Also called cerebral softening, encephalomalacia is a condition marked by softening of brain tissues, often due to hemorrhage or inflammation. Such softening is generally restricted or localized, but it may also be widespread. Encephalomalacia can affect varied sections of brain and cause tissue damage in the occipital, frontal, temporal, and parietal lobes. The affected section of brain ceases to function completely.
Encephalomalacia affects children, adults, and even unborn babies. In rare instances, degeneration or deterioration of brain may result in significant softening of brain matter.
Symptoms of encephalomalacia
The signs and symptoms of encephalomalacia can range from mild to severe and are primarily dependent on the area of brain that is affected and stops performing its functions.
A few common symptoms are listed below:
- Somnolence, i.e., excessive urge to sleep or bouts of drowsiness
- Head pressing
- Severe headaches
- Ataxia, i.e., reduced coordination, clumsy or wobbly movements
- Permanent or temporary case of blindness or impaired vision
- Loss of memory and/or mood swings if frontal lobe is affected
- Vertigo, i.e., severe sensation of head spinning
- Terminal coma
- In some cases, encephalomalacia may cause the brain size to vary which can then cause brain pliability to alter
Types of encephalomalacia
As per the area of brain that gets affected, encephalomalacia is classified into the below listed 2 types:
- Leukoencephalomalacia: It affects the white matter. The affected brain area transmits nerve signals all across the cerebrum and between the cerebrum and centers of lower brain
- Polioencephalomalacia: It affects the grey matter. Affected people may elicit significant reductions or loss of muscle control, sensory perception, speech, emotions, and memory.
The advancement of cerebral softening can also be categorized as per the stage and extent of brain damage and the colors:
- Red softening: This phase occurs after a hemorrhagic infarct, i.e., tissue death which occurs due to minimal or nil oxygen supply triggered by blocked veins in brain. The tissues become redder due to entry of red blood cells in the region of hemorrhagic infarct. Embolism may occur due to gas bubble, blood clot, fat globule, or alien matter in blood.
- Yellow softening: Increased softness and yellowing of brain tissue may be caused by accumulation of atherosclerotic plaque in the arteries of the brain. Simultaneously, there is buildup of yellow lymph around the brain’s choroid plexus which results in yellow color.
- White softening: It occurs in an area of brain with minimal or nil blood flow. As a result, there is death of neuronal tissues.
Causes of encephalomalacia
Encephalomalacia can occur in people of all age groups. However, the manifestation of the condition varies between the different age groups. Affected infants experience more severe problems as compared to adults; this is because adult brain has ability to recover damaged brain tissue and/or compensate for loss of abilities by using other non-damaged areas of brain for similar purposes/abilities.
Some causes of encephalomalacia are listed below:
- It can occur due to some kind of severe injury to head which causes hemorrhage or bleeding in brain.
- It can be caused by a stroke. A stroke causes death of a certain section of brain. This results in substitution of neurons by scar tissue made of astrocytes. Contractions of the scar tissue eventually cause encephalomalacia.
- Different health disorders and diseases can cause encephalomalacia-associated brain function decline
- Deterioration or degeneration of brain is an uncommon cause
- Encephalomalacia often occurs in brain areas with abnormal buildup of blood
- Brain infection by a biological germ or chemical toxin. The infection may directly affect the brain, or may pass into the brain via bloodstream, etc.
- Sometimes, cerebral softening can occur due to insufficient blood supply. Such blood flow disturbances may occur due to stroke; severe brain swelling; blockages in blood vessels that supply blood to brain; and surgical removal of brain tumors that have severely damaged or destroyed adjacent brain tissues.
- A mini-stroke
- Craniocerebral trauma or traumatic brain injury (such as penetration of bullet or other objects into brain, forceful blow to brain, etc.) marked by brain malfunction
- Studies show a link between low sugar and elevated protein in cerebrospinal fluid as a risk factor to encephalomalacia in the future triggered by some viral infection or disease
- Birth trauma was thought to be a cause in the past. But that is not the case now as there is no evidence to back up the theory.
- Infection or asphyxia can cause degeneration of brain’s white matter in newborns and result in cerebral softening.
Treatment of encephalomalacia
There is currently no way to cure or re-grow brain tissues that are damaged, destroyed, or dead. Hence, there is no cure for encephalomalacia or its damaging effect on different body functions.
Treatment is usually aimed at early detection of cerebral softening, ascertaining its underlying cause, and treating the underlying causative condition.
Severely damaged brain tissue may be surgically removed. However, surgery may or may not help improve varied functions or sensations.
Research is currently on to find if stem cell therapy can be used for treating encephalomalacia.
