home Folk remedies Hypoxic-ischemic damage to the central nervous system: features of pathology, causes, methods of treatment. Damage to the central nervous system, causes, symptoms

Hypoxic-ischemic damage to the central nervous system: features of pathology, causes, methods of treatment. Damage to the central nervous system, causes, symptoms

The central nervous system is precisely the mechanism that helps a person grow and navigate in this world. But sometimes this mechanism malfunctions and “breaks.” It is especially scary if this happens in the first minutes and days of a child’s independent life or even before he is born. We will talk about why a child’s central nervous system is affected and how to help the baby in this article.

What it is

The central nervous system is a close “ligament” of two important links - the brain and spinal cord. Main function, which nature assigned to the central nervous system - providing reflexes, both simple (swallowing, sucking, breathing) and complex. The central nervous system, or rather, its middle and lower sections, regulate the activities of all organs and systems, ensure communication between them. The highest section is the cerebral cortex. It is responsible for self-awareness and self-awareness, for a person’s connection with the world, with the reality surrounding the child.

Violations, and consequently, damage to the central nervous system, may begin during the development of the fetus in the mother’s womb, or may occur under the influence of certain factors immediately or some time after birth.

Which part of the central nervous system is affected will determine which body functions will be impaired, and the degree of damage will determine the extent of the consequences.

Causes

In children with central nervous system disorders, about half of all cases occur due to intrauterine lesions, doctors call this perinatal pathologies CNS. Moreover, more than 70% of them are premature babies, which appeared earlier than the due obstetric period. In this case, the main root cause lies in the immaturity of all organs and systems, including the nervous system; it is not ready for autonomous work.

Approximately 9-10% of toddlers born with lesions of the central nervous system were born on time with normal weight. Experts believe that the state of the nervous system in this case is influenced by negative intrauterine factors, such as prolonged hypoxia, which the baby experienced in the mother’s womb during gestation, birth injuries, as well as a state of acute oxygen starvation during a difficult delivery, metabolic disorders of the child, which Infectious diseases suffered by the expectant mother and complications of pregnancy began even before birth. All lesions that resulted from the above factors during pregnancy or immediately after childbirth are also called residual organic:

Fetal hypoxia. Most often, babies whose mothers abuse alcohol, drugs, smoke or work in hazardous industries suffer from a lack of oxygen in the blood during pregnancy. The number of abortions that preceded these births also has great importance, since the changes that occur in the tissues of the uterus after termination of pregnancy contribute to disruption of uterine blood flow during subsequent pregnancies.

Traumatic causes. Birth injuries can be associated with both incorrectly chosen delivery tactics and medical errors during birth process. Injuries also include actions that lead to disruption of the child’s central nervous system after childbirth, in the first hours after birth.
Fetal metabolic disorders. Such processes usually begin in the first - early second trimester. They are directly related to disruption of the functioning of the organs and systems of the baby’s body under the influence of poisons, toxins, and certain medications.
Infections in the mother. Particularly dangerous are diseases caused by viruses (measles, rubella, chickenpox, cytomegalovirus infection and a number of other ailments) if the disease occurred in the first trimester of pregnancy.

Pathologies of pregnancy. The state of the child’s central nervous system is influenced by a variety of features of the gestation period - polyhydramnios and oligohydramnios, pregnancy with twins or triplets, placental abruption and other reasons.
Severe genetic diseases. Typically, pathologies such as Down and Edwards syndromes, trisomy and a number of others are accompanied by significant organic changes in the central nervous system.

At the current level of development of medicine, CNS pathologies become obvious to neonatologists already in the first hours after the baby is born. Less often - in the first weeks.

Sometimes, especially with organic lesions of mixed origin, the real reason it is impossible to establish, especially if it is related to the perinatal period.

Classification and symptoms

Scroll possible symptoms depends on the causes, degree and extent of damage to the brain or spinal cord, or combined damage. Time also influences the outcome. negative impact- how long the child was exposed to factors that affected the activity and functionality of the central nervous system. It is important to quickly determine the period of the disease - acute, early recovery, late recovery or the period of residual effects.

All pathologies of the central nervous system have three degrees of severity:

Easy. This degree is manifested by a slight increase or decrease in the baby’s muscle tone, and convergent strabismus may be observed.

Average. With such lesions, muscle tone is always reduced, reflexes are completely or partially absent. This condition is replaced by hypertonicity and convulsions. Characteristic oculomotor disturbances appear.
Heavy. Not only motor function and muscle tone suffer, but also internal organs. If the central nervous system is severely depressed, convulsions of varying intensity may begin. Problems with cardiac and renal activity can be severe, as well as the development respiratory failure. The intestines may be paralyzed. The adrenal glands do not produce necessary hormones in the right quantity.

According to the etiology of the cause that caused problems with the activity of the brain or spinal cord, pathologies are divided (however, very arbitrarily) into:

Hypoxic (ischemic, intracranial hemorrhages, combined).
Traumatic (birth injuries of the skull, birth spinal lesions, birth pathologies of peripheral nerves).
Dysmetabolic (kernicterus, excess levels of calcium, magnesium, potassium in the child’s blood and tissues).
Infectious (consequences of infections suffered by the mother, hydrocephalus, intracranial hypertension).

Clinical manifestations different types lesions also differ significantly from each other:

Ischemic lesions. The most “harmless” disease is cerebral ischemia 1st degree. With it, the child demonstrates central nervous system disorders only in the first 7 days after birth. The reason most often lies in fetal hypoxia. At this time, the baby can observe relatively mild signs of excitement or depression of the central nervous system.
The second degree of this disease is diagnosed when if disturbances and even seizures last more than a week after birth. We can talk about the third degree if the child has constantly increased intracranial pressure, frequent and severe convulsions are observed, and there are other autonomic disorders.

Typically, this degree of cerebral ischemia tends to progress, the child’s condition worsens, and the baby may fall into a coma.

Hypoxic cerebral hemorrhages. If, as a result of oxygen starvation, a child has hemorrhage inside the ventricles of the brain, then in the first degree there may be no symptoms and signs at all. But the second and third degrees of such hemorrhage lead to severe lesions brain - convulsive syndrome, development of shock. The child may fall into a coma. If blood enters the subarachnoid cavity, the child will be diagnosed with overexcitation of the central nervous system. There is a high probability of developing acute dropsy of the brain.

Bleeding into the underlying substance of the brain is not always noticeable at all. Much depends on which part of the brain is affected.

Traumatic lesions, birth injuries. If during the birth process doctors had to use forceps on the baby’s head and something went wrong, if acute hypoxia occurred, then most often this is followed by a cerebral hemorrhage. At birth trauma the child experiences convulsions to a more or less pronounced degree, the pupil on one side (the one where the hemorrhage occurred) increases in size. Main sign traumatic injury central nervous system - increased pressure inside the child’s skull. Acute hydrocephalus may develop. The neurologist testifies that in this case the central nervous system is more often excited than depressed. Not only the brain, but also the spinal cord can be injured. This most often manifests itself as sprains, tears, and hemorrhage. In children, breathing is impaired, hypotension of all muscles, and spinal shock are observed.
Dysmetabolic lesions. In such pathologies, in the vast majority of cases, the child has increased arterial pressure, are observed seizures, consciousness is quite clearly depressed. The cause can be determined by blood tests that show either a critical deficiency of calcium, or a lack of sodium, or another imbalance of other substances.

Periods

The prognosis and course of the disease depends on what period the baby is in. There are three main periods of development of pathology:

Spicy. The violations have just begun and have not yet had time to cause serious consequences. This is usually the first month of a child’s independent life, the newborn period. At this time, a baby with lesions of the central nervous system usually sleeps poorly and restlessly, often without visible reasons cries, he is excitable, he can flinch without stimulus, even in his sleep. Muscle tone is increased or decreased. If the degree of damage is higher than the first, then reflexes may weaken, in particular, the baby will begin to suck and swallow worse and weaker. During this period, the baby may begin to develop hydrocephalus, which will be manifested by noticeable head growth and strange eye movements.

Restorative. It can be early or late. If the baby is aged 2-4 months, then they talk about early recovery, if he is already from 5 to 12 months, then about late recovery. Sometimes parents notice disturbances in the functioning of the central nervous system in their baby for the first time in early period. At 2 months, such toddlers hardly express any emotions and are not interested in bright hanging toys. In the late period, the child noticeably lags behind in his development, does not sit, does not walk, his cry is quiet and usually very monotonous, without emotional coloration.
Consequences. This period begins after the child turns one year old. At this age, the doctor is able to most accurately assess the consequences of a central nervous system disorder in this particular case. Symptoms may disappear, but the disease does not go away. Most often, doctors make such verdicts per year on such children as hyperactivity syndrome, developmental delay (speech, physical, mental).

The most severe diagnoses that can indicate the consequences of central nervous system pathologies are hydrocephalus, cerebral palsy, epilepsy.

Treatment

We can talk about treatment when lesions of the central nervous system are diagnosed with maximum accuracy. Unfortunately, in modern medical practice there is a problem of overdiagnosis, in other words, every baby whose chin trembles during a month’s examination, who eats poorly and sleeps restlessly, can easily be diagnosed with “cerebral ischemia.” If a neurologist claims that your baby has central nervous system lesions, you should definitely insist on complex diagnostics, which will include ultrasound of the brain (through the fontanelle), computed tomography, and special cases- and x-ray of the skull or spine.

Each diagnosis that is in some way associated with lesions of the central nervous system must be diagnostically confirmed. If signs of a central nervous system disorder are noticed in the maternity hospital, then timely assistance provided by neonatologists helps to minimize the severity possible consequences. It just sounds scary - damage to the central nervous system. In fact, most of these pathologies are reversible and subject to correction if detected in time.

Treatment usually uses drugs that improve blood flow and blood supply to the brain - large group nootropic drugs, vitamin therapy, anticonvulsants.

Only a doctor can give an exact list of medications, since this list depends on the causes, degree, period and depth of the lesion. Drug treatment Newborns and infants are usually treated in a hospital setting. After relief of symptoms, the main stage of therapy begins, aimed at recovery. proper operation CNS. This stage usually takes place at home, and parents bear a great deal of responsibility for following numerous medical recommendations.

Children with functional and organic disorders of the central nervous system need:

therapeutic massage, including hydromassage (procedures take place in water);
electrophoresis, exposure to magnetic fields;
Vojta therapy (a set of exercises that allows you to destroy reflex incorrect connections and create new - correct ones, thereby correcting movement disorders);
Physiotherapy for the development and stimulation of the development of sensory organs (music therapy, light therapy, color therapy).

Such exposures are allowed for children from 1 month and must be supervised by specialists.

A little later, parents will be able to master the techniques therapeutic massage and independently, but for several sessions it is better to go to a professional, although this is quite expensive.

Consequences and forecasts

Future prognosis for a child with lesions of the central nervous system can be quite favorable, provided that he receives prompt and timely medical care in acute or early recovery period. This statement is true only for mild and moderate lesions of the central nervous system. In this case, the main prognosis includes full recovery and restoration of all functions, minor developmental delay, subsequent development of hyperactivity or attention deficit disorder.

In severe forms, the prognosis is not so optimistic. The child may remain disabled, and deaths at an early age are not excluded. Most often, lesions of the central nervous system of this type lead to the development of hydrocephalus, childhood cerebral palsy, To epileptic seizures. As a rule, some internal organs are also affected, and the child also experiences chronic diseases kidneys, respiratory and of cardio-vascular system, marble leather.

Prevention

Prevention of pathologies from the central nervous system in a child is a task expectant mother. At risk are women who do not leave bad habits while carrying a baby, they smoke, drink alcohol or take drugs.

All pregnant women must be registered with an obstetrician-gynecologist in the antenatal clinic. During pregnancy, they will be asked to undergo so-called screening three times, which identifies the risks of having a child with genetic disorders from that particular pregnancy. Many gross pathologies of the fetal central nervous system become noticeable during pregnancy; some problems can be corrected medicines, for example, disturbances of uteroplacental blood flow, fetal hypoxia, threat of miscarriage due to a small detachment.

A pregnant woman needs to watch her diet and take vitamin complexes for expectant mothers, do not self-medicate, and be careful about various medications that you have to take during pregnancy.

This will avoid metabolic disorders at the baby's. You should be especially careful when choosing a maternity home (the birth certificate that all pregnant women receive allows you to make any choice). After all, the actions of staff during the birth of a child play a big role in possible risks the appearance of traumatic lesions of the central nervous system in a baby.

After the birth of a healthy baby, it is very important to regularly visit the pediatrician, protect the baby from injuries to the skull and spine, and get age-appropriate vaccinations that will protect the little one from dangerous infectious diseases, which at an early age can also lead to the development of pathologies of the central nervous system.

In the next video you will learn about signs of a nervous system disorder in a newborn, which you can determine yourself.

Trauma to the nervous system is one of the most common human pathologies. There are traumatic brain injury and spinal injury.

Traumatic brain injury accounts for 25-45% of all cases of traumatic injuries. This is explained high level injuries during car accidents or transport accidents.

Traumatic brain injuries are closed (CTBI), when integrity is preserved skin and hard meninges, or there are soft tissue wounds without damage to the aponeurosis (the broad ligament covering the skull). Traumatic brain injuries with bone damage, but with preservation of the integrity of the skin and aponeurosis are also classified as closed. Open traumatic brain injuries (OTBI) occur when the aponeurosis is damaged. Injuries in which cerebrospinal fluid leaks are classified as open in any case. Open head injuries are divided into penetrating, when the dura mater is damaged, and non-penetrating, when the dura mater remains intact.

Classification of closed craniocerebral injuries:

1. Bruises and wounds of the soft tissues of the skull without concussion and brain contusion.

2. Actually closed injuries brain:

 Concussion (commotio cerebri).

 Brain contusion (contusio cerebri) mild, moderate and severe

3. Traumatic intracranial hemorrhages (compression of the brain – compressio):

 Extradural (epidural).

 Subdural.

 Subarachnoid.

 Intracerebral.

 Intraventricular.

4. Combined injuries of the skull and brain:

 Bruises and injuries to the soft tissues of the skull in combination with trauma to the brain and its membranes.

 Closed fractures of the bones of the cranial vault in combination with damage to the brain (bruise, concussion), its membranes and blood vessels.

 Fractures of the bones of the base of the skull in combination with damage to the brain, membranes, blood vessels and cranial nerves.

5. Combined injuries when mechanical, thermal, radiation or chemical exposure occurs.

6. Diffuse axonal brain damage.

7. Compression of the head.

The most common type of lesion is brain concussion . This is the mildest type of brain damage. It is characterized by the development of mild and reversible changes in the activity of the nervous system. At the time of injury, as a rule, there is a loss of consciousness for several seconds or minutes. It is possible to develop so-called retrograde amnesia for events preceding the moment of injury. Vomiting is observed.

After restoration of consciousness, the following complaints are most typical:

 Headache.

 General weakness.

 Tinnitus.

 Noise in the head.

 Rush of blood to the face.

 Sweaty palms.

 Sleep disturbance.

 Pain when moving eyeballs.

The neurological status reveals labile, mild asymmetry of tendon reflexes, small-caliber nystagmus, and there may be slight stiffness of the neck muscles. The condition is completely relieved within 1-2 weeks. In children, concussion can occur in three forms: mild, moderate, and severe. In mild forms, loss of consciousness occurs for a few seconds. If loss of consciousness does not occur, then adynamia and drowsiness may occur. Nausea, vomiting, and headache persist for 24 hours after the injury. Shake medium degree severity is manifested by loss of consciousness for a period of up to 30 minutes, retrograde amnesia, vomiting, nausea, headache for a week. A severe concussion is characterized by a prolonged loss of consciousness (from 30 minutes to several days). Then a state of stupor, lethargy, and drowsiness appears. The headache persists for 2-3 weeks after the injury. The neurological status reveals transient damage to the abducens nerve, horizontal nystagmus, increased tendon reflexes, and congestion in the fundus. The cerebrospinal fluid pressure rises to 300 mmH2O.

Brain contusion Unlike a concussion, it is characterized by brain damage of varying severity.

In adults, mild brain contusion is characterized by loss of consciousness after the injury from several minutes to an hour. After regaining consciousness, the victim complains of headache, dizziness, nausea, retrograde amnesia occurs. The neurological status reveals different pupil sizes, nystagmus, pyramidal insufficiency, and meningeal symptoms. Symptoms regress in 2-3 weeks.

A moderate brain injury is accompanied by loss of consciousness for several hours. Retrograde and antegrade amnesia occurs. Headaches are usually severe. Repeated vomiting. Blood pressure either increases or decreases. In the neurological status, a pronounced shell syndrome and distinct neurological symptoms occur in the form of nystagmus, changes in muscle tone, the appearance of paresis, pathological reflexes, and sensory disturbances. Fractures of the skull bones and subarachnoid hemorrhages are possible. The cerebrospinal fluid pressure is increased to 210-300 mmH2O. Symptoms regress within 3-5 weeks.

Severe brain contusion is characterized by loss of consciousness for a period of several hours to several weeks. Severe disturbances in the vital functions of the body develop. Bradycardia less than 40 beats per minute, arterial hypertension more than 180 mm Hg, possibly tachypnea more than 40 beats per minute. There may be an increase in body temperature.

Severe neurological symptoms occur:

 Floating movements of the eyeballs.

 Paresis of upward gaze.

 Tonic nystagmus.

 Miosis or mydriasis.

 Strabismus.

 Swallowing problems.

 Change in muscle tone.

 Decerebrate rigidity.

 Increased or depressed tendon or skin reflexes.

 Tonic convulsions.

 Oral automaticity reflexes.

 Paresis, paralysis.

 Convulsive seizures.

With severe bruises, as a rule, there are fractures of the bones of the vault and base of the skull, massive subarachnoid hemorrhages. Focal symptoms regress very slowly. Liquor pressure rises to 250-400 mmH2O. As a rule, a motor or mental defect remains.

In childhood, brain contusion is much less common. It is accompanied by persistent focal symptoms with impaired movements, sensitivity, visual, coordination disorders against the background of severe cerebral symptoms. Often focal symptoms clearly visible only on days 2-3 against the background of a gradual decrease in cerebral symptoms.

If a brain contusion is accompanied by subarachnoid hemorrhage, then clinical picture clearly manifested meningeal syndrome. Depending on the location of the accumulation of spilled blood, either psychomotor disturbances (excitement, delirium, hallucinations, motor disinhibition), or hypothalamic disorders (thirst, hyperthermia, oliguria), or hypertension syndrome occur. If subarachnoid hemorrhage is suspected, a lumbar puncture is indicated. The liquor is hemorrhagic in nature, or the color of meat slop.

Brain compression occurs when intracranial hematomas and depressed skull fractures form. The development of a hematoma leads to a gradual deterioration of the patient’s condition and an increase in signs of focal brain damage. There are three periods in the development of hematomas:

spicy with traumatic effects on the skull and brain;

latent– “bright” period after injury. It is most typical for epidural hematomas and depends on the background against which the hematoma is formed: a concussion or a brain contusion.

AND actual compression period or a formed hematoma.

The most characteristic of a hematoma is dilation of the pupil on the affected side and hemiparesis on the opposite side (Knapp syndrome).

Other symptoms of brain damage due to compression of the brain include the following:

 Impaired consciousness.

 Headache.

 Repeated vomiting.

 Psychomotor agitation.

 Hemiparesis.

 Focal epileptic seizures.

 Bradycardia.

Other causes of brain compression include hydroma. Its formation occurs when a small subdural hematoma forms, the bleeding into which stops, but it is gradually replenished with fluid from the cerebrospinal fluid. As a result, it increases in volume, and the symptoms increase according to the pseudotumor type. Several weeks may pass from the moment of injury. Often, with the formation of a hematoma, subarachnoid hemorrhage occurs.

In children, the clinical picture of intracranial hematomas is somewhat different. The severity of the first phase may be minimal. The duration of the light interval depends on the intensity of bleeding. The first signs of a hematoma appear when its volume is 50-70 ml. This is explained by the elasticity of the child’s brain tissue, its greater ability to stretch, and the wide pathways of cerebrospinal fluid and venous circulation. Brain tissue has a great ability to compress and compress.

Diagnostics craniocerebral injuries includes a complex of methods:

 Thorough neurological examination.

 X-ray of the skull bones can reveal fractures and bone depressions.

 Examination of cerebrospinal fluid allows us to speak about the presence of subarachnoid hemorrhage. Its implementation is contraindicated in case of hematomas, because Wedging of the brain substance may occur into the foramen magnum or into the notch of the tentorium of the cerebellum.

 Electroencephalography allows you to identify local or diffuse changes in the bioelectrical activity of the brain, the degree of depth of their changes.

 Echo-encephalometry is the number one research method for suspected hematoma, tumor or brain abscess.

 CT and MRI are the most informative modern research methods that allow us to study the structure of the brain without opening the skull bones.

 The study of biochemical parameters is of auxiliary importance, because any traumatic effect on the body will be accompanied by activation of the sympathetic-adrenal system. This will be manifested by increased release of adrenaline metabolites and catecholamines in the acute period of injury. By the end of the acute period, the activity of the sympathetic-adrenal system appears to be reduced; it often returns to normal levels only 12 or 18 months after the traumatic brain injury.

Long-term consequences of TBI include:

 Hydrocephalus.

 Traumatic encephalopathy.

 Traumatic epilepsy.

 Paresis.

 Paralysis.

 Hypothalamic disorders.

The emerging autonomic dystonia is a symptom of the current traumatic process, and not a consequence of a previous head injury.

Treatment of traumatic brain injury

If there is a depressed fracture or hematoma, the patient is subject to immediate neurosurgical treatment.

In other cases, treatment is conservative. Shown bed rest. Symptomatic therapy is carried out: analgesics, dehydration, and for vomiting - Eglonil, Cerucal. For sleep disorders - sleeping pills. For psychomotor agitation - tranquilizers, barbiturates, antipsychotics. For severe intracranial hypertension, diuretics (Lasix, mannitol, glycerin mixture) are prescribed. For subarachnoid hemorrhages, repeated lumbar punctures are indicated.

In case of severe brain injuries, resuscitation measures, monitoring the activity of the pelvic organs and preventing complications are indicated.

During the recovery period, physical therapy, physiotherapy, massage, restorative medications, classes with a speech therapist, and a psychologist are indicated.

Open head injuries are divided into penetrating and non-penetrating depending on the damage to the dura mater. Injuries with damage to the dura mater are much more severe, because there are opportunities for infection to enter the cranial cavity and develop meningitis, encephalitis and abscess. An unconditional sign of an open penetrating traumatic brain injury is the leakage of cerebrospinal fluid from the nose and ear.

Open penetrating brain injuries are caused by car accidents and gunshot wounds. The latter are especially dangerous because a blind wound channel is formed with high degree infection. This further aggravates the condition of patients.

In the clinic of open craniocerebral injuries, the following manifestations may occur:

 Severe cerebral symptoms with headache, vomiting, dizziness.

 Shell symptoms.

 Focal signs of damage to the brain substance.

 The “spectacles symptom” develops when the bones of the base of the skull are fractured.

 Bleeding from wounds.

 Liquororrhea.

 When the walls of the ventricles of the brain are injured, purulent ependymatitis occurs with an extremely severe course.

Diagnostics carried out in the same way as in case of traumatic brain injury. Inflammatory changes are observed in the blood. The cerebrospinal fluid pressure is increased. There are characteristic congestion phenomena in the fundus.

Treatment Open craniocerebral injuries are performed surgically. Crushed brain tissue, bone fragments, and blood clots are removed. Subsequently, plastic surgery of the bone defect of the skull is performed. Drug treatment involves the prescription of antibiotics, anti-inflammatory drugs, and diuretics. Anticonvulsants, exercise therapy, massage, and physiotherapy are prescribed.

Spine and spinal cord injuries

Spinal injuries can be closed - without damage to the skin and adjacent soft tissues, open - with their damage. Penetrating spinal injuries occur when the integrity of the walls of the spinal canal is disrupted and infection becomes possible. Spinal injuries without spinal cord dysfunction, spinal cord dysfunction without spinal damage, and combined injuries are possible.

Spinal injuries include:

 Fractures.

 Dislocations of the vertebrae.

 Sprains and tears ligamentous apparatus.

 Violation of the integrity of intervertebral discs.

Spinal cord injury occurs as follows:

 Concussion.

 Rupture.

 Hematomyelia occurs when there is bleeding in the spinal cord. In this case, the gray matter of the brain suffers to a greater extent.

 Meningeal spinal hemorrhages (hematorachis) occur when blood enters above or below the dura mater, subarachnoid hemorrhage occurs when blood enters under the arachnoid membrane.

Among the causes of vertebral and spinal cord injuries, the first place is taken by transport (car injuries) and falls from height.

Clinical picture spinal injuries include the following symptoms:

 Local pain.

 Muscle tension.

 Spinal cord concussion acute stage often occurs with symptoms of transverse spinal cord lesions, which undergo reverse development. This phenomenon is called diaschisis, or diffuse inhibition in the spinal cord, or spinal shock. It occurs with inhibition of the functions of the spinal cord below the level of the lesion and dysfunction of the pelvic organs. The duration of this state varies within different limits. Restoration of spinal cord functions occurs over a period of several weeks to 1 month.

 With a spinal cord contusion (bruise), destructive changes in the brain substance occur. The diaschisis stage takes longer, recovery is slower and incomplete. There may be bedsores. Development of complications in the form of pyelonephritis, urosepsis.

 Spinal damage does not correspond to the level of spinal cord damage. This is explained by the peculiarities of the blood supply to the brain. To establish the level of damage to the spine, spondylography – radiography of the spine – is of exceptional importance.

Treatment for spinal injuries, it involves immobilizing the patient, positioning on a backboard, traction, monitoring the activity of the pelvic organs, and preventing bedsores.

If spinal cord compression is detected, surgical treatment is necessary. Drug therapy is carried out symptomatically. During the period of restoration of functions, sanatorium-resort treatment and mud therapy become of particular importance.

Peripheral nervous system injuries occur with traumatic brain injuries, fractures of the collarbone, limbs, gunshot, knife wounds.

Traumatic nerve rupture is called neurothemesis. In this case, a violation of the motor, sensory and trophic functions provided by these nerves occurs.

Reversible disorders are possible with a concussion or bruise of the nerve. In this case, there may be phenomena of neuropraxia, when the nerve axon remains intact, changes occur at the level of microtubules and cell membranes. Axotemesis involves rupture of the axon while maintaining Schwann cells, epi-, peri-, and endoneurium. When the axon is ruptured, the distal segment of the nerve undergoes Wallerian degeneration, and the central segment begins to regenerate.

Restoration of nerve function occurs after 2-3 weeks when it is concussed or bruised; with axotemesis, recovery occurs in parallel with nerve regeneration. The nerve growth rate is 1 mm/day. When the ends of the severed nerve diverge, restoration does not occur completely. To do this, they resort to the operation of neurorrhaphy - suturing the nerve. It is performed in cases where there is no recovery of nerve function within 2-3 months. If surgery is not performed, a neuroma will form at the end of the severed nerve, which can cause phantom pain. The presence of a large number of autonomic fibers in the damaged nerve causes the presence of causalgic burning pain. The patient experiences relief by immersing his limbs in cold water or wrapping them with rags soaked in water.

Treatment nerve injuries include surgical treatment in acute period according to indications. Anti-inflammatory, anticholinesterase, analgesic drugs. Physiotherapy, massage. After 1.5-2 months, mud therapy, balneotherapy, and spa treatment are recommended.

The activity of all our organs and systems is controlled by the central nervous system. It also ensures our interaction with environment and regulates human behavior. Disturbances in the activity of the central nervous system can be provoked by a variety of factors, but in any case they negatively affect the functioning of the body. Some of these pathological conditions quite amenable drug correction, but others, unfortunately, are incurable. Let's talk about the reasons that cause damage to the central nervous system, as well as the symptoms accompanying this process in a little more detail.

Causes of damage to the central nervous system

Problems in the activity of the central nervous system can be caused by a variety of factors. So they can be provoked by various vascular disorders, and infectious lesions. In some cases, such problems are a consequence of the consumption of poisons, or the result of injuries. In addition, they can develop against the background of tumor formations.

Vascular diseases

So vascular lesions central nervous system are especially common and should be taken with particular seriousness, since such pathologies often cause fatal outcome at different groups population. Such ailments include strokes and chronic cerebrovascular insufficiency, which can lead to pronounced changes in the brain. Such disorders develop against the background of hypertension, atherosclerosis, etc.

The main manifestations of malfunctions in the cerebral circulation of the acute type are represented by headache, nausea, vomiting, sensory disturbances, as well as motor activity. They develop very quickly and most often suddenly.

Infectious lesions

Chronic diseases affecting the central nervous system

Such diseases are presented multiple sclerosis, myasthenia gravis, etc. Scientists still cannot accurately determine the reasons for their development, but the main theory is hereditary predisposition, as well as the concomitant effects of various negative factors(infections, intoxications, metabolic disorders).
common feature All such diseases are a gradual development, which most often begins in middle age or old age. In addition, the disorders are systemic in nature, affecting, for example, the entire neuromuscular system. Also, all such ailments last a long time, with gradual increase intensity of symptoms.

Traumatic lesions of the central nervous system

Such ailments are caused by concussions, bruises, and compression of the brain. They can develop as a result of injury to the brain or spinal cord, which has the form of encephalopathy, etc. Thus, a concussion makes itself felt by disorders of consciousness, headaches, as well as nausea, vomiting and memory disorders. With a brain injury, the described clinical picture is accompanied by various disturbances of sensitivity, as well as motor activity.

Hereditary lesions of the central nervous system

Such ailments can be chromosomal or genomic. In the first case, pathology develops against the background of changes in chromosomes, in other words, at the cellular level. Genomic abnormalities appear due to changes in genes, which are inherently carriers of heredity. The most common chromosomal disorder is Down syndrome. If we talk about genomic disorders, they can be represented by several variants with a predominant disruption of the activity of the neuromuscular and nervous systems. Chromosomal diseases are usually accompanied by manifestations of dementia and infantility, and some endocrine problems. Those suffering from genomic diseases are usually susceptible to motor disorders.

Organic lesions of the central nervous system

Defective brain function indicates the development of organic damage to the nervous system. This condition can be manifested by increased excitability, as well as rapid distractibility, urinary incontinence during daylight hours and sleep disturbances. In most cases, the functioning of the organs of hearing or vision is affected, and incoordination of movements may also appear. The functioning of the human immune system is disrupted.

Such pathologies can develop in both children and adults. Congenital organic lesions often result from viral infections developing in a woman during pregnancy, as well as her consumption of alcohol or nicotine.

All living things cannot exist without taking into account signals external environment. The nervous system perceives them, processes them and ensures interaction with the surrounding nature. It also coordinates the work of all systems within the body.

Neurological disease

The central nervous system plays important role in regulating people's behavior. Diseases of the central nervous system today affect people of all ages.

Damage to the central nervous system is neurological disease. Patients with disorders of the central nervous system are monitored by a neurologist, although diseases of any other organs may be concomitant.

Nervous system disorders are closely intertwined with severe disharmony mental activity, which provokes changes in the positive qualities of a person’s character. Damage to the central nervous system can affect the functioning of the brain and spinal cord, leading to neurological and mental disorders.

Causes of central nervous system damage

The central nervous system can be damaged as a result of the use of certain medications, physical or emotional stress, or difficult and difficult childbirth.

CNS damage can be caused by drug use and abuse alcoholic drinks, which leads to a decrease in the potential of important brain centers.

The causes of central nervous system diseases are injuries, infections, autoimmune diseases, structural defects, tumors, and stroke.

Types of central nervous system lesions

One type of disease of the central nervous system is neurodegenerative diseases, which are characterized by progressive dysfunction and cell death in certain areas nervous system. These include Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease, lateral amyotrophic sclerosis(ALS). Alzheimer's disease causes memory loss, personality changes, dementia and ultimately death. Parkinson's disease causes tremors, rigidity, and loss of motor control as a result of loss of dopamine. Most characteristic symptoms Huntington's diseases are random and uncontrolled movements.

Retroviral infections pose a potential threat to the central nervous system, illustrating the molecular interactions between certain viral pathogens and pathological reactions resulting from this interaction.

Viral infections of the nervous system are increasing from year to year, confirming the significant increase in global epidemics in recent years.

Disturbances in the functioning of the central nervous system in some cases occur during fetal development or during childbirth.

When the central nervous system is damaged, an imbalance occurs in all human organs, the functioning of which is regulated by the central nervous system.

A failure in the functioning of the central nervous system will in any case lead to damage or disruption of the activity of other organs.

Organic damage to the central nervous system

Defective brain activity means that an organic lesion of the nervous system has occurred, which can be congenital or acquired. Most people experience mild damage that does not require treatment. The presence of moderate and severe degrees of this disease requires medical intervention, as the activity of the central nervous system is disrupted.

Signs of organic damage to the central nervous system are increased excitability, easy distractibility, urinary incontinence daytime, sleep disturbance. In some cases, the functioning of the organs of hearing and vision deteriorates, and coordination of movements is also impaired. Suffering the immune system person.

Viral infections that occur in a woman who is carrying a child, the use of various medical supplies, smoking or drinking alcohol during pregnancy affect the functioning of the central nervous system and lead to its disruption.

Organic damage to the nervous system can be observed in both children and adults.

This diagnosis is currently one of the most common. Organic damage to the central nervous system (CNS) in its classical content is a neurological diagnosis, i.e. is under the purview of a neurologist. But the symptoms and syndromes accompanying this diagnosis can relate to any other medical specialty.

This diagnosis means that the human brain is defective to a certain extent. But if mild degree(5-20%) “organics” (organic damage to the central nervous system) is inherent in almost all people (98-99%) and does not require any special medical interventions, then the average degree (20-50%) of organics is not just quantitatively different condition, but a qualitatively different (fundamentally more severe) type of disruption of the nervous system.

Causes organic lesions divided into congenital and acquired. Congenital cases include cases when during pregnancy the mother of the unborn child suffered some kind of infection (acute respiratory infection, flu, sore throat, etc.), took certain medications, alcohol, or smoked. A unified blood supply system will bring stress hormones into the fetus’s body during periods of psychological stress of the mother. In addition, they influence sharp changes temperature and pressure, exposure to radioactive substances and x-rays, toxic substances dissolved in water, contained in the air, in food, etc.

There are several particularly critical periods when even a slight external influence on the mother’s body can lead to the death of the fetus or cause such significant changes in the structure of the body (including the brain) of the future person that, firstly, no medical intervention can correct it, and secondly, these changes can lead to to the early death of a child before 5 - 15 years of age (and usually mothers report this) or cause disability from the very early age. And in the very best case scenario lead to severe brain inferiority, when even at maximum stress the brain is able to work at only 20-40 percent of its potential power. Almost always these disorders are accompanied by varying degrees the severity of disharmony of mental activity, when, with reduced mental potential, they are not always sharpened positive traits character.

This can also be facilitated by taking certain medications, physical and emotional overload, asphyxia during childbirth ( oxygen starvation fetus), protracted labor, early placental abruption, uterine atony, etc. After childbirth, severe infections (with pronounced symptoms of intoxication, high temperature etc.) up to 3 years can give rise to acquired organic changes in the brain. Brain injuries with or without loss of consciousness, long-term general anesthesia or short-term, drug use, alcohol abuse, long-term (several months) independent (without prescription and constant supervision of an experienced psychiatrist or psychotherapist) use of certain psychotropic drugs can lead to some reversible or irreversible changes in the functioning of the brain.

Diagnosis of organic matter is quite simple. A professional psychiatrist can already determine the presence or absence of organic matter by the child’s face. And, in some cases, even the degree of its severity. Another question is that there are hundreds of types of disorders in the functioning of the brain, and in each specific case they are in a very special combination and connection with each other.

Laboratory diagnostics are based on a series of procedures that are quite harmless to the body and informative for the doctor: EEG - electroencephalogram, REG - rheoencephalogram (examination of cerebral vessels), USDG (M-echoEG) - ultrasound diagnostics brain. These three examinations are similar in form to an electrocardiogram, only they are taken from a person’s head. CT scan with its very impressive and expressive name, it is actually capable of identifying a very small number of types of brain pathology - a tumor, a space-occupying process, an aneurysm ( pathological expansion brain vessels), expansion of the main cisterns of the brain (with increased intracranial pressure). The most informative study is the EEG.

Let us note that practically no disorders of the central nervous system disappear on their own, and with age they not only do not decrease, but intensify both quantitatively and qualitatively. The mental development of a child directly depends on the state of the brain. If the brain has at least some damage, then this will certainly reduce the intensity mental development child in the future (difficulty in the processes of thinking, memorization and recall, impoverishment of imagination and fantasy). In addition, a person’s character is formed distorted, with varying degrees of severity. certain type psychopathization. The presence of even small but numerous changes in the child’s psychology and psyche leads to a significant decrease in the organization of his external and internal phenomena and actions. There is an impoverishment of emotions and some flattening of them, which directly and indirectly affects the child’s facial expressions and gestures.

The central nervous system regulates the functioning of all internal organs. And if it does not work fully, then the other organs, even with the most careful care for each of them separately, will not be able, in principle, to work normally if they are poorly regulated by the brain. One of the most common diseases of our time, vegetative-vascular dystonia, against the background of organic matter, acquires a more severe, peculiar and atypical course. And thus, not only does it cause more trouble, but these “troubles” themselves are more malignant in nature. Physical development the body comes with any disturbances - there may be a violation of the figure, a decrease in muscle tone, a decrease in their resistance to physical activity even of moderate size. The likelihood of an increased intracranial pressure increases by 2-6 times. This can lead to frequent headaches and various kinds of unpleasant sensations in the head area, reducing the productivity of mental and physical labor by 2-4 times. There is also an increased likelihood of endocrine disorders increases by 3-4 times, which leads to minor additional stress factors diabetes mellitus, bronchial asthma, imbalances of sex hormones with subsequent disruption of the sexual development of the body as a whole (an increase in the amount of male sex hormones in girls and female hormones- in boys), the risk of developing a brain tumor increases, convulsive syndrome(local or general convulsions with loss of consciousness), epilepsy (group 2 disability), cerebrovascular accidents in adulthood, if present hypertension even moderate severity (stroke), diencephalic syndrome (seizures causeless fear, various expressed discomfort in any part of the body, lasting from a few minutes to several hours). Over time, hearing and vision may decrease, coordination of movements of a sports, household, aesthetic and technical nature may be impaired, complicating social and professional adaptation.

Organic treatment is a long process. Must be taken twice a year for 1-2 months vascular drugs. Concomitant neuropsychic disorders also require their own separate and special correction, which must be carried out by a psychiatrist. To monitor the degree of effectiveness of organic treatment and the nature and magnitude of changes in the state of the brain, monitoring by the doctor himself at the appointment and EEG, REG, and ultrasound are used.

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