Treatment of organic damage to the nervous system

What is organic damage to the nervous system?

Organic damage to the central nervous system

- a pathological condition in which the brain does not function fully. The lesion can be congenital or appear due to trauma, stroke, infectious diseases of the brain, alcoholism and drug addiction.

Lesions are divided into grades 1-3. Stage 1 lesions are diagnosed in many people; they do not manifest themselves in any way and do not require treatment. Lesions of degrees 2 and 3 interfere with normal life and can provoke more dangerous diseases, so they need to be treated.

Types of tumors

Neoplasms that form in the brain can be:

1. Benign – tumor tissue does not contain cancer cells. Neoplasia of this type is characterized by clear edges and slow growth. They are much easier to treat surgically, but can become malignant, that is, turn into cancer;
2. Malignant tumors contain abnormal cells that can divide uncontrollably and metastasize to other organs. In this case, the disease is difficult to control; in the later stages, surgery is impossible. Treatment in this case is difficult, has a high cost and, as a rule, poor prognosis.

Brain glioma

Glioma

This type of tumor is diagnosed more often, accounting for approximately 60% of all types of cancer that form in the brain. The tumor is formed from glial cells. In most cases, this is a primary neoplasm, most often formed in the area of ​​the chiasmata or ventricles, but it can also affect the brain stem; pathogenesis rarely extends to the bones of the skull, however, in rare cases this is possible. The size of gliomas is usually up to 14 cm. Metastases are rare, growth is usually slow, but due to penetration into adjacent tissues, the boundaries of the lesion are difficult to distinguish.

Three varieties are known

• astrocytoma – diagnosed more often than others (it accounts for about 50% of gliomas);
• oligodendroglioma – up to 10% of cases;
• ependymoma – less than 7%.

According to the World Health Organization classification, there are 4 stages of glioma:

1. The first stage is benign. It is characterized by slow growth. Example: giant cell astrocytoma.
2. Second stage. Features: borderline malignancy with slow tissue growth, easily progresses to stages 3 and 4. In this case, only one symptom of cancer is identified - cellular atypia.
3. Third and fourth stage. In this case, the tumor has all the signs of cancer, for example, necrotic changes in glioblastoma multiforme.

Brain astrocytoma

Removal of a large GRADE II WHO astrocytoma of the right temporal lobe (before surgery)

This malignant neoplasm of varying degrees of aggressiveness is diagnosed quite often. The beginning is given by degenerated glial cells - astrocytes (hence the name - astrocytoma). There are:

1. Common astrocytomas: protoplasmic, fibrillary and hemisrocytic.
2. Special astrocytomas: cerebellar, piloid, microcystic and subependymal.

Astrocytomas are distinguished by the stage of malignancy:

1. The first stage (benign tumor) includes piloid or pilocytic astrocytoma of the brain.
2. Second stage of malignancy: fibrillary tumor is also an ordinary neoplasia, second degree of malignancy.
3. The third stage is already cancer. It includes anaplastic astrocytoma of the brain.
4. The most life-threatening are glioblastomas (giant cell glioblastoma and gliosarcoma), which are classified as stage 4 and are characterized by rapid growth and the ability to metastasize.

In addition to the ones mentioned, there are other types of astrocytomas, for example, ependymoma (develops from ventricular cells), oligodendroglioma (forebrain) - grow quite slowly without the formation of metastases, and glioma of the brain stem.

Meningioma of the brain

Removal of a large middle cranial fossa meningioma before surgery

Pathogenesis begins with pathogenic cells in the superficial membrane that surround the brain tissue. The neoplasm is oval in shape, grows slowly, and is therefore considered benign. Meningiomas are diagnosed in 15% of cases (of all brain tumors). The risk of degeneration into cancer is about 3-4%. The clinical signs that appear are caused by increased intracranial pressure and tissue compression. With malignancy (degeneration of somatic cells into carcinogenic ones), meningiomas become aggressive. Usually more than one lesion forms and may spread to the spinal cord. After surgical treatment, there is a high probability of relapses. As a rule, pathology is diagnosed by chance, because symptoms appear only when the lesion reaches a large size. There are no early signs of the disease.

Note. Meningiomas often form in females.

Other types of brain tumors

There are quite a lot of types of neoplasms. Here are some of those that are diagnosed relatively often (besides those mentioned above):

• medulloblastoma is a brain cancer that originates from the structures of the cerebellum;
• germinoma - formed from germ cells, most often it is detected in the first half of a person’s life;
• Craniopharyngeoma - develops in the pituitary gland at the base of the brain;
• Shawnoma – formed from degenerated Schwann cells;
• tumors in the pineal gland area.

How does organic damage to the nervous system manifest and what is dangerous?

When the central nervous system is damaged, the following symptoms are observed:

• fast fatiguability;
• impaired coordination, inability to perform simple movements and actions because of this;
• problems with hearing, vision;
• inability to concentrate on a task, the need to constantly be distracted;
• trouble sleeping, insomnia, nightmares or constant awakenings;
• urinary incontinence;
• decreased immunity, which often causes colds and other diseases.

Brain lesions are especially dangerous for children who are lagging behind in physical development and cannot study normally and communicate with peers. Also, lesions lead to oligophrenia, that is, mental retardation, and dementia - loss of skills and knowledge, and the inability to acquire new ones.

Diagnostics

The initial examination involves an oral interview and a physical examination. The doctor assesses the patient’s general condition, determines the nature of clinical manifestations, their duration and intensity, evaluates coordination, reflexes, psycho-emotional state, and so on. Next, the patient will have to undergo a thorough diagnosis, which may include the following types of studies:

• general blood and urine tests;
• blood chemistry;
• Ultrasound (echoencephalography);
• angiography - X-ray contrast study of the condition of the blood vessels of the head;
• examination of eye function and level of vision;
• computed tomography or magnetic resonance imaging – obtaining high-precision layer-by-layer images, which allows you to identify all the nuances of the disease and determine the method of tumor removal;
• magnetic resonance spectroscopy – study of the functioning of pathogenic tissues at the biochemical level;
• positron emission tomography (PET) of the head shows the characteristics of metabolic processes in the painful focus, which makes it possible to talk about the rate of development of the disease;
• biopsy - tissue collection for histological examination; in this case, the material is obtained after tumor removal.

Also of great diagnostic importance is the study of cerebral fluid, in which pathological cells are located. The stereotactic biopsy method is the most informative in terms of determining the type of carcinogenesis and its characteristics.

Advantages of treating central nervous system lesions in our clinic

1. We accept adults and children
   . We enroll adult patients and preschool children. We send young patients to a doctor who specializes in brain damage in children.
2. We treat children in the presence of parents
   . If a child experiences fear or anxiety, we conduct a consultation in the presence of the parents. If necessary, we carry out further treatment in front of the parents to reduce stress for the child.
3. We select therapy individually
   . We assess the degree of damage, the presence of concomitant diseases and disorders. We select treatment taking into account the patient’s age, general health, and response to previous therapy.
4. We warn you about the duration of treatment and possible results
   . We will tell you how long the treatment can last, since organic lesions require long-term therapy. We predict how effective the therapy will be in a particular case, and discuss this with the patient.

To make an appointment with a doctor, call or use the feedback form. The administrator will call you back, answer questions and help you choose a convenient appointment time.

Lesions and injuries

Traumatic brain injury (TBI) is an organic damage to the brain and brain structures (membranes, blood vessels, nerves) resulting from mechanical damage to the brain.

As a result of mechanical impact, nerve fibers are ruptured or damaged, which leads to a disruption in the transmission of nerve impulses. Such damage can occur in various areas of the brain responsible for speech, hearing, perception, attention, and memory.

Therefore, different people may experience different problems as a result of TBI - with memory, attention, perception and recognition. The result of traumatic brain injury is often disturbances in thinking, emotional sphere (depression, irritability), hearing impairment, writing, arithmetic, reading and speech.

Most of these violations can be compensated. After treatment of a TBI received in a hospital, the patient needs rehabilitation (elimination of the consequences of a traumatic brain injury) aimed at restoring lost functions.

At the DoctorNeuro Center for Speech Neurology, the condition of each patient is assessed by an interdisciplinary team of specialists. Doctors evaluate the problem comprehensively, each from the point of view of their specialization. In diagnosing the consequences of TBI, various functional diagnostic methods are used. The entire process of your rehabilitation will take place under the supervision of an experienced neurologist. He will study the medical history, prescribe an examination and a consultation of doctors, select medications and concomitant therapy, and monitor the progress of rehabilitation.

“Rehabilitation training can begin at any time, but the first year after injury and recovery from an acute condition is the most important for achieving maximum results.”

Krivtsova Yulianna Pavlovna, Neurologist of the first category

Survey

Neurologist

Rehabilitation after a TBI begins with an appointment with a neurologist. The doctor conducts an examination, studies existing medical documentation (discharge, CT, MRI reports) and, if necessary, prescribes additional examination. This may include functional diagnostics, computer diagnostics, laboratory tests, and examination of the patient by other specialists. The neurologist determines the scope of the necessary examination individually in each individual case.

The purpose of the examinations is to assess the volume, extent and type of impairments resulting from traumatic exposure. Based on the results of such a comprehensive examination (diagnosis), the doctor will be able to prescribe therapy and develop a rehabilitation route.

EEG

An electroencephalogram allows you to assess the functional state of the bioelectric activity of the brain to identify or exclude functioning pathologies in its individual areas.

USDG

Doppler ultrasound (USDG) of the vessels of the head and neck is prescribed to assess the degree of arterial and venous blood flow, exclude indirect signs of venous and intracranial hypertension, and diagnose vasospasm.

Oculist

The neurologist may prescribe an additional consultation with an ophthalmologist in order to exclude pathology from the fundus of the eye. Congestion in the fundus can serve as evidence of cerebral hypoxia, which is very important for the selection of drug therapy.

Neuropsychologist

Using special methods of neuropsychological diagnostics, a neuropsychologist identifies disturbances in the functioning of higher mental functions resulting from traumatic brain injury. The specialist assesses the state of the patient’s memory, attention, thinking, as well as the state of his emotional sphere (presence of aggression, irritability, depression) - it is with the problems identified during the examination that the neuropsychologist will work in the process of neurorehabilitation of the patient.

Speech therapist

The speech therapist evaluates the patient's speech if it is damaged.

Treatment

Based on a comprehensive examination and determination of the degree of damage to higher mental functions, a neurologist prescribes an individual neurorehabilitation program: both the necessary drug therapy and rehabilitation sessions with a neuropsychologist and speech therapist.

As an effective innovative treatment method, a neurologist can prescribe transcranial magnetic stimulation (TMS). This is a modern non-invasive technique for the treatment of neurological disorders. The effectiveness of TMS has been proven by both foreign and Russian experience.

The principle of operation of TMS is the painless and safe effect of short-term magnetic pulses on the affected nerve cells of the cerebral cortex, which significantly accelerates the restoration of the function of areas of the brain lost as a result of traumatic exposure.

TMS can be prescribed as monotherapy or work in combination with drug therapy.

Symptoms of TBI due to a recent head impact

• Headache,
• dizziness,
• Losing consciousness even for a few seconds,
• Falling asleep during the first two hours
• Nausea, vomiting,
• Visual impairment: pain in the eyes, displacement (bifurcation) of the image,
• Noise in ears,
• Retrograde amnesia (after a blow, events lasting from a few seconds to 2 hours may disappear from the victim’s memory).

Symptoms of TBI resulting from a head blow in the past (sometimes after 3-5 years)

• Frequent headaches
• Disturbance of sleep and/or sleep/wake cycle,
• Visual impairment,
• Impaired cognitive functions (impaired memory, concentration, fatigue, difficulty following the sequence of actions, etc.).

Exercise tests

There is another very interesting method for identifying the degree of decrease in blood circulation (this is the so-called myocardial ischemia) these are tests with physical activity: veloergometry (the patient with the ECG electrodes connected is on a bicycle and pedals). The state of the heart and blood vessels is assessed in response to physical activity. A similar method is the treadmill test (only the patient is on a treadmill). Thus, we see that thanks to the combination of all examination methods, it is possible to collect a detailed picture about this disease. Thus, the cardiologist has a clear picture of the disease and is already moving along the precisely planned path of treatment for this disease.

Expert electrocardiographers

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