Encephalopathy is the common name for brain diseases, which are based on ischemia (impaired blood supply), hypoxia (oxygen deprivation) of brain tissue due to a wide variety of causes, and, as a result, nerve cell death.

There are congenital and acquired encephalopathy. Congenital encephalopathies may be due to genetic defects, abnormal brain development, or associated with exposure to damaging factors during pregnancy, primarily such as brain hypoxia and birth trauma. Acquired encephalopathy occurs due to the impact on the brain of damaging factors throughout a person’s life. Depending on the etiology and pathogenesis, there are several types of acquired encephalopathy.

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There are congenital and acquired encephalopathy.

Congenital encephalopathies may be due to genetic defects, abnormal brain development, or associated with exposure to damaging factors during pregnancy, primarily such as brain hypoxia and birth trauma.

Acquired encephalopathy occurs due to the impact on the brain of damaging factors throughout a person’s life.

Depending on the etiology and pathogenesis, there are several types of acquired encephalopathy.

1. Post-traumatic encephalopathy is the late or long-term effects of traumatic brain injury.
    

2. Toxic encephalopathy is a consequence of the systematic effects of neurotropic substances: ethyl alcohol, chloroform, barbiturates, lead, etc., as well as bacterial toxins
    

3. Radiation encephalopathy is caused by exposure of the brain to ionizing radiation.

   
    

4. Encephalopathies caused by metabolic disorders in diseases of internal organs. In various liver diseases accompanied by necrosis of liver cells and changes in the vascular system of the liver, toxic substances are not neutralized by the liver and enter the systemic circulation, causing a toxic effect on the brain and causing hepatic encephalopathy. Metabolic encephalopathies also include encephalopathy associated with renal pathology. Pancreatic encephalopathy is associated with pancreatic pathology, which occurs more often as a complication of acute pancreatitis.
    

5. Encephalopathy due to frequent baronloads, frequent jet lag, climatic conditions
    

6. A separate, and most common group, are the so-called vascular encephalopathy, etiologically associated with chronic circulatory disorders of the brain:

   • cerebral atherosclerosis
   • arterial hypertension
   • venous congestion in the brain vessels (often due to hernias of intervertebral disks of the cervical spine)
   • vegetative dystonia
   • violation of systemic hemodynamics
   • systemic connective tissue diseases
   • vasculitis
   • blood diseases, etc.

What happens in the early stages of brain damage?

Diffuse disturbances in the structure of the brain and, accordingly, violations of its functions.

The early signs of encephalopathy are such nonspecific symptoms as a decrease in mental performance, memory (especially in recent events), difficulty in changing activities, sleep disturbance, lethargy during the day, and general fatigue. Frequent complaints of diffuse headaches, tinnitus, general weakness, unstable mood, irritability, unreasonable reduction of emotional background, depression.

Unfortunately, at this stage, at this so-called first stage of dyscirculatory encephalopathy, objective diagnostic methods (neurological examination, neuroimaging, EEG, etc.) may not show any visible changes.

The disease often occurs under the guise of neuro-circulatory dystonia, depression, insomnia syndrome, chronic fatigue syndrome, etc.

As a rule, in these cases, a short course of vascular, nootropic, vitamin preparations is prescribed. Most often, a single course, without guiding the patient to further treatment and prevention of deterioration.

Unfortunately, very often the onset of a formidable process remains undervalued by both the doctor and the patient.

With further disease progression, the second stage of dyscirculatory encephalopathy develops. Symptoms characteristic of the first stage persist, but become more pronounced. The symptoms of organic brain damage are already expressed, which are a result of frequent transient ischemic attacks, microstrokes, etc. Neurological examination can reveal nystagmus, reduced visual acuity and hearing, increased muscle tone and tendon reflexes, the presence of pathological pyramidal and oral reflexes, impaired coordination, vegetative disorders. These disorders can progress as the underlying disease develops, which is accompanied by encephalopathy. When electroencephalography (EEG) recorded disorganization of the main rhythms, the appearance of pathological slow waves, signs of epileptic activity. With computed tomography (CT) and MRI, signs of diffuse atrophy of the brain are observed: dilatation of the ventricles of the brain, subarachnoid space, and deepening of the cerebral grooves. Clear neurological syndromes are identified: parkinsonian, pseudobulbar. Some patients may experience mental disorders. At this stage of the disease, both the patients themselves and their relatives note a significant deterioration in the condition. Patients often need the help of others. Treatment at this stage can improve the condition, contribute to some regression of symptoms. However, the full restoration of the former quality of life can no longer be said.

The third stage of dyscirculatory encephalopathy is characterized by the obligatory presence and progression of neurological syndromes (amyostatic, dyscirculatory, pyramidal, pseudobulbar, etc.)

Complaints of headache, loss of memory, noise in the head, insomnia, poor coordination of movements persist. Characterized by the development of epileptiform seizures, a decrease in intelligence and criticism to their condition, the so-called dementia (dementia) develops.

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