Cerebral Softening – Types and Symptoms

Cerebral softening is also known as encephalomalacia. The brain tissue is softened because of various mechanisms. It affects anyone, including developing babies. The softening takes place in a specific part of the brain, causing brain damage. It leads to complete loss of function of the localized area of the brain

 Causes of Cerebral Softening

The major cause of this condition is a restricted flow of blood in the brain. The tissue dies and is liquefied. This process is called liquefactive necrosis. The restricted flow of blood to the brain can be caused by:

  • Cerebral Infarction- This is when there is a blockage to the blood vessels in the brain.
  • Cerebral Ischemia- This is a condition where the blood vessels do not transport enough blood in the brain.
  • Cerebral Hemorrhage- This is when a blood vessel breaks which causes bleeding in the brain. 
  • Microbial Infection- Organisms such as bacteria, virus, or fungi can cause an infection in the brain (encephalitis) or an infection on the membrane covering the brain (meningitis).
  • Traumatic Brain Injuries

In newborns or fetus, cerebral softening is caused by decreased oxygen supply in the brain. This condition causes multicystic encephalomalacia. Decreased oxygen supply could be caused by:
  • Asphyxia-This is a condition where that affects the umbilical cord resulting in the fetus lacking an oxygen supply.
  • Meningitis 
  • Encephalitis
  • Twin to Twin Transfusion Syndrome
  • Contraction of infections commonly called TORCH. This stands for Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes Simplex Virus. Infection of either of these diseases could lead to a decreased supply of oxygen to the baby.
Types of Cerebral Softening
 
Cerebral softening can be classified according to the part of the brain affected, the color of the cerebral softening or the onset of the condition. Classification according to color includes:

  • Leukoencephalomalacia- This is softening that affects the white matter. The white matter is responsible for communication between the different parts of the brain. Softening of the white matter could affect vital functions such as heart rate, body temperature control, breathing rate, and blood pressure. 
  • Polioencephalomalacia- This is the softening of the gray matter. It is also known as cerebrocortical necrosis. It is caused by the interruption of vitamin B1 production or if there is a vitamin B1 deficiency. The gray matter is responsible for neurological activities. Softening of the gray matter affects muscle control, memory recall, speech, and sensory perception.
Softening depending on the color is classified into three groups namely:

  • Red Softening- The affected brain regions appear red. The cause of the softening is bleeding infarct. Blood is accumulated around the brain tissue, causing it to soften. This condition can also be caused if blood flows to a region that was initially blocked by an embolus. An embolus is a clot from the carotid or heart valve that moves to one of the blood vessels that supply nutrient and oxygen to the brain and is lodged. Blood flow to that region of the brain is stopped. The embolus may disintegrate and dislodge, resulting in reflow of the blood. A hemorrhage occurs and tissue appears red in color. 
  • White Softening-This softening is white in color. It is caused by a poor blood supply to the brain because of an occlusion in the artery. The lack of blood gives the tissue a white appearance.
  • Yellow Softening- This softening is yellow in color. It is caused by a buildup of atherosclerotic plaques in the arteries. It can also occur in a brain injury where the choroid plexus surrounds the yellow lymph. 

Concerning the onset of encephalomalacia, it can be classified into two groups namely:

  • Early Onset- The condition occurs in newborns. The affected brain areas develop multiple cystic cavities, a condition called multicystic encephalomalacia.
  • Late Onset- This is when the condition occurs in adults.

Signs and Symptoms
 
The patient may experience some or all of the following symptoms:

  • Vertigo
  • Blindness
  • A headache
  • Drowsiness
  • Loss of speech
  • Paralysis on one half of the body
  • Increased pressure in the head
  • Terminal coma

If left untreated it may result in:

  • Death
  • Seizures
  • Functional disability

Diagnosis

To confirm the presence of cerebral softening, a magnetic resonance imaging (MRI) is done to the brain. Alternatively, a computerized tomography (CT) scan can also be conducted as a diagnostic test. The cerebral softening in newborns and infants is visualized as cavities where the normal brain tissue is meant to be. In adults, the softening is characterized by depleted volumes of chunks of the brain, especially at the frontal and temporal lobes.

Treatment

There is currently no cure for cerebral softening. This is because it is not possible to stimulate the body to generate new brain cells or to restore the function of the damaged cells. However, there is a lot of research going on how to restore the function of the partially damaged brain matter using stem cell therapy. The stem cells can be stimulated to function as nerve cells.

Effective treatment relies on early diagnosis. The affected part can be surgically removed. The downside to this treatment is that the remaining unaffected part of the brain goes through many changes to adjust to the missing section of the brain.

Prognosis
 
Infants born with encephalomalacia are much more severe. It is not possible to save the baby. Even you find doctors who succeed in performing the treatment, the infant will be left with neurological defects. Early diagnosis and proper treatment are essential in controlling the illness. Adults have a better prognosis. Through surgical removal of the cerebral tissue, they are able to manage the situation.

Life expectancy

The life expectancy varies from one person to another.  It is dependent on the appropriate treatment. However, infants have a shorter lifespan as compared to those who develop the illness later on in life. Cerebral softening is one of the most serious types of brain damage. So, if you have encephalomalacia, find doctors right away or visit your local healthcare facility to learn more about the illness. 

Doing something about the illness immediately will definitely give you a higher chance of not having too much damage in the brain. That’s why it’s also important that you educate yourself further by researching and asking your doctor about it as much as possible. 
 

 

 
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