Organic brain damage: symptoms and treatment methods. Organic mental disorders What are organic brain lesions?

Organic mental disorders include a group of diseases, the development of which leads to the emergence of certain mental and psychiatric disorders when the brain is damaged.

The causes of the development of organic disorders include:

Types and types of organic mental disorders

As a result of brain damage, various mental disorders gradually develop, which can take from several months to several years, which, depending on the leading syndrome, are grouped as follows:

Dementia;
Hallucinosis;
Delusional disorders.
Psychotic affective disorders;
Non-psychotic affective disorders;
Anxiety disorders;
Emotionally labile, or asthenic, disorders.
Mild cognitive impairment;
Organic personality disorders.

Are there common characteristics of patients with organic mental disorders?

All patients with organic mental disorders have varying degrees of impaired attention, difficulty in remembering new information, slowed thinking, difficulty in setting and solving new problems, irritability, fixation on negative emotions, sharpening of features previously characteristic of a given personality, a tendency to, as verbal as well as physical.

Characteristics of organic mental disorders

Dementia

Dementia syndrome can develop as a result of any of the listed causes of organic mental disorders. With it, attention, memory, thinking, and understanding of the surrounding reality are grossly impaired, the ability to learn almost completely disappears, and basic self-service skills are lost. These phenomena are chronic or progressive. Such a patient is helpless and, as a rule, needs to be deprived of legal capacity and the appointment of a guardian. A diagnosis of dementia is made if the above disorders last for at least six months. Unfortunately, such conditions are almost irreversible; with the help of modern medications it is possible to only slightly slow down the progression of dementia, help the patient become more collected in everyday life, less fussy, anxious, that is, slightly improve the quality of his life. The main emphasis in the treatment of such patients is on quality care, attention and compassion of loved ones.

Mild cognitive impairment

With this disease, attention first of all suffers, which is one of the earliest symptoms, memory decreases, the patient has difficulty acquiring new knowledge, has difficulty setting and solving new problems, and becomes more absent-minded. However, these phenomena are not as profound as in dementia; the patient retains everyday skills, takes care of himself, retains the ability to count, and can independently plan his budget. It is worth noting that dementia never develops suddenly. If you have discovered that you or your loved ones have attention problems, memory loss, or difficulties in learning new knowledge, you need to urgently contact a psychiatrist for a detailed examination, diagnosis and treatment. If you let the situation take its course, mild cognitive impairment will inevitably progress, turn into moderate, then severe, and this process will end in dementia, when it is too late to change anything.

Hallucinosis

Hallucinations are defined as a disturbance of vision when the patient sees, hears, feels various images, sounds, smells, sensations on the skin, inside the body that do not exist in reality. Accordingly, they distinguish between auditory, visual, olfactory, gustatory, and tactile. Hallucinosis is permanent or recurrent, periodically renewed. These patients usually do not have gross impairments of memory, intelligence, disorders of consciousness, or mood; often these patients are critical of their condition, that is, they assess it as a disease and are aware of the need for treatment.

Delusional disorders

Delirium is defined as distorted, absurd, unshakable judgments and conclusions that arise as a result of illness, subordinating the patient’s behavior, and not amenable to criticism and correction. In delusional disorder, the leading syndrome is delusional ideas of various contents: relationships, poisoning, surveillance, damage, jealousy, invention, reform, hypochondriacal, of special origin, special meaning, there may be other types of delusions. Usually accompanied by emotional instability, pathologically elevated or depressed mood, and sometimes hallucinations are interpreted deliriously. These patients, just like with x, do not have gross impairments of memory, intelligence, or disorders of consciousness. However, they usually either do not have criticism of their condition, or it is peculiar, partial. Accordingly, many of these patients do not want to be treated, they are afraid, and they agree to treatment only after lengthy persuasion.

Psychotic affective disorders

Psychotic affective disorders are characterized by pathologically altered mood: depressive (low mood with a feeling of melancholy), manic (high mood). They are accompanied by delusions and/or hallucinations. Usually the patient’s mood corresponds to the content of the delusion: delusional ideas of self-accusation, self-abasement, low value, sinfulness, persecution, relationships, poisoning, surveillance, damage, jealousy, serious illness (hypochondriacal delusions) are colored by a depressive mood; delusional ideas of invention, reformation, and special origin are accompanied by manic experiences.

Hallucinosis, delusional disorders, psychotic depressive disorders are collectively called organic psychoses. These are serious conditions that, if the patient does not comply with the treatment regimen or insufficient treatment is prescribed, can lead (especially in delusional disorder) to aggression towards others, committing crimes, refusing to eat with the development of dystrophy, and committing suicide. Therefore, this group of patients requires special attention from the attending physician and the patient’s relatives.

Non-psychotic affective disorders

Such diseases are called non-psychotic because they are not accompanied by delusions and hallucinations, usually do not require urgent or emergency hospitalization in a psychiatric hospital, and are treated only on an outpatient basis. Depression, or even subdepression, are recognized as conditions that are characterized by persistent, pathologically depressed mood, loss of interests and pleasures, decreased ability to concentrate, low self-esteem, feelings of self-doubt, a gloomy, pessimistic vision of the future, sleep disturbances, low appetite; Unlike psychotic depression, patients do not experience food refusal or suicide. Hypomania, on the contrary, is defined as a state of pathologically elevated mood, accompanied by constant elevation of mood, increased activity, talkativeness, sociability, a sense of physical and mental well-being, increased sexuality, and a decreased need for sleep.

Anxiety disorders

Anxiety disorders are characterized by constant, debilitating, unmotivated anxiety that can range from mild anxiety to a feeling of terror. Usually the patient has no external reasons for anxiety. Anxiety is accompanied by a rapid heart rate, rapid breathing, or shortness of breath, and sometimes increased blood pressure. Such patients are characterized by sleep disturbances, secondary depressed mood, anxiety about their future, and fears of going crazy. The state of anxiety is very painful for patients; usually these people seek help and actively turn to a psychiatrist.

Emotionally labile (asthenic) disorders

Defined as a state of neuropsychic weakness. There are two options. With emotional-hyperesthetic weakness, short-term reactions of dissatisfaction, irritability, anger on minor occasions, tearfulness easily occur, patients are capricious, gloomy, and dissatisfied. There is marked hypersensitivity to sounds, smells, and light. Attention is distracted, the patient has difficulty concentrating. Headaches and insomnia appear. All this reduces performance, a person quickly gets tired, becomes lethargic, passive, and tends to rest often. With the hyposthenic version of asthenic syndrome, lethargy, fatigue, weakness, sluggishness come to the fore; night sleep does not bring a feeling of rest. Asthenic syndrome accompanies absolutely all diseases; it is universal. The only difference is that asthenia, which occurs with any other disease, sooner or later undergoes reverse development and goes away with recovery. The asthenic state in an organic disorder is the leading one; it is usually persistent and hardly reversible.

It's worth remembering

Organic personality disorders

Such diseases develop in cases where the substance of the brain is significantly damaged, and there is no talk of recovery or significant relief of the condition. Changes characteristic of all patients with organic disorders - absent-mindedness, difficulty in remembering new information, slowed thinking, difficulty in setting and solving new problems, irritability, fixation on negative emotions, sharpening of traits previously characteristic of a given personality, a tendency to aggression - become persistent, irreversible, more crudely expressed, a person’s personality changes. Viscosity, thoroughness, slowness both in oral and written speech are added, suspicion, attacks of anger, aggression, euphoria become more frequent, the patient loses the ability to calculate the consequences of his actions, various violations of sexual behavior are possible (decreased, increased sexuality, disturbances of sexual preference ).

Diagnostics

Under no circumstances should you ignore the described phenomena and, especially, self-medicate! You need to independently contact a psychiatrist who will prescribe an examination and further treatment. Therapy for all the mental disorders described above is carried out on an outpatient basis, by a psychiatrist or in a day hospital. However, there are cases when a patient needs to be treated in a 24-hour psychiatric hospital:

with ah, ah, psychotic affective disorders, conditions are possible when the patient, for painful reasons, refuses to eat, he has persistent suicidal tendencies, aggressiveness towards others (as a rule, this happens if the patient violates the maintenance therapy regimen or completely refuses drug treatment );
for dementia, if the patient, being helpless, was left alone.

General principles of drug treatment of organic mental disorders

1.Striving for maximum restoration of the functioning of damaged brain tissue. This is achieved by prescribing vascular drugs (medicines that dilate small arteries of the brain, and, accordingly, improve its blood supply), drugs that improve metabolic processes in the brain (nootropics, neuroprotectors). Treatment is carried out in courses two to three times a year (injections, higher doses of medications), the rest of the time continuous maintenance therapy is provided.
2. Symptomatic treatment, that is, an impact on the leading symptom or syndrome of the disease, is prescribed strictly according to indications by a psychiatrist.

Is there a way to prevent organic mental disorders?

Organic mental disorders, as a rule, are secondary; they arise either against the background of an unfavorable general disease, or are a consequence of external brain damage. Some organic mental disorders can be avoided if the causes of their occurrence are prevented.

Mental weakness with a pronounced decrease in intelligence, thinking, memory, intelligence, and adaptation to society is caused by organic damage to the blood vessels of the brain. Often this process is irreversible and negatively affects the well-being, appearance, behavior, and character of the victim. Even a slight change in brain and nerve tissue causes abnormalities in all systems. The symptoms of the pathology, both in adults and in children, depend entirely on the degree of damage to parts of the brain, because each of its elements is responsible for certain functions of the body.

Causes of the disorder

An organic disease that affects the structures of the brain and nervous system can occur for many reasons. These include:

• Disorders associated with pathologies of the heart, blood vessels and nerves. They are more common in atherosclerosis, Alzheimer's disease, and parkinsonism. Through the narrowed vascular lumen, a sufficient amount of oxygen does not reach the brain, which leads to the gradual death of nerve cells.
• Disorders caused by diseases of internal organs. Changes may occur due to pathogenic processes in the liver or kidneys (eg, hepatitis, cirrhosis, fibrosis). With the accumulation of toxic substances, a high concentration of which negatively affects the functions of the entire body, neural connections are destroyed. Dementia is treatable if detoxification is started promptly.
• Intoxication of the body (with severe alcoholism, drug addiction).
• Head injuries that appear either immediately or later, and remind you for the rest of your life. Patients suffer from periodic attacks of dizziness and cephalalgia. In severe cases, problems with hearing and vision are observed. Paralysis of the limbs, tics, and episyndrome may develop. Sometimes traumatic brain injuries in newborns occur during childbirth. The consequences of such injuries can be quite severe and threaten not only the health, but also the life of the child.

Infectious diseases (abscess, meningitis, encephalitis), cyst growth, for example, echinococcosis, are provoking factors of the disease.

Infectious lesions

Quite a lot of infections lead to the development of organic brain lesions. This:

• Coxsackie viruses are a common cause of aseptic meningitis.
• Herpes, which attacks the central nervous system, causing meningitis and encephalitis.
• Staphylococcus, which causes staphylococcal meningitis.
• Echoviruses that can infect almost any cell in the body.

In addition, HIV infection in advanced stages affects the central nervous system, manifesting itself as an abscess and leukoencephalopathy. Infectious brain disorders manifest themselves:

• Asthenia.
• Psychotic disorganization.
• Affects.
• Personality disorders.
• Obsessive-compulsive disorders.
• Hysteria, neuroses, hypochondria.

Vascular pathologies

Ischemic brain disease, hemorrhagic stroke, DEP (dyscirculatory encephalopathy) are diseases associated with vascular pathologies.

• Ischemia develops due to blockage of the vascular lumen by cholesterol plaques or blood clots.
• In a hemorrhagic stroke, an aneurysm ruptures, causing blood to leak into adjacent areas of the brain.
• DEP provokes a constant lack of oxygen due to diffuse damage to the cerebral vessels. The disorder is characterized by multiple small foci located throughout the surface of the brain.

Signs of brain damage:

• Severe pain in the head.
• Dizziness, the causes of which are initially unclear to the victim.
• Nausea.
• Nervousness.
• Sleep disturbance.
• Fainting.
• Numbness of the limbs.
• Cognitive impairment.
• Affective disorders.
• Parkinsonism.
• Difficulty swallowing.
• Voice change.
• Slurred speech.
• Blood pressure surges.
• Violation of stability.

Demyelinating diseases

Among demyelinating brain lesions, a diagnosis such as multiple sclerosis should be noted. This is a chronic autoimmune disease in which foci (scars) of sclerosis are formed throughout the central nervous system with the replacement of healthy tissue with connective tissue. The myelin sheaths of nerve endings gradually disintegrate, which is accompanied by swelling of the nerve fibers, impaired conduction of impulses, and the formation of sclerotic plaques. The disease affects young people and even children. The disease manifests itself:

• Reduced pain threshold.
• Paresis of the limbs on one side of the body.
• Numbness, weakness.
• Gait disturbance.
• Tremors of the hands and neck.
• Low-grade body temperature.

Poisoning

Serious poisoning of the body is caused by alcohol abuse, drug addiction, poisoning with drugs, mushrooms, heavy metals, arsenic, and combustion products of polyvinyl chloride. Each specific case manifests itself with certain symptoms.

For example, intoxication with psychotropic substances is characterized by the appearance of:

• Dizziness.
• Diarrhea.
• Headache.
• Decreased blood pressure.
• Chills.

Chronic intoxication causes nervousness, lethargy, and decreased performance. Cognitive impairments include decreased intelligence, impaired attention and memory.

Brain injuries

These are contact and intracranial injuries of the face, skull bones, membranes and substance of the brain. These include:

• Concussions, brain contusions.
• Fracture of the bones of the skull.
• Diffuse breaks and tears of axons.
• Compression of the brain.
• Intracranial and subarachnoid hemorrhage.

After such injuries, it is necessary to take into account that the brain may be damaged not only at the site of impact. The counter-impact force also plays a significant role, causing hydrodynamic vibrations that negatively affect the meninges.

Organic brain damage in children

Perinatal (hypoxic) organic disorders of the brain occur both during intrauterine development and after the birth of a child. Any damaging factors can negatively affect the still undeveloped brain and nervous system of the fetus or newborn. These include:

• Preeclampsia, umbilical cord abnormalities, hypoxia.
• Bad habits of the mother (drinking alcohol, smoking, taking drugs).
• Poor nutrition, in which the pregnant woman did not replenish her diet with essential microelements and nutrients.
• Chronic and acute diseases of the expectant mother.
• Trauma during childbirth.
• Weak labor, premature placental abruption.
• Profound prematurity.
• Infectious diseases.

Manifestations of organic brain disorders in infants become noticeable almost immediately. This:

• Trembling of the chin and limbs.
• Muscle hypotonicity or hypertonicity.
• Reduced activity.

It happens that the pathology is weakly expressed, and it can only be detected using special diagnostic methods. If treatment is not promptly addressed, the disorder will begin to progress, increasingly damaging brain tissue.

Symptoms of damage to the entire brain or any part of it are manifested in:

• Cerebrasthenic syndrome, characterized by tearfulness, anxiety, moodiness, weakness, lethargy, and fatigue.
• Tics, enuresis, obsessive fears.
• Cognitive impairment (poor memory, speech delay, difficulty learning new skills).
• Psychopathic syndrome (manipulativeness, inability to sympathize, tendency to narcissism, etc.).
• Mental infantilism of the organic type with apathetic syndrome.
• Minimal brain dysfunction, characterized by hyperactivity, sleep disturbance, loss of appetite, hypokinesia.

Possible complications in the form of cerebral palsy, episyndrome, neuropathy.

Clinical signs

Not everyone knows what organic brain damage is. The main signs of the disorder are:

• Apathy.
• Absent-mindedness.
• Logoneurosis.
• Impaired concentration.
• Lethargy.

Organic brain damage in older people often manifests itself as dementia syndrome, when a person begins to forget the names of loved ones, important dates, and words. With the further development of the pathology, the victim cannot think adequately, form sentences, or express emotions.

Diagnostics

To understand the main causes and symptoms of the pathological condition, the patient is sent to a computed tomography scan of the brain. This study allows you to accurately identify problem areas:

• If there is a disturbance in the frontal lobe, mental abnormalities, loss of smell, and difficulty speaking are possible.
• The parietal area affected by damage is manifested by decreased attention, night and daytime cramps, and disruption of all types of senses.
• A disorder in the temporal lobe manifests itself in the form of episyndrome, logoneurosis, and hearing loss.
• Hallucinations, decreased visual acuity, and impaired stability occur when the occipital part is damaged.

Treatment

The main feature of all types of organic brain lesions is the inability to restore damaged neural connections. With proper treatment, the disease can be stopped and healthy areas can be stimulated. To eliminate the manifestations of pathological changes in the brain, the following groups of drugs are used:

• Drugs to improve blood supply to neurons.
• Neuroprotectors that thin the blood and ensure blood circulation in the tissues.
• Anticonvulsants.
• For infectious pathology, treatment consists of taking antibiotics and antiseptics.

Be sure to prescribe a massage that improves blood circulation and physical therapy that relieves spasms. Correcting a condition that is accompanied by mental disorders requires complex therapy, including medication:

• Tranquilizers.
• Antidepressants.
• Sedatives.
• Nootros.

And psychotherapy using:

• Psychoanalysis.
• Autotraining.
• Art therapy.

The patient’s age and individual characteristics play a major role in determining the treatment regimen.

Consequences

With or without therapy, the following outcome is possible:

• Recovery occurs when the brain damage is insignificant, the manifestations of the disorder are mild and have practically no effect on the body.
• Disability and incapacity for work, when a person cannot care for or provide for himself.
• Fatal outcome. Possible if the disease occurred in old age, and the therapy was carried out by an unqualified doctor.

If pathology is identified in time and proper treatment is prescribed, then newborns have a greater chance of a full recovery. Positive dynamics in therapy for older people is observed only in half of the cases.

A diagnosis such as organic brain damage is very common today. This is due to the fact that this is not just one disease, but a whole group of different pathologies that are characterized by at least some structural pathological changes in the brain tissue.

According to neurologists, such a diagnosis can be given to 9 out of 10 people of any age. But, fortunately, most often the organic changes are so minimal that they have absolutely no effect on the functioning of the brain or the patient’s well-being. In the case when symptoms of such a disorder begin to appear, it can be assumed that most of the brain has undergone pathological changes (approximately 20-50%), if the number of damaged neurons exceeds 50%, then persistent pathological symptoms and syndromes develop, which we will discuss below.

Video lecture on organic brain damage:

What it is?

For comparison, functional disorders of the brain do not have a morphological substrate, but pathological symptoms are still present, for example, schizophrenia, epilepsy.

Depending on the etiology, organic brain damage can be diffuse (dyscirculatory encephalopathy, Alzheimer's disease, etc.) or localized (tumor, injury, stroke, etc.).

Accordingly, the symptoms will differ. In the first case, organic brain damage is most often manifested by memory impairment, decreased intelligence, psychoorganic syndrome, cerebroasthenia, dementia syndrome, headache, and dizziness. The second option most often occurs with general cerebral and focal neurological symptoms, which depend on the location of the pathological focus and its size.

Causes of organic brain damage

There are many causes of organic brain damage. Let's look at the most common ones.

Vascular diseases of the brain

This group of causes of organic damage to brain tissue includes hemorrhagic and ischemic stroke, dyscirculatory encephalopathy, and chronic ischemic brain disease. The root cause of such disorders is considered to be hypertension and atherosclerosis. They usually manifest themselves as a psychoorganic syndrome, and in the case of a stroke, focal neurological symptoms are also associated

Neoplasms of brain tissue

Traumatic brain injury

The consequences often make themselves felt not only by headache and dizziness, but also by organic damage to brain tissue. The degree of the latter and, accordingly, the symptoms depend on the type of injury (concussion, bruise, compression, traumatic hematomas) and its severity. Disorders may include both psychoorganic syndrome (from latent to pronounced forms) and focal symptoms (paresis, paralysis, impaired sensitivity, vision, speech, etc.)

Infectious lesions

There are a lot of infectious agents that can penetrate the blood-brain barrier and affect the membranes and brain tissue itself. These are viruses, bacteria, fungi, protozoa. All these pathological microorganisms can cause the development of meningitis, encephalitis, arachnoiditis, and abscesses. As a rule, the course of such lesions is acute and with adequate treatment all symptoms disappear completely, but sometimes residual effects in the form of cerebroasthenia, mnestic and other mental disorders can be observed.

Chronic and acute intoxications

Intoxication with damage to brain neurons can occur as a result of alcohol poisoning, drug use, tobacco smoking, the use of certain medications, liver and kidney failure (endogenous intoxication), poisoning with pesticides, household chemicals, carbon monoxide, mushrooms, salts of heavy metals, etc. symptoms depend on the toxic substance, the time of its influence on the body and the dose. Any symptoms are possible, including intoxication psychoses with hallucinations, deep coma and dementia.

Neurodegenerative diseases

These diseases usually affect older people and are the cause of senile dementia in 70-80% of cases. Most often we have to deal with Alzheimer's disease, Pick's dementia, and Parkinson's disease. With these pathologies, the cause of which is unknown, damage and death of brain neurons occurs, which is the cause of various mental disorders. Most often, such patients suffer from dementia, depression, anxiety disorders, and mental disorders.

Important to remember! Determining the exact type and individual nosology in the presence of signs of organic brain damage is very important, as this makes it possible to specifically treat a person, and not just eliminate the symptoms of the disease. By influencing the cause of the lesion, you can achieve significant improvement and disappearance or reduction in the severity of pathological symptoms.

Main symptoms

As already mentioned, the main manifestation of organic brain damage is psychoorganic syndrome and dementia.

Psychoorganic syndrome includes 3 main symptoms:

1. Memory loss– the ability to remember new information decreases, false memories appear, and some memories are lost (amnesia).
2. Weakening of intellectual activity. The ability to concentrate decreases, distractibility increases, thinking is disrupted, a person captures only individual details, and not the entire phenomenon as a whole. Orientation in space and one’s own personality is gradually disturbed. A person loses the ability to adequately assess the situation and his actions.
3. Cerebroasthenia and affective disorders. Cerebroasthenia is increased general weakness, constant headache, dizziness, and increased emotional exhaustion. Affective disorders consist of increased irritability, depressive disorders, decreased interest in the environment, and inappropriate emotional response.

Dementia is an acquired, persistent decline in a person’s cognitive activity. Unlike dementia, which can be congenital, dementia is the breakdown of mental functions as a result of organic damage to the brain. In some cases, it is so pronounced that the person completely loses the ability to self-care.

Signs of the disease, depending on the location of the lesion (focal symptoms):

1. Damage to the frontal lobe of the brain– convulsions, paralysis of the oculomotor muscles, motor aphasia (inability to pronounce words), inability to perform purposeful movements, mental disorders (defiant behavior, sloppiness, euphoria and impaired criticism of one’s behavior), impaired olfactory function, monoparesis of the limbs, paralysis of facial muscles.
2. Damage to the parietal lobe– impairment of all types of sensitivity, convulsive seizures, inability to count, read, or perform purposeful actions.
3. Damage to the temporal lobe– disorders of taste, hearing, smell with possible hallucinations, temporal lobe epilepsy, sensory aphasia, emotional lability.
4. Damage to the occipital lobe– loss of visual fields, blindness, loss of balance and coordination, visual hallucinations, seizures.

Thus, signs of organic brain damage depend on the primary pathology, the localization of pathological foci, their number and distribution in the brain tissue.

bad habits of a woman during pregnancy;

young age of mother (up to 18 years);

infectious diseases in women during pregnancy;

toxicosis;

genetic pathology;

complications of pregnancy (Rhesus conflict, polyhydramnios, placental insufficiency, etc.);

TORCH infections;

the effect of radiation;

hypoxia and ischemia during childbirth;

trauma during childbirth.

The high degree of plasticity of the brain in a newborn allows in most cases to overcome all pathological changes, therefore the child often does not have any symptoms after such a lesion. But in some cases, residual phenomena remain, which can be transient or develop into a more severe pathology - cerebral palsy, hydrocephalus. Oligophrenia, epilepsy.

Organic psychosyndromes.

Acute organic psychosidromas are conditions in the clinical picture of which some disturbances in clarity of consciousness(drowsiness, stupor, coma) and changes in perception(confusion, illusory deceptions, hallucinations, delusional perceptions) after direct or indirect exogenous brain damage. Unlike them, when endogenous psychoses no physical cause can be established. In childhood exogenous(organic) psychoses often look like endogenousnew, a endogenous psychoses - how exogenous. Careful psycho- and somatodiagnostic clarification is necessary. Incorrect diagnoses often become the reason for ideological battles between “psychics” and “somatics”. You should definitely formulate a holistic picture of the disease.
The clinical picture of chronic organic psychosyndromes depends on at what stage of the child’s development the brain damage occurred. The general rule applies: the sooner this happened, the more severe the consequences. If the damage occurs in the 1st-5th month of pregnancy, then the result is mental retardation, but if it occurs between the 6th month of pregnancy and the 18th month of life, then the result is early organic damagebrain. With a later onset, personality changes manifest themselves, as is observed with post-encephalitic and post-traumatic manifestations of the disease.
Cause of early childhood brain damage there may be a variety of disorders in the prenatal period, during childbirth and after birth, for example: physical damage, poisons, medications, alcohol, epidemic rubella or infantile paralysis, maternal antibodies (Rh factor), metabolic disorders (in particular diabetes), hypofunction thyroid gland, pre-, peri- and postnatal asphyxia.
Acute organic psychosyndromes may be caused by subsequent diseases and lead in the future (in some cases) to personality changes of the type chronic organic psychosyndrome. The connection between the acute illness and later mental features must be supported by “bridge symptoms”, i.e. persistent symptoms. A history of organic disease leads to the fact that behavioral characteristics are subsequently attributed to the disease, while psychosocial causes are ignored.

Common diseases that occur with high fever.

Common diseases of bacterial and viral origin that occur with high fever, the so-called febrile delirium, are characterized by disorientation, confused speech (“fantasizing”), illusory disturbances of perception and limited ability to perceive, and reactions with very minor disorders of consciousness.

Encephalitis and meningoencephalitis.

We are talking about primary inflammatory diseases of the brain with or without the presence of mekingeal phenomena caused by bacterial infections or neurotropic viruses. Currently rare Encephalitis lethargicaand Polioencephalitis, a special form of infantile spinal palsy with predominant damage to the brain. Recently, it has been noted that various types of viruses cause atypical clinical manifestations of encephalitis. The leading symptoms are: neurological symptoms of prolapse, seizures, sleep rhythm disturbances and unstable psychopathology. Relatedencephalalitidsc severe course and frequent death are observed in childhood diseases - mumps, measles, chickenpox, rubella, influenza, ECHO, Coxsackie, herpes and other viral diseases, as well as as a complication after vaccinations, for example against smallpox (post-vaccination encephalitis). The main symptoms are: impaired consciousness, high fever, seizures, neurological symptoms (loss). EEG changes and pathology in the cerebrospinal fluid are important for diagnosis. The question remains controversial as to whether there is specificpostencephaliticsyndrome. It is not possible to prove an unambiguous connection between certain behavioral characteristics and previous encephalitis. It is noted that immediately after an infectious disease, signs of mental retardation (of varying degrees of severity), partial dysfunction, changes in affectivity and motor skills may appear, forming the syndrome cerebral dysfunction. The nature of the relationship between the child and his environment may be decisive for the scale of the consequences of the illness.

Psychoses due to damage to the brain stem.

We are talking about rare forms of encephalitis that begin between the third year of life and puberty (mainly at the age of 13-15 years) and, along with neurological symptoms and psychoorganic syndrome, manifest themselves in the form of psychosis, reminiscent of an endogenous disease. The prognosis of the disease is favorable. In most cases, recovery occurs without the formation of a defect. The clinical diagnosis can be confirmed by a picture of the cerebrospinal fluid and EEG data. There is no specific therapy.

Leukoencephalitis.

In leukoeecephalitis, the appearance of neurological symptoms is preceded by a long prodromal stage with uncharacteristic behavioral disorders. Initially, success in school decreases, as an expression of a progressive deficit in mental and physical functions, speech disorders, loss of interests, increased readiness for fear, and timidity appear. It is important to distinguish the clinical picture from the development simple form of schizophrenia. The diagnosis is supported by a picture of the cerebrospinal fluid (increased number of cellular elements and protein) and EEG data (Radermecker complex).

Traumatic brain injuries.

Traumatic brain injuries can, depending on the severity, cause, as in adults, disturbances of consciousness, various transient syndromes, contusion psychoses or apallic syndrome (Kretschmer syndrome). The severity of traumatic brain injury can be assessed by the duration and depth of loss of consciousness and post-traumatic amnesia. The more severe these manifestations, the more severe the long-term consequences, such as decreased intelligence.
Among reasons traumatic brain injuries, as well as the causes of child mortality, are in first place in Western Europe accidents related to transport incidents. The annual risk of traumatic brain injury with cerebral symptoms is estimated at 1% for boys and 0.5% for girls!
Along with the immediate psychoorganic consequences of injuries mental reactions the child and his loved ones are an integral part of the post-traumatic situation. The degree of recovery depends on the extent of the painful consequences and the targeted application of rehabilitation programs. even children with severe injuries have significant functional reserves, which, as a rule, are not taken into account when determining the forecast. Scale post-traumatic consequences(psycho-organic syndrome, ROM) become obvious after about two years. Along with the symptoms of prolapse caused by focal lesions, such as frontal syndrome and classic impairment of skills, a hyperkinetic syndrome appears, which must be distinguished from a similar one observed with a lack of volitional impulses and inhibition. The clinical picture is quite varied. Global disorders are relegated to the background, giving way to focal lesions with isolated specific limitations of individual functions. There are disorders of visual attention, changes in mood with euphoric or irritable-aggressive episodes, as well as restrictions on mental and intellectual mobility and specific restrictions on cognitive and motor functions. In 10-30% of cases, post-traumatic epilepsy develops. Probability of appearance psychoreactive neurotic disorders increases in parallel with the severity of functional impairment: The risk of developing mental illness after a severe traumatic brain injury is very significant, and its probability is estimated at approximately 70%.

Hyperkinetic syndrome.

Synonyms: overly active child, child with hyperkinesis, psycho-organic syndrome (POS), childhood hyperkinesis syndrome, minor brain damage, brain damage syndrome, minimal cerebral dysfunction (MCD), mild congenital cerebral dysfunction, organic brain mental axial syndrome, early childhood brain damage , early childhood exogenous psychosyndrome, attention deficit disorder (DSM III).

Clinical picture . The main features are: attention deficit not appropriate for the developmental period, hypersensitivity to stimuli, decreased sense of fear, impaired sense of distance when communicating, increased impulsiveness and observed in some cases sharply increased motor activity. The level of mental abilities can range from normal to partial weakening of individual abilities(described in the corresponding section). A very high degree of distractibility does not allow children to maintain the required position for a long time during various activities that require a certain perseverance and attention. This is reflected, for example, in age-appropriate games, during class activities, and when doing homework. The described manifestations are not an expression of insufficient motivation; they are caused by a continuous fluctuation in the focus of attention, which chooses first one object or another as the object of its interest. In impulsive, thoughtless, hasty actions, children seem to be galloping. The decision is made before the consequences can be considered. Actions precede intentions. In addition, such children are characterized by low self-esteem. They are easily vulnerable and in their moods and affects easily move from rage to depression. In motor-hyperactive children(“jumpers”) there is a pronounced motor impulse to perform aimless, continuously following each other movements of “continuous jumping”. Variants of the clinical picture in to a certain extent depend on age, developmental dynamics, reactions to loved ones and to the more distant environment and, above all, on the relationship between children and parents, the situation at school. The latter is directly related to the degree and nature of some of the weakness of the functions of these children. The specific psychopathology of hyperkinetic syndrome develops regardless from early childhood brain damage or brain dysfunction. It would be erroneous to evaluate or describe this clinical picture as “minimal cerebral dysfunction” (MCD), as was common in the past. Impaired brain function is neither a prerequisite nor a consequence of the development of this psychopathological syndrome. Only 39% of children aged eight years, who are at increased risk of developing a mental disorder, show objectively demonstrable signs of brain dysfunction (EEG abnormalities and neurological microsymptoms). On the contrary, 25% of all eight-year-old children with impaired brain function develop mental abnormalities, which, under certain circumstances, are also associated with hyperkinetic syndrome. According to the current level of knowledge, hyperkinetic syndrome is an independent nosological unit. The symptoms of this syndrome are considered to be a manifestation of developmental failure and thus a sign of immaturity. Manifestations of immaturity are defined as deviations in development from age-appropriate food. Fluctuations in qualitative characteristics and rates of the maturation process confirm that the mentioned disorders may appear earlier or later, i.e. before or during puberty, for example between 8 and 13 years. Thus, the characteristics of the symptoms that appeared indicate the absence of a causal relationship between them and the syndrome of early childhood brain damage. These syndromes develop before the age of eight. To a much greater extent we are talking about general or specific developmental deviations. This is a characteristic of the clinical picture of hyperkinetic syndrome in child psychiatry. If the symptoms of certain syndromes include impairments in abilities (for example, partial weakness of abilities), then they should be described along with objectively confirmed neurological or neurophysiological disorders. There is no causal relationship with the psychopathological picture. The role that partial weakness of individual abilities plays in the occurrence of child psychiatric pathology should be established in the future with the help of special studies. It has been proven that children with partial abilities are at increased risk of developing mental illness, especially when their understanding of spoken language is impaired. In addition, it must be scientifically proven what role objectively confirmed disorders of brain function play in childhood psychiatric morbidity.
In the pathogenesis of hyperkinetic syndrome, an important role is played by the relationship between the child and his parents, as well as, possibly, genetic factors. This must be taken into account in the practice of therapeutic counseling. The loss of justifying organic factors that would help relieve parents of responsibility for the pathogenesis of this syndrome may awaken in them an increased sense of guilt for their failure to raise a child. Educational work with parents and their involvement in treatment is necessary.

Partial weakness of individual functions.

By partial weakness of individual functions we mean a decrease in the ability of individual functions of the central nervous system with established localization while maintaining the functions of the brain as a whole. Individual abilities may be impaired individually or in combination with others. Unlike classical patterns of disability, in the described phenomenon there is no possibility of precise localization of neuro-anatomical functional affiliation. The consequence of weak abilities is difficulties perception and differentiation of external stimuli, as an expression of retarded development by the sense organs concerned, whether in the sense of persistent deficiency or retarded development only. Scroll recognized weaknesses of individual abilities is becoming more and more extensive. Possibility of them classifications based on symptoms, i.e. of impaired individual functions is a prerequisite for assessing complex abilities. There are also weaknesses in abilities, related to sensory orientation. If, for example, it is reduced visual ability of visual perceptions, then the perception of visual impressions - gestures and facial expressions of those persons with whom the child communicates - is also impaired, as well as the understanding of the abstract semantic and symbolic content of images of the surrounding world. This can lead to severe impairment of social behavior and developmental delays. If violated auditory perception ability then individual sounds may turn out to be unrecognized or indistinguishable, in whole or in part, by their strength, sonority, pitch and sequence. This makes others assume that the child has poor hearing. The described disorder can be expressed symptomatically in the form of delayed speech development. If slow tactile-kinesthetic orientation, the result of this may be a decrease in the ability to distinguish between the right and left sides and weakness in spatial orientation.
Along with other various manifestations of weakness of partial abilities related to sensory orientation, there are partial weakness of abilities, related to the process perception and storage of information, her inintegration and reproduction.
Legasthenia is a syndrome that is expressed in difficulties in learning to read andspelling(LRS). Reading the text fails because the child “gets stuck” on “gluing” letters together or reads incorrect, arbitrarily modified words. The repetition of individual syllables occurs with errors. It is typical to mix up individual letters that are difficult to differentiate, for example d, g, p, b, or a, o. There are mirror spellings of words or entire phrases, changes in the correct sequence of letters in a word, omissions of letters or repeated spellings, as well as slipping, climbing or merging when writing individual words. Final syllables are omitted or, conversely, repeated. The center of gravity of the described violation may be in spoken or written language. Occurs in varying degrees of severity and in combination with weaknesses in other abilities, such as specific counting disorders. Secondary disorders in children with LRS: dissociation, emotional disturbances, including aggression, psychosomatic symptoms. To diagnose partial weakness of abilities, the method of choice is herropsychological testing. To carry out testing, special professional knowledge is required. It is also necessary to use various testing techniques, take into account family and personal history, neurological examination and a modern psychiatric approach.
Therapy. In case of partial weakness of abilities, which becomes especially important at school age, especially with LSR, functional training can only be recommended if one has knowledge of the child’s family situation. Experience shows that the weakness of individual functions is an expression of functional disorders and family dynamics that cannot be differentiated either by psychological testing or clinically. If LRS is, for example, a symptom of an overestimation in the family of a child’s school performance, then this symptom will be further intensified by the prescribed training treatment.
The duration of treatment using the function training method is 1-2 years, with psychotherapy - several years. In this case, therapeutic sessions of short duration are prescribed in small groups (4-6 children). Various options are used, from purely therapeutic to study groups and homework groups.

Treatment of a child with brain damage.

Explaining to parents all issues related to child developmental disorders requires that doctor refused the role of “healer” and made every effort to conduct a confidential dialogue with them. If the doctor succeeds, then we can consider that the first step in treating the child has been taken. Clarity about the nature and causes of violations often comes from parents the child has the opportunity to free himself from the burden of fantasies about his own guilt, insolvency, worthlessness and punishment. If the cause of the defeat cannot be determined, then this ignorance should be recognized and communicated to the parents. Finally, accurate knowledge of the child's limited functions is more important than the question of whether there is real brain damage or whether the damage is imaginary. Convinced that their hopes for a healthy child are deceived, parents find themselves at the mercy of deep narcissistemotional experiences, which cause them to appear defense mechanisms. They need to be recognized and processed in order for the child’s treatment to be successful. There are different types of defensive play. Some parents try to resort to self-deception and consider the child healthy while this is still possible (denial of the disease), others accuse the specialist doctor of incompetence and move from one doctor to another (projection), some parents react in the form of self-blame and complicity in the child’s illness, increased fears, pampering the child or, conversely, withdrawing him and abandoning him (formedreactions). Other parents “mechanize” their relationship with the child, for example, attaching great importance to the ritual of care, excluding the emotional component from it (insulation), etc. Often the internal ambivalence of parents towards the child is expressed in the desire to place the child in a boarding school. If unconscious motives and intentions are discussed with parents, then in most cases, after realizing disappointment and depression, a good understanding of the sick child occurs. This is the best prerequisite for success in treatment. The advice of the attending physician should always be consistent with the subjective and objective capabilities of the parents and the child. During treatment, parents must take on specific therapeutic tasks, such as ongoing exercise. At the same time, it is important that the construction of the therapeutic process is meaningful, that the treatment is targeted, and that the child’s functional successes are noted during its implementation. The best indicator of a well-mastered therapeutic process is active participation child, who is pleased to note the successes he has achieved in improving functions. New types of treatment and more refined diagnosis of developmental features have led to a shift from passive observation to active therapeutic actions in treatment of children with brain lesions. Early recognition and perhaps more early initiation of targeted treatment already in the first three years of life they significantly increase the chances of cure, as evidenced by the accumulated experience. In the most favorable cases, you can count on full compensation for violations. Depending on the nature of the disorders, physiotherapy according to BobarthKonig, the use of assistive devices (for example, hearing aids already in the first year of life), speech therapy, home speech improvement, perceptual training, music, treatment with games, occupational therapy, therapeutic pedagogy and periodic medication are indicated. treatment. Since the rapid progress of perinatal medicine suggests a further increase in the number of viable children at risk with partial brain lesions, currently accounting for approximately 10-20%, the individual and social significance should not be overestimated early therapy, as well as prevention secondary neurotization.
Application child analytical therapy also indicated for children c secondary neurotization, suffering from insufficient attention, when the leading symptom is not fear, but disinhibition. Hyperactive children are unlikely to experience fears. The goal of therapy is to find the necessary tone, consonant with the child’s perception, and to let him feel fear as a warning signal (for example, a red traffic light as a signal prohibiting crossing the street). Therapy can be successful if the therapist reveals his intentions as little as possible, if he achieves insight into the child’s feelings and causes the latter to revive the impulses of perception and defense. The technique chosen by the doctor undergoes changes to the extent required by a shift in emphasis from drives to strengthening defense mechanisms. At the same time, the doctor’s goal is to transfer to parents and educators the previously taken away functions.

The brain is the most complex and most important organ in our body. It is thanks to him that we are superior to all other species. The brain processes all information and all actions that the body performs.

It controls all cells and is responsible for their adaptation to constantly changing environmental conditions. So, from simple tissue - skin, cells evolved into nerve cells. The former have only mechanical properties: protection, permeability. While the nervous ones in their entirety are capable of learning and allow one to remember information and coordinate thoughts.

However, any physical or chemical process must be provided with energy and nutrients. Therefore, proper nutrition, the absence of negative factors and pathological processes are necessary for long and fruitful brain function.

Different types of brain lesions

Since there are a lot of brain disorders, it was advisable to come up with a classification that would cover all diseases:

Organic brain diseases: their types

Organic brain damage (OMD) is characterized by the presence of pathological changes that can be seen using neuroimaging methods.

Any pathological processes are visualized and correlated: benign cysts, amyloid accumulation.

A feature of organic lesions is that there is a substrate in the brain. For example, he also has neurological pathological symptoms, but it is impossible to “see” anything. Organic disorders can be either local or diffuse. Symptoms are also different. With local damage, one type of activity is impaired (intellect). And with generalized symptoms, general cerebral symptoms appear.

Types of organic brain lesions:

Residual organic damage: causes and symptoms

Residual organic damage is the consequences that appear after damage to brain structures in the perinatal period (from 22 weeks of pregnancy to 7 days after birth).

Despite the fact that premature pregnancy is not a mandatory indication for organic brain damage, a weakly developed nervous system is very vulnerable to any unfavorable factors, and since the neuromuscular response has not yet been formed, pathological processes may occur.

The causes of residual organic damage are:

• diseases at the chromosome level;
• insufficient consumption or supply of oxygen to the mother’s body and the associated fetus;
• radiation;
• ecology;
• use of medications or cleaning products;
• poisoning of the expectant mother with alcohol or drugs;
• poor nutrition, expressed in insufficient consumption of micro or macro substances;
• acute or chronic diseases of women;
• pathology of pregnancy.

Any of these factors can lead to slow growth of the baby, which will provoke organic brain damage in children. The clinical picture of this lesion appears immediately after birth, which can be determined not only by a neurologist.

However, it is worth noting that some pathologies can be reversible with the right lifestyle and nutrition. Therefore, it is very important to consult a doctor for help at the initial stages in order to begin treatment as early as possible and in the future forget about any manifestations of organic brain damage.

Clinical picture of acute hypertension

There are practically no specific symptoms that appear with organic brain damage. This is due to the fact that any manifestation depends on the underlying disease, which led to brain damage.

You can identify symptoms that will be characteristic of almost all concomitant pathologies:

• decreased activity;
• apathy, lack of interest in something;
• sloppiness appears.

A rarer symptom, but also common. Patients may forget the names of their relatives or friends, or their appearance. There is a violation of counting and people will not be able to list the numbers from 1 to 10 or remember the sequence of days of the week.

Writing disorders manifest themselves in the rearrangement of syllables and words. In the most severe cases, a person will not be able to speak independently, but will only be able to repeat a small phrase that he hears. Emotionally, there are several possible outcomes.

Or the person becomes kind of unemotional, reacting to everything too calmly, which can’t help but be noticeable. Or, on the contrary, the manifestation of emotions is inadequate and perverted. Hallucinations may occur.

Establishing diagnosis

Diagnosis of organic focal diseases of the brain is important both at the earliest stages and at later stages with already prescribed treatment. Early detection of the disease will allow you to take action and prescribe medications that can stop its progression or even reverse it.

The most important diagnostic stages:

• taking anamnesis;
• neurological examination;

Foci of organic brain damage are shown by arrows

Anamnesis allows you to determine the duration of the disease, its course, and its connection with heredity. A neurological examination is mandatory to identify the causes. Tomography identifies atrophic lesions that cause symptoms.

Providing medical care

A feature of the nervous system is that restoration of neural connections is impossible. You can only increase the activity of the surviving parts of the brain.

The main groups of drugs prescribed for the treatment of organic brain damage:

In addition to drug therapy, the following general strengthening and therapeutic measures are prescribed:

• massage that improves blood circulation to the brain;
• , to improve cerebral circulation and relieve spasms;
• individual or group classes with a speech pathologist and psychologist.

Possible outcomes

All possible consequences and outcomes are divided into three points:

1. Recovery. This is possible if there are no visible defects and the depth of the lesion is small.
2. Disability. The patient is alive, but to a greater or lesser extent loses the ability to work and take care of himself.
3. Disability. Without outside help a person cannot survive.
4. Death.

Any consequences depend on the massiveness of the lesion, the location of the pathological process, age, etiological factor and correctness of treatment.