises, massage and regular stay in the 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 healthy diet. A positive effect on the brain is mental exercise - solving crosswords and logical puzzles.
Surgery for this pathology is carried out only when additional damage to brain tissue during surgery outweighs the possible consequences of non-interference. In post-traumatic pathologies, it is carried out if necessary, the restoration of blood circulation in the brain.
Traditional treatment
Folk remedies in this case can become exclusively auxiliary methods of therapy. When using them, it is very important to consult a treating neurologist. A wide range of folk remedies is used to restore blood flow in the vessels of the brain. For this purpose, use tinctures and balms from the Caucasian dioscorea, propolis, red clover.
It strengthens the vessels of the brain of the hawthorn. Use both fresh and dried berries. They make tinctures and teas.
Consequences and forecast
The prognosis of the course and cure becomes clear within a year after the injury. Physical and neurological deficit in a patient depends on the severity of encephalopathy and the localization of the lesion site. In each case, it is individual.
Encephalopathy itself after an injury does not become a basis for disability. In case of traumatic brain injuries of mild to moderate severity, when the patient complies with all the requirements of the drug regimen, physiological and social functions are most often fully restored. However, in severe cases, when there are problems in self-care and a significant decrease in working capacity, the individual grounds for disability are selected for the patient individually. Post-traumatic encephalopathy can lead to the establishment of all disability groups for the patient, depending on the severity of the central nervous system lesion.
Encephalopathy Prevention
Prevention of neurological post-traumatic disorders is the patient's careful observance of 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 healthy lifestyle and proper nutrition. Quitting smoking, alcohol, drugs is a prerequisite for patients who have suffered brain injuries.