Brain shrinkage (Cerebral Atrophy)

 

• Overview

The loss of brain cells called neurons is referred to as brain atrophy or cerebral atrophy. Additionally, the connections that allow cells to communicate are destroyed by atrophy. It may be brought on by any number of conditions that harm the brain, such as Alzheimer's disease and stroke.

You naturally lose some brain cells as you age, but this is a gradual process. Brain atrophy brought on by illness or injury happens more quickly and does more harm.

The brain's distinct regions can be affected by atrophy.

Specific parts of the brain lose function as a result of focal atrophy, which damages the cells there.

The entire brain is affected by generalized atrophy.

The illness that produced the brain shrinkage can have an impact on a patient's life expectancy if they have brain atrophy. The average lifespan of someone with Alzheimer's disease is four to eight years after diagnosis. If multiple sclerosis is adequately treated, people with MS can live nearly normal lives.

• What signs of brain atrophy are there?

Depending on which area or areas of the brain are affected, several signs of brain atrophy may be present.

Memory, learning, abstract thought, and executive functions like planning and organizing are all lost in dementia.

A seizure is a burst of aberrant electrical activity in the brain that results in uncontrollable shaking, convulsions, and occasionally unconsciousness.

Aphasias cause difficulties with language comprehension and speech.

• What causes the atrophy of the brain?

Brain cells can be harmed and atrophy brought on by illnesses, injuries, and infections.

• Injuries

When blood flow to a portion of the brain is disrupted, a stroke results. Neurons in the area perish if there is no flow of blood containing oxygen. Speech and movement that were governed by certain brain regions are lost.

Traumatic brain injury is brain damage that can result from a fall, car accident, or other head trauma.

• disorders and illnesses

Brain cells in people with dementia, including Alzheimer's disease, suffer from gradual deterioration and stop communicating with one another. It results in memory loss and cognitive decline that can drastically impact one's quality of life. The most common cause of dementia, Alzheimer's disease often manifests itself after the age of 60. 60 to 80 percent of all instances are caused by it.

Movement problem known as cerebral palsy is brought on by improper fetal brain development. It results in movement abnormalities such poor muscular coordination, trouble walking, and other issues.

An genetic disorder called Huntington's disease gradually kills neurons. Midlife is usually when it starts. It gradually degrades a person's mental and physical capabilities, including chorea and severe sadness (involuntary, dance-like movements throughout the body).

A category of uncommon, genetic diseases known as leukodystrophies harm the myelin sheath, which surrounds nerve cells and serves as a protective layer. It typically starts in childhood and can lead to issues with hearing, vision, movement, and behavior.

Multiple sclerosis is an inflammatory illness in which the immune system destroys the protective covering around nerve cells. It often manifests in young adulthood and more frequently affects women than males. The nerve cells deteriorate with time. Sensation, movement, and coordination issues can emerge as a result. However, it can also cause dementia and brain atrophy, just like the other illnesses mentioned.

• Infections

The HIV virus, which assaults the immune system of the body, is what causes AIDS. Although the virus doesn't assault the neurons directly, it does harm the connections between them by releasing proteins and other materials. The AIDS-related toxoplasmosis toxoplasmosis can also harm brain neurons.

The term "encephalitis" describes a brain infection. Herpes simplex (HSV) is the most common culprit, but Zika and West Nile viruses can also be to blame. The viruses damage neurons and result in symptoms like paralysis, seizures, and confusion. Encephalitis can also be brought on by an autoimmune disorder.

The condition known as neurosyphilis harms the brain and its covering. People who don't receive adequate treatment for the sexually transmitted disease syphilis are susceptible to it.

Some of these illnesses, including traumatic brain injury, neurosyphilis, and AIDS, might be avoidable. Wearing condoms during safe intercourse can lower your risk of contracting HIV and syphilis. Brain injuries can be avoided by using seatbelts when driving and by wearing helmets when riding a bike or a motorcycle.

The leukodystrophies, multiple sclerosis, and Huntington's disease, for example, cannot be prevented.

• Options for treatment

Treatment varies depending on the etiology of the brain atrophy.

Tissue plasminogen activator (TPA), a drug used to treat stroke, breaks the clot and allows blood flow to the brain. An injured blood artery or blood clot can also be fixed through surgery. Drugs that inhibit clotting and lower blood pressure can help stop further strokes.

Surgery can also be used to treat traumatic brain injury and stop further brain cell destruction.

Disease-modifying medications including ocrelizumab (Ocrevus), glatiramer acetate (Copaxone), and fingolimod are frequently used to treat multiple sclerosis (Gilenya). These medicines aid in shielding nerve cells from immune system assaults.

Antiviral medications are used to treat AIDS and particular types of encephalitis. Autoimmune encephalitis can be treated with steroids and specific antibody medications.

Antibiotics are used to treat syphilis in order to help avoid nerve cell destruction and other disease consequences.

Alzheimer's disease, other types of dementia, cerebral palsy, Huntington's disease, and the leukodystrophies all cause permanent brain damage for which there is no effective treatment or cure. Some drugs, however, just address the symptoms of certain illnesses rather than their underlying causes.

• Diagnosis

Depending on the ailment your doctor thinks you may have, a diagnosis will be made. Typically, it will start with a physical examination and end with a few tests.

Brain imaging scans like these will reveal cerebral atrophy:

Using X-ray images taken at various angles, computer tomography (CT) may provide detailed scans of your brain.

After exposing the brain to a brief magnetic field, magnetic resonance imaging (MRI) produces images of the brain on film.

• Outlook

Your prognosis or outlook will depend on the ailment that produced the atrophy in your brain. Treatment is able to control some diseases, such as AIDS, encephalitis, multiple sclerosis, and stroke. In some circumstances, brain shrinkage can be prevented or slowed down. Others, such as Alzheimer's and Huntington's disease, will steadily deteriorate over time in terms of both symptoms and brain atrophy.

Discuss the reason of your brain shrinkage, potential treatments, and your outlook with your doctor.