Agenesis of the corpus callosum: causes, treatment and consequences. Causes of agenesis of the corpus callosum: what you need to know before pregnancy Pathogenesis and etiology of the disorder

The brain is the most complex organ Hundreds of scientific works are devoted to the human body, its structure and functioning.

The work of all organs without exception is controlled by the brain. Not a single action (conscious or unconscious) occurs without his participation.

To perform such a large amount of work, the brain must be a well-oiled machine, in which every part is in its place and performs a specific function.

In addition to the well-known cerebral hemispheres, the brain includes: the cerebellum, pituitary gland, hypothalamus, corpus callosum and medulla oblongata. Below we will talk about the corpus callosum and its place in work nervous system.

The cerebral corpus callosum (CC), or commissure major, as doctors call it, represents tens of millions nerve endings. It is a dense whitish substance covered with a thin layer of gray matter.

MT, along with two other spikes, is a connecting link between the hemispheres of the human brain. It ensures interconnection and transfer of information between individual segments.

Anatomy of the corpus callosum

The commissure is oblong, 2–4 centimeters wide, its length depends on age and gender, but does not exceed 10 centimeters. Consists of several departments.

The splenium of the corpus callosum is a thickening in the posterior part. The middle section is the trunk. The main part is 2/3 of the entire length of the solder.

The front one is a knee that ends in a thin beak.

The structure of the MT is such that it lies deep in the longitudinal sulcus and connects only the hemispheres, without affecting the rest of the brain.

Functions of the organ

For a long time after its discovery, scientists could not understand what specific functions the corpus callosum performs. It was initially assumed that it contained a focus of epileptiform activity.

For patients with epilepsy, surgeons cut it open to eliminate seizures. The seizures passed, but people's behavior changed. Thus, a patient with a dissected corpus callosum hugged his wife with his right hand and pushed her away from him with his left.

And only experiments on animals, and subsequently with the participation of a volunteer, brought clarity:

1. The obvious function is to connect the right and left hemispheres physically, since the corpus callosum is located deep in the longitudinal gap between the hemispheres. Nerve fibers connect both symmetrical sections of different hemispheres, as well as asymmetric, as well as different sections of one hemisphere.
2. Information communication between the hemispheres. The fibers of neurons (white matter) fan out in all directions, transmitting information received by different parts of the hemispheres.
3. Coordination of the hemispheres. MT ensures not only the exchange of received information between the left and right hemispheres, it is also responsible for the analysis of this information and an adequate response.

Corpus callosum in men and women

Scientists have not yet come to a unanimous opinion about the relationship between the size of the corpus callosum and the functions it performs. At first, American scientists argued that women have a wider MT than men, and this supposedly explains the peculiarities of women's intuition.

A few years later, French scientists refuted this theory and stated that the male corpus callosum in relation to the size of the brain is larger than that of women, and the brain itself is larger.

But they managed to deduce one regularity: a different density of neural fibers between the segments of the hemispheres responsible for speech is a distinctive feature of the weaker half of humanity.

In women, both hemispheres are involved at once, while the brain of men involves one hemisphere to a greater extent than the second.

Malformations of the corpus callosum and their consequences

The first trimester is the most important stage of pregnancy. It is during this period that all the main organs are laid, and it is at this time that they are most vulnerable. The neural tube forms towards the end of the trimester, at 12-13 weeks.

The expectant mother is given an ultrasound scan, and it shows whether the newborn has any structural disorders of the brain, including the corpus callosum, because they will lead to mental retardation.

Therefore, it is very important to monitor your health, undergo all examinations on time and take vitamin complexes during pregnancy.

The main malformations of the corpus callosum:

1. Dysgenesis
2. Agenesis
3. Hypoplasia

All these defects entail a number of disturbances in the functioning of other organs. But most importantly, they are the cause of mental retardation.

Parents of children with these defects talk about fairly favorable prognoses if there are no concomitant diseases of the central nervous system.

Such children, of course, are doomed to take medications for life: nootropics - improving the nutrition of brain tissue, neuroleptics - correcting behavior, hormonal and anticonvulsant drugs.

Such children are observed by neurologists and neurosurgeons. Rehabilitation is carried out by psychologists, defectologists, speech therapists, neuropsychologists, and psychiatrists.

The 30% chance of a favorable outcome that doctors give for such defects depends on the hard everyday work of the parents. It is necessary to deal with both physical and speech, psychomotor, and mental development.

The child will not always want to study. He can get tired quickly, become moody, absent-minded, even aggressive.

Agenesis

Agenesis of the corpus callosum in the fetus is the complete or partial absence of the main commissural commissure between the hemispheres. It can be either an independent disease or part of other congenital defects, for example, Aicardi syndrome.

Reasons for the absence of the corpus callosum:

1. Genetic anomaly. Chromosomal mutation may be hereditary (not necessarily in the next generations, it is quite possible that the precedent was in the 5th-6th generation or earlier). An accurate diagnosis can be made by a geneticist after an examination.
2. Intrauterine infection. Three decades ago, the term TORCH appeared, which unites the most common infections dangerous to the fetus - toxoplasmosis, mycoplasmosis, syphilis, rubella, cytomegalovirus and herpes. Unfortunately, they lead to serious developmental defects, miscarriage and death of newborns.

Partial agenesis of the corpus callosum is not so dangerous. The functions of the missing areas are taken over by the neighboring segments, as well as the anterior and posterior commissures. However, it also requires constant monitoring of the baby’s condition and drug treatment.

Usually the deviation is visible on ultrasound examination, but sometimes the disease goes unnoticed. In the first few months of life, the problem becomes obvious.
Symptoms of agenesis of the corpus callosum:

1. Functions of vision and hearing are impaired. The baby hears poorly or does not perceive sounds at all, and does not focus his gaze on an object. This is noticeable already at 1.5-2 months.
2. The size of the head, and therefore the brain, is smaller than normal. During a routine consultation, a neurologist measures the circumference of the child’s head with a centimeter.
3. Disturbances in the structure of the bones of the facial part of the skull are especially pronounced in the area of ​​the eyes and nose.
4. Various forms of epilepsy - convulsions, freezing, loss of consciousness.
5. Delayed mental, psychomotor and speech development.

Parents can notice these symptoms themselves and consult a doctor. There are several signs that can only be detected through examinations:

• tumors, neoplasms, cysts - both at the site of the corpus callosum and in other organs, most often in the stomach and intestines;
• adhesions and characteristic spots on the fundus;
• disturbances in the electroencephalogram can appear only during functional tests, although sometimes the EEG in such children represents a variant of the norm.

Hypoplasia and dysplasia

It represents disturbances in the development of tissues of both a separate area of ​​the corpus callosum and the entire organ. Caused by the same reasons as agenesis - chromosomal abnormalities, intrauterine infections and wrong image life of the expectant mother.

Smoking, drinking alcohol and drugs lead to improper formation of the fetal neural tube.

MT dysgenesis is not life-threatening, but problems are inevitable. First of all, such children have problems with oral and written speech, perception of light signals and reaction to external stimuli.

Hypoplasia of the corpus callosum of the brain is a general underdevelopment of the brain. Hypoplasia, like other developmental anomalies of the corpus callosum, can be an independent disease or be associated with other developmental defects.

Main features:

• disproportionate skull. As a rule, this is noticeable, but deviations can sometimes be insignificant;
• the structure of the convolutions is changed - they become flat;
• muscular dystonia. The baby's movements are uncertain, infants do not hold their heads well and do not lean on their arms. If the disease was overlooked in the first months of life, then at an older age awkwardness and clumsiness are noted. Children often fall and drop objects;
• disturbances in the functioning of the nervous system. Sometimes it is very difficult to predict the reaction of a sick baby to a particular stimulus;
• developmental delay. The baby begins to walk later than others and has difficulty mastering speech.

Usually, abnormalities in the structure of the brain are visible on ultrasound during pregnancy. But poor quality equipment, low qualifications of the doctor, and the specific position of the fetus during the examination can make it difficult to make a diagnosis in the early stages.

Up to two years of age, children with hypoplasia of the corpus callosum can develop on par with their peers, and only after this age do symptoms begin to appear.

There are several ways to define both hypoplasia and dysplasia:

• Magnetic resonance imaging - allows you to see organic lesions the brain and all its parts.
• Electroencephalogram - shows how the patient reacts to certain stimuli and records epiactivity.
• Neurosonography - ultrasound of the brain through the fontanel. Possible only in the first 1.5 years, then connective tissue replaced by bone.

Finally

Scientists admit that the brain is like the Universe. Doctors are unable to explain many principles and patterns. All functions of each department have not been fully studied; doctors cannot say how great the compensatory capabilities of brain structures are.

But one thing is certain: every segment, every cell and every neuron is of great value, especially such an important structure as the corpus callosum.

Violation of such important functions as data transmission and coordinated work of the hemispheres will undoubtedly affect a person’s mental abilities. The large commissure of the brain plays a very important role.

The corpus callosum of the brain plays an important function in the body, but even such a small organ is susceptible to disease - hypoplasia of the corpus callosum, one of the rare but no less dangerous anomalies that affects the functioning of this organ.

The corpus callosum is located exactly midway between the two hemispheres of the brain. Its functions were discovered relatively recently, around the 60-70s of the last century, and by accident. In the treatment of epileptic seizures, there was a practice of splitting the body into two halves, as a result of which the seizures disappeared, but many side effects appeared from such a procedure, which prompted the doctors who conducted the study to the right thoughts. The corpus callosum is a conductor of neurons between the two hemispheres; thanks to it, many important processes occur in our body, such as:

It is impossible to say that all these processes will be limited for the patient; this is possible only in an extremely severe form of the disease, but the presence of deviations will be noticeable to the naked eye.

For example, when the corpus callosum was dissected in an adult with epileptic seizures, after some time it was noticed that everything related to creativity (drawing, poetry, etc.) could only be done with the left hand, while ordinary procedures (receiving food, rewriting text) only with the right hand.

What can we say about a person with hypoplasia of the corpus callosum? In this case, the consequences are much more severe, but... First things first.

The cause of this disease is not fully known, but scientists agree that the lion's share lies in genetic abnormalities that are laid down in fetal development, in particular, at 2–3 weeks of the embryonic period.

In addition, there is an opinion that the presence of hypoplasia is caused by mutations that affect the development of the brain. Unfortunately, doctors are not able to give more accurate information.

Mothers who are at risk include:

• use alcoholic drinks during pregnancy;
• had rubella during pregnancy, just like toxoplasmosis or severe forms of influenza;
• were exposed to radiation;
• were subject to general intoxication of the body.

This disease belongs to the category of rare and, according to statistics, occurs in every 10,000th baby.

How to recognize?

Hypoplasia of the corpus callosum in a newborn is diagnosed, as a rule, after the first two months of life, but more often it occurs during fetal development.

If doctors looked at the disease before the birth of the child, then during the first 2 years of life the child will develop harmoniously, as befits a normal baby, and only after the specified time has passed, parents may notice some deviations, such as:

• infantile spasms;
• convulsions;
• epileptic seizures;
• weakening of the cry;
• impaired sense of touch, smell and vision;
• decreased communication skills;
• manifestations associated with muscle hypotension.

infantile spasms – convulsions characterized by sudden flexion and extension of the arms and legs

muscle hypotonia is a condition characterized by decreased muscle tone that can develop in combination with a decrease in muscle strength in the patient.

In the event that childhood, for some reason it was not possible to diagnose and recognize the presence of the disease, it will certainly manifest itself in adulthood, symptoms include:

• impairment of visual or auditory memory;
• hypothermia;
• problems with movement coordination.

Hypothermia – problems with the body’s thermoregulation (decrease in body temperature below 35 degrees)

How is diagnostics carried out in a hospital setting?

As a rule, a large number of concomitant diseases can develop with hypoplasia of the corpus callosum, so it is possible that there may be other symptoms (different from those mentioned above). In 80% of cases, the diagnosis of this disease occurs in fetal development using ultrasound diagnostics.

However, it is possible to order additional tests after birth (if during pregnancy clinical picture was not completely clear) or after the parents contacted a specialist. The doctor conducts an initial survey and clarifies the presence of symptoms characteristic of this diagnosis, after which he usually prescribes:

• magnetic resonance therapy (MRI);
• head electroencephalogram (EEG);
• other neurological studies.

Based on the data obtained from the above-mentioned studies, the doctor makes a conclusion and prescribes treatment.

Features of treatment

Unfortunately, effective treatment has not yet been invented, and doctors mostly struggle with the symptoms of the disease, so children with this diagnosis are doomed to constant treatment and supportive care.

The specific plan is selected by the attending physician individually for each person. It all depends on the severity of the damage to the corpus callosum and the clinical picture of the disease.

In 70-75% of cases there is an unfavorable outcome. There is a high probability of mental retardation and the development of serious mental disorders such as schizophrenia, etc.

If your baby has been diagnosed with hypoplasia of the corpus callosum in a newborn, then your support and help will be important to him. Here are a few general recommendations, to provide preventive actions for the baby at home:

Unfortunately, the diagnosis of hypoplasia is serious and often does not come alone, we can only wish patience to parents with sick children, but you yourself should hope for the best, since 25-30% have a positive result, and perhaps you will be among these percentages .

Like chemical elements that combine various types connections, the left and right hemispheres of the telencephalon are connected to each other by the corpus callosum. This structure acts as a connecting bridge between two parts of the brain.

The corpus callosum is a structure consisting of clusters of nerve fibers - axons (up to 300 million), and is located under the cerebral cortex. This formation is unique to mammals. Body consists of of three parts: the rear section is a roller, the front section is a knee, which later turns into a key; The trunk is located between the roller and the knee.

History of discovery

Despite the active study of brain structures in the last century, the functions of the corpus callosum have long remained in the shadows of the scientific microscope of researchers. Fiber formation received close attention from the American neuropsychologist Roger Sperry, who later received the Nobel Prize for his study.

The scientist performed a series of surgical interventions on the corpus callosum: like any neuropsychologist, Sperry cut the contacts, removed the structure and observed the functioning of the brain after the operations. He noticed a pattern: when the neural network connecting both hemispheres was removed, a patient who had previously suffered from epilepsy got rid of his illness. The researcher concluded: the corpus callosum is actively involved in the epileptic process and the spread of pathological excitation throughout different parts of the brain. In 1981, Roger Sperry was awarded the most prestigious international prize in the field of physiology and medicine for the results of his work.

However, despite such studies, the full functional set of this structure is still not discovered, and many mysteries in the functioning of the brain are associated with its activity, including the development of the schizophrenic process.

What is the corpus callosum responsible for?

Possessing a colossal number of axons (structures responsible for transmitting electrical impulses to nerve cells), the corpus callosum is literally connects two hemispheres of the brain. Its fibers connect similar areas of the cortex (for example: the parietal cortex of the left hemisphere connects to that of the right). Thus, the fibrous cluster is responsible for the coordination and joint work of both parts of the brain. An exception is the temporal cortex, since the structure adjacent to the corpus callosum, the anterior commissure, is responsible for its connection.

The corpus callosum allows one hemisphere to “share” information with the other: when conducting experiments on higher mammals, it turned out that, by cutting the optic tract, the corpus callosum transmits information from the visual cortex of the left hemisphere to the right.

TO functions This structure also includes maintaining human intellectual activity: by synthesizing information from two parts of the brain, the corpus callosum provides a deeper understanding of data received from outside. An experiment supports this position (all neurophysiology is based on experimental data): by dissecting and extracting a cluster of connecting nerve fibers, scientists noticed that the subjects were finding it difficult to understand written and spoken speech.

The most interesting and mysterious functions include the unity of consciousness and emotional response to a stimulus. When the corpus callosum was removed, people tended to show an ambivalent attitude towards the phenomenon or object (ambivalence). That is, they observed the presence of two diametrically opposed thoughts or emotions at the same time, such as: hatred and love, fear and pleasure, disgust and interest. A similar phenomenon is observed in the psychopathology of schizophrenia, when patients, without realizing it, showed love and hateful enmity towards something. This is not about the alternate manifestation of opposite feelings: emotions are located on parallel lines and in the same period of time.

Corpus callosum in men and women

Male and female brains develop differently: from the prenatal formation of the neural tube according to sexual characteristics and ending with the lifelong action of hormones. Lately you can often hear that female body no different from men's. However, this is not true: neurophysiology, psychophysiology and neuropsychology provide a lot of experimental data in favor of the differences between the male and female brains.

This also applies to the corpus callosum, namely: the number of nerve fibers corresponding to the structure is greater in women than in men. This study speaks in favor of the fact that the female sex operates better with speech concepts. Possessing a larger apparatus for exchanging information, a woman thus balances between the hemispheres, when the male brain “specializes” in one of them. However, in contrast to this statement, there are many reproaches.

Diseases

Dysgenesis, also known as dysplasia of the corpus callosum of the brain, is a congenital pathology of the nervous structure, manifested in its abnormal development of individual areas and tissues. The disease is the result of a defect in certain chromosomes. The disease is accompanied by a violation of the tissue composition of the corpus callosum and entails a violation of its functions.

The consequences of dysgenesis of the corpus callosum of the brain manifest themselves in the form of disorders of the neurological and mental sphere of a person. These include:

• slower response to external stimuli;
• slowdown in the development of intellectual properties of the psyche;
• impairment of recognition and understanding of written speech;
• dyslexia;
• difficulty and inhibition in the processing of light signals by the brain.

In addition, there is also another pathology - the absence of the corpus callosum of the brain in a newborn - agenesis.

Agenesis

This pathology spreads to an average of 3% of the population, which is a fairly high figure. Agenesis of the corpus callosum is a disease that is often accompanied by other ailments. The congenital absence of a hemisphere-connecting structure has its own symptoms:

• Slowing down of the child’s psychological and neurological development;
• facial dysmorphism - impaired blood flow to the facial muscles;
• pathology gastrointestinal tract, kidneys and the presence of tumors;
• excessively rapid sexual development;
• epileptic seizures;
• gross developmental disorders internal organs;
• defects in the development of the visual system;
• diseases of the musculoskeletal system;H

Hypoplasia

This pathology is characterized by incomplete development of the tissues of the corpus callosum. Unlike the previous disease, hypoplasia is manifested by underdevelopment, and not a complete absence of structure. Hypoplasia of the corpus callosum of the brain in a child is diagnosed by doctors during the first months of life, because the manifestations of the disease are distinctive:

• spasms of unobvious origin;
• epileptic conditions (fits, local convulsions);
• faint cry of a baby;
• absence or impairment of the sensitive sphere, that is, the child may not hear, see or smell;
• weakening or lack of muscle strength, resulting in atrophy or very weak muscles.

The consequences of hypoplasia of the corpus callosum of the brain are unfavorable, and in the absence of proper diagnosis, the prognosis is unfavorable. In 70% of children with this pathology, they suffer from severe mental retardation.

Outbreaks

The corpus callosum can suffer from demyelination, a disease in which the outer sheath of the axon is destroyed. Myelin plays an extremely important role in the functioning of the brain: thanks to it, the speed of transmission of electrical impulses across the expanses of gray matter reaches hundreds of meters per second, without myelin - up to 5 m/s. The presence of foci in the tissues of the body causes inhibition of the nerve signal and, consequently, the relationship between the hemispheres worsens. In addition to demyelination itself, the occurrence of lesions is a prerequisite for the development of multiple sclerosis.

Brain atrophy is a decrease in the size of each cell and a decrease in their number. The process is expressed by deterioration or complete degradation of organ functions. Regardless of the location of the atrophic tissues, patients’ cognitive abilities (cognition of new information) decrease, but extremely rarely completely disappear. In most cases, neurological disorders are observed ( somatic diseases central nervous system), in a quarter of cases neurotic (mental) pathologies are expressed, and mixed ones are also found.

Cerebral atrophy of the brain is characterized by accelerated destruction and slower development of new cells, so the disease is known to have a slow but constantly progressive course.

Causes

The activity of the nervous system has not been fully studied, so not all the causes of atrophic processes in tissues are known. There is a version that degenerative processes in cells during cerebral atrophy are possible under the influence of hereditary factors. In some cases, their onset is provoked by harmful influences.

Reasons inherent in the period intrauterine development:

1. Abnormal genes that are inherited.
2. Chromosome mutations.
3. Infections.

Acquired reasons:

1. Intoxication of the body that continues for a long time.
2. Severe or prolonged brain infections.
3. Radiation (usually provokes minor degenerative changes).
4. Smoking.
5. Alcoholism.
6. Addiction.
7. Exposure to chemicals (at home or at work).
8. Brain injuries accompanied by swelling, hematomas, and circulatory disorders.
9. Cysts.
10. Neoplasms.

Congenital predisposition to atrophy is considered a predominant factor compared to acquired causes. They can activate the development of genetically determined anomalies. Acquired atrophic processes in the brain account for no more than 5%, the remaining cases are associated with congenital pathologies.

Diagnostics

Basic methods:

1. MRI— creating images of sections of parts of an organ (in this case, the brain). The person lies down on the couch and takes the position recommended by the instructor. The device starts up and the scan results are displayed on the display. Provides information about the chemical structure of tissues. Pathological conditions are viewed visually in the image.
2. CT— layer-by-layer examination of the organ. Helps determine the physical state of a substance. In case of illness, the doctor determines changes in the density of the object.
3. EFFECT— creation of a three-dimensional image of the internal structure of the distribution of radionuclides using the emission of photons when the patient is placed in a gamma chamber.
4. PAT- study of the human brain by recording a pair of gamma quanta, for the formation of which a radiopharmaceutical (radioactive drug) is first introduced into the body.
5. MR spectroscopy— review of metabolic processes, analysis of biochemical changes in tissues.

Additional ways to diagnose brain atrophy:

1. USDG (ultrasound dopplerography) - identification of pathologies of blood vessels and arteries of the brain. A person sits on a couch. Gel is applied to the neck. The picture of the vessels is compiled according to the information received by the sensor, which is carried out at the location of the vessels.
2. TKDG (transcranial Dopplerography)- a more advanced method of studying the vessels and arteries responsible for the blood supply to the brain. Particular attention is paid to the brachiocephalic arteries.
3. Thoracic angiography— diagnosis of the condition of blood vessels after the introduction of X-ray contrast agents. Necessary for assessing the condition of the thoracic aorta. There are direct and indirect methods. Direct involves inserting a catheter through the elbow or femoral vein. The indirect method involves installing a catheter through the femoral or subclavian artery.
4. Selective angiography- catheterization diagnostics of all vessels involved in the blood supply to the brain.
5. EEG— obtaining a graphic image of electrical fluctuations with an electroencephalograph and comparing them with normal values ​​to identify deviations in the metabolic process of neurons.
6. Evoked potential method— tracking the bioelectric reactions of the brain to study brain functions (somatosensory (touch, sense of temperature, pain, position of body parts in relation to each other), visual, auditory), changing or disappearing with atrophy.
7. Blood plasma analysis.
8. Laboratory tests of cerebrospinal fluid(cerebrospinal fluid).

When diagnosing brain atrophy in children and adults using MRI, common signs can be observed in a group or individually.

Signs, causing the presence of dementia:

1. Reduction of the temporal lobes of the brain.
2. Reducing the volume of the hippocampus, which is responsible for the formation of emotions, maintaining the mechanisms of short-term memory and its transition to long-term memory, necessary for maintaining attention.
3. Expansion of the sulci of the cerebral cortex with involutional changes visible on it.
4. On the frontal, parietal and temporal lobes, a decrease in the subarachnoid space in the convexital (adjacent to them) surface is found.

Manifestations of cerebrovascular insufficiency (changes in cerebral vessels):

1. Destruction of the boundaries between white and gray matter.
2. Postischemic microcysts (after microstrokes) - in most patients.
3. Macrocysts are more than 5 mm in diameter in a minority of patients with brain atrophy.
4. Expansion of the lateral sulcus (separates the temporal lobe of the brain from the frontal and parietal).
5. Involution of the structure of the cerebral cortex.

Degrees of the disease

Depending on the volume of affected brain tissue, several degrees of atrophy are distinguished. They are taken into account during the examination in order to determine the severity of pathologies caused by degenerative processes, and, if necessary, draw up rules of behavior and patient care for relatives.

Atrophy 1st degree

At first, the disease is invisible to both the patient and others. Anxiety of the patient or his environment may arise due to other pathology, which directly or indirectly affects the processes of brain cell atrophy. Depending on the localization of the process: cortical atrophy or damage to subcortical structures, different changes will be visible.

With the development of moderate atrophy, dizziness and headaches begin, the course and frequency of which gradually worsen. The progression of the disease at this stage can often be slowed down. Based on the MRI readings, the doctor can select the necessary treatment methods.

Atrophy 2nd degree

Constantly increasing clinical manifestations defects in thinking, speech and physical activity. Depending on the damage to certain structures, specific processes are inhibited and degraded.

Due to brain atrophy, irreversible changes in motor skills, as well as in motor coordination and gait, can occur, for example, with cerebellar degeneration. Thinking, memory and intelligence also suffer. Outwardly, a person’s character and manners may change. On late stages atrophy, patients lose the ability to use familiar things, such as Toothbrush, cutlery (requires hand feeding).

Symptoms

Scroll common symptoms of brain atrophy:

1. Simplification of thinking, decrease in analytical abilities.
2. Changes in speech. It becomes more measured, poor, inarticulate.
3. Decrease in memory up to its complete loss.
4. Deterioration of motor skills.

Symptoms depending on the atrophied area:

1. Violations breathing.
2. Cardiovascular pathology.
3. Crashes in digestive tract.
4. Absence protective reflexes.
5. Violations muscle tone.
6. Deterioration coordination of movements.
7. Violations metabolic processes.
8. Incorrect thermoregulation.
9. Loss of some or all reflexes.

Natural brain atrophy in old age
Brain atrophy is a physiological phenomenon that usually begins moderately between the ages of 40 and 60 years. Signs may appear around age 70. A brain that has undergone aging every 10 years it decreases on average by 1-2%.

American scientists believe that aging begins under the influence of the lateral and third ventricles of the brain that increase each year. Over the age of 65 the ventricles grow approximately 0.95 ml each year.

Also, in many people, due to age-related changes, the subarachnoid space (the cavity between the membranes of the brain with cerebrospinal fluid) increases. From 40 years old the volume of cerebrospinal fluid (CSF) increases by 1 ml. By the age of 90, it may increase by 40 ml compared to the primary value.

As people age, their cerebral hemispheres become smaller. Dynamics possible reducing their volume by 0.23% per year. Frontal lobe loses up to 0.55%. Temporal lobes become smaller by 0.28%. Occipital and parietal are being reduced by 0.30% per year.

Brain atrophy predetermines the development of various forms dementia (dementia). 7% people over 65 years of age experience the development of this pathology. Dementia is much more common in people over 80 years of age.

Age-related changes increase gradually. They begin with harmless signs, but as they progress they make a person inferior. First, changes appear in a person's character. Active become passive, A sociable, emotional — lethargic and indifferent, withdrawn.

The person begins to use poorer speech. Lexicon More is shrinking. Sometimes cultured patients swear with abusive words, which may also indicate not a deterioration in character, but progressive brain atrophy.

Speech defects - external manifestations of thinking disorders. Patients are unable to think broadly. All thoughts are banally simple, and actions are primitive. Such people do not evaluate their behavior from the outside and commit illogical actions. All mental activity comes down to doing the simplest things (regardless of their relevance), which, as the disease progresses, can be replaced by a complete lack of activity.

Motor activity with atrophy of the brain, as well as its cortex, always suffers, sometimes even to the point of complete immobility. Deterioration in motor skills is especially visible, so patients with brain atrophy cannot perform complex work: neither mental nor physical. The first signs are often expressed by deterioration of handwriting.

Alcoholic atrophy

Signs even initial stages brain atrophy very clearly expressed since the first manifestation is encephalopathy, expressed in a sharp change in a person’s character and mood to depression, sometimes with a suicidal tendency. Disorders appear due to insufficient blood supply to the brain and its increasing dystrophy.

Under the influence of alcohol, neurons in various parts of the brain (and spinal cord) are affected, with the subsequent formation of accumulations of decay products around the affected vessels. Neuronal damage is expressed through several processes: by shrinkage, movement or lysis(dissolution).

Symptoms gradually increase and worsen. The pathology begins with encephalopathy and delirium (confusion, delirium), which can subsequently lead to death.

In the process of brain atrophy with constant alcohol consumption, vascular sclerosis. Deposits form around the brown pigment and hemosiderin, which contain iron. Such changes lead to hemorrhages (cerebral hemorrhages) and formation of cysts in the choroid plexuses.

Stands out separately Makiyafawa-Binyami syndrome, the manifestation of which is central necrosis of the corpus callosum with the appearance of swelling. The disease is accompanied by hemorrhages in the brain and demyelination (destruction of the myelin layer of nerve fibers of the nervous system).

Cortical atrophy of the brain substance

If the neurons of the genu of the corpus callosum or the anterior part of the posterior cerebellar peduncle are damaged, hemiplegia (paralysis of half the body). When damaged, the posterior portions of the cerebral cortex lose their control functions, so symptoms may spread to the floor of the body:

1. Hemianesthesia (loss of skin sensitivity).
2. Hemianopsia (inability to see objects when looking in a certain direction, loss of right or left visual fields).
3. Different muscle groups move differently however muscle weakness not visible.
4. Also one side of the body may completely lose sensation.

Multiple system atrophy

Degeneration of various neurons is called multiple system atrophy or Shy-Drager syndrome. The disease causes disturbances in various systems body.
It starts with primary signs:

1. Akinetic-rigid syndrome(movements are rare and inhibited with slight muscle tension).
2. Cerebellar ataxia(disturbances in gait, stability, possible disturbances in performing voluntary movements of the limbs).
3. Urogenital problems.

The progression of the disease brings new symptoms:

1. parkinsonism (slow movements, small writing with round, uneven letters).
2. Cerebellar dysfunction (persistent lack of coordination of movements, inability to constantly maintain balance, frequent falls).
3. Orthostatic hypotension (in an upright position, a person suffers a sharp drop in pressure due to the inability of the blood vessels to maintain it, resulting in dizziness and fainting).
4. Sweating disorders.
5. Urinary incontinence or vice versa inability to urinate at the certain time.
6. Constipation.
7. Impotence in men.
8. Dry skin and mucous membranes.
9. Speech disturbances and difficulty eating (swallowing) due to paralysis of the vocal cords.
10. Double vision.
11. Loud breathing during sleep. Possible: shortness of breath, snoring, stridor (whistle).
12. Sleep disorders in particular apnea (cessation of breathing for several seconds or minutes followed by awakening), rapid eye movements.
13. Cognitive degradation (suppression of the ability to learn new things).

Granular brain atrophy

The disease is very rare. It is characterized by the following clinical signs:

1. Strokes . They flow into acute form. Always accompanied by paralysis (inability to make voluntary movements), hemiparesis (complete or partial loss of strength in half the body).
2. Aphasic disorders (aphasia). Speech disorders. They occur when the part of the cerebral cortex responsible for speech is damaged, as well as the nearest subcortical structures.
3. Dementia. Dementia gradually increases, and mental retardation may appear. A person loses previously acquired knowledge and does not perceive new ones well.

It is often diagnosed in old age, but can begin at any age. With granular atrophy, they appear and progress cerebrovascular disorders. First of all, damage to the arterioles is observed.

During diagnosis (MRI), the surface of the cerebral cortex changes its external structure to a lumpy one, as if strewn with grains (granules).

Left hemisphere

Appear speech disorders. Developing motor aphasia: speech sounds slowly, with great effort from the patient; in some cases, all words are composed of individual sounds, sometimes they are illegible.

Logical thinking is noticeably degrading. The patient develops a state of constant depression (one of the primary symptoms of atrophy of the left hemisphere in the temporal region).

Visible images are not completely covered by vision, but consist of separate fragments. A person cannot read, handwriting changes, becomes unrecognizable and sloppy. Analytical thinking gradually disappears, incoming information is not analyzed and logically perceived. A person does not remember dates, does not navigate them, also does not perceive numbers, and the ability to count is lost.

Due to incorrect perception and processing of incoming information mnemonic processes are disrupted(memory is lost). A person perceives what is said in his presence in fragments of phrases or even individual words, so a distorted meaning reaches him.

In severe cases, atrophy of the left hemisphere of the brain causes partial or complete paralysis of the right side of the body. First, motor activity is impaired, and then loss of sensitivity and decreased muscle tone increase.

Frontal lobes

Are getting worse mnemonic processes (ability to remember), also noticeable degradation (simplification) thinking. Intelligence decreases.

The initial stage is expressed in character change:

1. The person becomes more secretive, but expresses simplified thoughts.
2. Gradually becomes isolated from others.
3. Commits illogical actions.
4. Sets meaningless goals.

Phrases and actions are repeated every day. Life passes as if according to a pre-written (quite primitive and the same for every day) scenario. All speech comes down to simple sentences. Patients lose most vocabulary, therefore, they express thoughts and needs in monosyllables.

If atrophy frontal lobes brain occurs for Alzheimer's disease, then the processes of memorization and thinking suffer the most. A person’s personality and character are preserved much better than, for example, with Pick's disease, therefore, adequacy from a person can be expected in most cases.

Cerebellum

Come to the fore changes in muscle tone, and ataxia (inconsistency of movements). A person loses dexterity and stability when walking and standing, motor skills may be impaired to the point of inability to perform any work. A person may lose the ability to self-care.
Movement disorders with atrophic changes in the cerebellum have some features:

1. Before the end of the action appears intentional tremors (imperceptible at rest and manifested in movement, its amplitude is quite low)
2. Arms and legs become more angular instead of the usual smoothness.
3. All actions (speech and movements) are slowing down.
4. Scanned Speech (words are pronounced syllable by syllable, and pronunciation is slow).

In addition to movement disorders, cerebellar atrophy is characterized by nonspecific symptoms: headaches, frequent attacks of nausea and vomiting, the person may be drowsy, and hearing loss is also noted.

The progression of atrophy adds new symptoms:

1. Intracranial hypertension (high blood pressure).
2. Ophthalmoplegia (paralysis of the eye muscles). Cerebellar atrophy occurs due to paralysis of the cranial (oculomotor) nerves.
3. Areflexia (loss of reflexes).
4. Enuresis (urinary incontinence during sleep).
5. Nystagmus (high frequency eye movements, not controlled by the patient).

Brain atrophy in newborns

The appearance of brain atrophy in infants is often influenced by hydrocephalus, dropsy among the people. With this pathology the amount of cerebrospinal fluid increases, serving as a protective membrane for the brain, but in case of increase squeezing him.

During intrauterine development, such pathology is detected by the method ultrasound. Hydrocephalus can develop due to disturbances in the formation of the nervous system. The process is influenced intrauterine infections, such as herpes, cytomegaly (disease of the salivary glands, minimally manifested in adults).

Congenital conditions can lead to hydrocephalus developmental defects. matter birth injuries moderate or severe severity, in which the infant experiences a cerebral hemorrhage followed by the development of meningitis.

Children with brain atrophy are the first months of life are spent in intensive care. In some cases, staying at home during pauses between courses of treatment and round-the-clock monitoring by neurologists is allowed. Further Children require long rehabilitation.

Therapeutic methods, developmental activities, positive emotions can make things possible or speed up the process. taking over certain functions by healthy parts of the brain to replace the work of atrophied ones. The prognosis for complete recovery is usually poor.

Treatment

There is no way to restore atrophied brain cells. You can only relatively slow down the course of atrophy. All treatment methods are aimed at relief or relief of symptoms, appearing in the process of degradation of various parts of the brain.

Patients need a calm environment around them. Extremely It is advisable for them to be at home. Hospitalization is undertaken in extreme cases. All of them are caused by the lack of ability to provide adequate care for the patient.

Hospitalization or living in a boarding school for the disabled is practiced for patients with obvious severe mental disorders, inadequacy, and mental retardation. It is also possible to move the patient to a specialized institution if it is impossible to provide constant care.

It is desirable to create conditions for a person with brain atrophy that involve activity, healthy lifestyle life. Sleep or long rest during the daytime (most of the time) is not required. If possible the sick person is involved in daily household chores, other work or vigorous activities, entertainment.

Psychotropic drugs in the treatment of brain atrophy are undesirable, however, their relative necessity is revealed in cases of manifestations of an excited state, increased irritability, or, conversely, apathy in varying degrees.

The only way to treat brain atrophy in modern medicine is slowing down the destruction of neurons and cells. Scientists have found the following groups of drugs to be effective in this regard:

1. Vascular drugs (Cavinton).
2. Nootropics - brain function stimulants (Ceraxon).
3. Metabolic drugs - means to improve metabolic processes.
4. Vitamin B6 helps maintain the correct structure of nerve tissue fibers.

Symptomatic treatment relieves signs of atrophy for a certain time; the following are effective:

1. Antidepressants - relieve depression and some disorders of brain function.
2. Sedatives - deposition of signs of nervous system disorders.
3. tranquilizers - psychotropic drugs help to temporarily relieve anxiety, calm a person, remove muscle tension, and stop seizures. They have a hypnotic or vice versa activating effect.

Prevention of brain atrophy

No precise methods have been identified to prevent the occurrence of this pathology. It is only possible to delay this process and not create additional conditions for the emergence of destructive processes in the brain.

Required compliance with the rules:

1. Timely treatment of any diseases in the body, directly or indirectly affecting the brain.
2. Passing examinations to identify pathologies.
3. Alternation of monotonous work and everyday life with active recreation and sports.
4. Balanced diet with a minimum percentage of harmful substances.
5. Don't neglect necessary rest.
6. Preventing the development of atherosclerosis cerebral vessels. For this you need: weight control, avoidance of fatty foods, treatment of pathologies endocrine system(release of hormones) and metabolism, all possible prevention of excessive obesity.

Must be excluded risk factors, which, when overabundant, lead to atrophy of brain tissue. Required:

1. Quit smoke.
2. Refuse alcohol and drugs.
3. Remove (if possible) everything factors that suppress the immune system.
4. To not allow psycho-emotional stress, respond moderately to stress.

Practice shows that people with an active, cheerful attitude more often than others live to a ripe old age without signs of common pathologies associated with brain atrophy.

This happens thanks to impulses that are concentrated in the corpus callosum of the brain.

What is the corpus callosum: general information

The corpus callosum of the brain (MC), or the greater commissure, as experts call this element, is a collection of nerve fibers.

It connects the two parts that form the brain - the right and left hemispheres. Also, the corpus callosum coordinates their stable operation, ensures the coherence of the transmission and reception of signals from each of the hemispheres. In addition, the corpus callosum unites the gray matter of each of the cerebral hemispheres.

The formation is a dense white structure. The anatomy of the corpus callosum is quite complex - in general, it is an elongated structure from front to back, the length of which, depending on age and gender, ranges from 7 to 9 cm.

The location of the large commissure is the longitudinal fissure of the human brain.

Anatomy and functions

The corpus callosum is covered on top by a small layer of cerebral gray matter, which explains, accordingly, the gray covering on it. Upon visual examination, 3 main sections can be distinguished:

• trunk (or midbrain);
• knee (part of the brain located in the front);
• beak or splenium of the corpus callosum (posterior section).

The brightness of the large commissure (when viewed on photographs or in section) is provided by fibers that are located radially and are located in each of the hemispheres.

The middle section, when viewed, looks like a bulge, which is also the longest part of the entire brain. The posterior section is visually visible as a thickening relative to other sections and zones, which is freely located above neighboring areas of the brain. The gray matter is represented by stripes and is located on top.

Functions provided by the corpus callosum:

• transfer of information (impulses) important for the functioning of the body from one hemisphere to the other;
• formation of the main characteristics that define personality and its characteristics;
• basic (basic, defining) skills and the possibility of their application throughout a person’s life;
• work on the formation of the emotional and personal sphere.

The big commission is under attack...

Disorders of the corpus callosum are a rare phenomenon, occurring in 2% of all cases of diseases of the brain and central nervous system. In case of diseases of the corpus callosum, the following are observed:

• disorders of various nature and intensity, manifested in the emotional, personal and cognitive spheres;
• physiological problems in the functioning of the limbs;
• problems with eyeballs and vision in general.

Corresponding diseases develop - agenesis, hypoplasia and dysplasia (dysgenesis) of the corpus callosum of the brain.

Agenesis: main causes, symptoms, treatment

Agenesis of the corpus callosum, as an independent disease, is a complex disorder of a structural nature. If this occurs, then the patient experiences, accordingly, a disruption of the associative connections between the right and left hemispheres of the brain, which is not observed in the normal state, since this organ is responsible for uniting these areas.

The disease develops as a result of disturbances (abnormalities) during development. It is rare - about 2%, congenital, manifested in complete or partial absence when examined in photographs or studies of this structural formation.

Agenesis is expressed by the complete absence of a large commissure or its underdevelopment, sometimes it is only partially present (there is no specific area). In this case, the formation, if it is underdeveloped or partially present, is presented in the form of significantly shortened septa or transparent columns of the cerebral vault.

Provoking factors and symptoms

Modern neurologists and scientists cannot accurately name the main reasons that influence the development of this pathology. The main suspected factors are:

• heredity (in 70% of cases, if the family has already had problems of a similar nature, they will recur in future generations);
• genetic (including chromosomal) changes and mutations;
• chromosome rearrangement (during fetal formation);
• the development of infections caused by a virus that occur during pregnancy (in utero, especially dangerous in the early stages);
• injuries;
• ingestion of substances with a toxic (poisonous) effect on the body or developing fetus (including exposure to alcohol);
• consequences of taking medications ( side effects or complications);
• disruption of pregnancy (nutrient deficiency in the fetus during development);
• metabolic disorders in the body of a pregnant woman.

The main symptoms indicating the presence of agenesis of the corpus callosum in a person and the need for immediate qualified diagnosis:

• hydrocephalus;
• disorders in the development and functioning of the visual and auditory nerves;
• the appearance of benign cysts and other types of tumors in the brain;
• cerebral convolutions that are not sufficiently formed to perform their intended functions;
• early puberty;
• development of lipomas;
• various problems and disturbances in the functioning of the gastrointestinal tract (of varying nature and intensity);
• psychomotor impairment;
• behavioral problems (especially acute in childhood);
• diagnosis of mild mental retardation (detected in childhood);
• impaired coordination of movements;
• low muscle tone;
• violations of the development of muscles and bones of the skeleton.

Package of measures

Treatment is most often drug therapy. Includes taking antiepileptic drugs, as well as corticosteroid hormones. Also, in some cases, exercise therapy (physical education with a therapeutic bias) is indicated.

Dysplasia and hypoplasia - incorrect or underdevelopment of MT

Hypoplasia or, as this disease is also called, microcephaly, is a complex pathology, during the course and development of which a significant decrease is observed (the value is taken based on normal indicators) volumes of the brain and, accordingly, the corpus callosum as well.

In most cases, along with the diagnosis of hypoplasia, other disorders are observed, including improper development of the present parts of the corpus callosum (dysplasia or dysgenesis), insufficient development of the spinal cord, underdevelopment of the limbs and a number of internal organs.

Causes and clinic pathology

The main cause of developmental disorders and reduction in size (or complete absence) of the corpus callosum is one or another congenital pathology. Factors causing such changes:

• Presence of bad habits in a pregnant woman (smoking, taking drugs or alcohol);
• intoxication;
• exposure to radiation (ionizing);
• consequences of complex and serious diseases - rubella (acquired in adulthood or especially during pregnancy), influenza, toxoplasmosis.

• decrease in brain volume relative to normal indicators (main symptom);
• changes in the usual structure of the brain convolutions and some structures (the convolutions are flat);
• insufficient development of the temporal and frontal lobes of the human brain for normal functioning;
• reduction in the size of the pyramids - elements of the medulla oblongata (pyramidal syndrome develops);
• violations and failures identified in the work of the cerebellum;
• violations of the functions of the trunk (brain section);
• in most cases, there is a violation of intelligence;
• violations of physical development;
• neurological disorders and characteristic disorders;
• pathology of the optic tubercle.

State of modern medicine

With hypoplasia, the skull is smaller than a person should normally have.

Despite the development modern medicine quality and effective treatment there is no such violation. It is possible to reduce symptoms to a minimum.

It is important to remember that this anomaly leads to a decrease in life expectancy. The main measure of influence is taking medications.

Consequences of hypoplasia

If appropriate measures are not taken at the early stage of development and formation of the anomaly, then the majority of patients in the future (already in childhood and adolescence) will experience various problems in the field of neurology.

Also, many patients with hypoplasia have moderate and severe intellectual impairment, developmental delay, both mental and physical.

Thus, according to various medical studies, in at least 68-71% of cases diagnosed with hypoplasia of the corpus callosum, there is a consequence such as mental retardation. In addition, the disorder leads to the emergence of more serious mental disorders, such as schizophrenia.

Consequences of dysgenesis

Dysgenesis of the corpus callosum can cause changes in the muscle system and in the skeleton as a whole. It is a common cause of scoliosis.

Delays in mental and psycho- emotional development children and teenagers. Intellectual impairment, neurological problems, and developmental delays are also observed, so patients in most cases require constant supervision and intensive treatment.

If measures are taken to eliminate the manifestations, children can learn the necessary skills, including mastering a simple school curriculum.

In dry but important remainder

Thus, the corpus callosum of the brain, despite its tiny size, has a great influence on a person’s life. It allows the formation of personality, is responsible for the emergence of habits, conscious actions, the ability to communicate and distinguish between objects.

That is why it is extremely important to take care of your health during pregnancy, since the main metabolic disorders are formed during this period.

We should not forget that the corpus callosum forms the intellect and makes a person a personality. Despite all attempts to study this structure, scientists have not yet been able to uncover all its secrets, and therefore very few methods for treating disorders, if any, have been developed.

The main ones are drug therapy and a special set of exercises - exercise therapy, which allows you to maintain optimal indicators of physical development. Measures to eliminate the symptoms of disorders should be taken immediately, otherwise the desired improvements may not occur.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

DYSGENESIS OF THE CORPUS CALLOSUM

Based on the results of ultrasonography, my child (age 4 months) was diagnosed with a congenital malformation of the brain - dysgenesis of the corpus callosum. Tell me, please, what is the threat of this diagnosis? What consequences can this diagnosis lead to if dysgenesis is not treated? How does this defect affect psycho-motor development?

Thanks in advance for your answer.

for worries, and especially for treatment. In most cases, NSG data can offer rather indirect and

uncertain results and are taken into account only in conjunction with clinical examination data. In this case, an in-person consultation with a qualified neurologist is necessary.

Attention - advice on the forum does not replace a face-to-face consultation!

My child (at 4 months old) was diagnosed with an ultrasound scan: cerebral parkitis of the right temporal region, and at the age of 7 months, based on the results of an MRI, they were diagnosed with an arachnoid cyst of the right temporal region. Could you DPT vaccination influence this

Agenesis of the corpus callosum

Agenesis of the corpus callosum is a congenital pathology, the development and spread of which is played by genetic factors. The corpus callosum itself is the largest structural formation of the brain, which connects both hemispheres to each other. The intersection of fibers, as well as their connection with the hemispheres, begins already at twelve, thirteen weeks. Agenesis of the corpus callosum, the consequences, treatment and symptoms of which will be discussed below, occurs with the partial or complete absence of it itself, as such.

The corpus callosum is a dense plexus of nerves in the brain. It is designed to connect the right and left brain hemispheres. It consists of up to two hundred and fifty million neurons. The corpus callosum is flat and wide, consists of axons, and is located directly under the cortex. The fibers mainly run in the transverse direction and connect the symmetrical parts of the brain, but there are also longitudinal fibers that connect the asymmetrical parts of the opposite hemispheres, or one part. Agenesis of the corpus callosum, the consequences of which are reflected in the intellectual abilities of a person, is part of many widespread congenital developmental disorders, pathologies and diseases. The main callosal commissure in this case is partially or completely absent; it is replaced by transparent columns of the fornix, short and incomplete septa. The frequency of occurrence of this kind of defects is one case in two thousand conceptions, the reason for this is heredity or spontaneous unexplained gene mutations.

Symptoms of agenesis of the corpus callosum

• Interruption of the beginning of its origin and development;
• Porencephaly;
• Atrophy of the optic and auditory nerves;
• Lipomas of various types;
• Schizencephaly;
• Localization of cysts and neoplasms in the area of ​​connection of the hemispheres;
• Spina bifida;
• Visual defects;
• Microencephaly;
• Seizures;
• Splitting syndrome;
• Inhibition of psychomotor development;
• Facial dysmorphism;
• Aicardi syndrome;
• Deviations in the development of the gastrointestinal tract, the presence of tumors in it;
• Lacunar transformations in the fundus;
• Early puberty and so on.

Symptoms of agenesis of the corpus callosum can manifest themselves in different ways, one way or another, expressed in intellectual retardation of various levels, epileptic seizures, disorders of motor physical activity, as well as anomalies in the formation and growth of human internal organs. Often the disease manifests itself in conjunction with Aicardi syndrome, a rare genetic disease characterized by special changes in the electroencephalography of the head and abnormalities in the development of the eyes. There are both skeletal abnormalities and skin lesions associated with agenesis.

Treatment

Treatment of agenesis of the corpus callosum comes down to minimizing serious symptoms and eliminating infantile spasms. The therapy is actually ineffective and has not been fully developed, so various potent drugs are used in maximum courses and dosages. Treatment for agenesis of the corpus callosum is in development, but the disease itself is still being closely studied, and the disease is very poorly diagnosed at the stage of its onset, due to the peculiarities of fetal presentation and the inability to clearly visualize the cavities and structures of the fetal brain. The absence of the corpus callosum or its underdevelopment leads to disturbances in the neurological development of the child. But statistics recorded a number of cases where there were no other anomalies, and a normal karyotype was determined. The duration of observation of children in this example ranged from several months to eleven years.

At least once in their life, every person has felt dizzy. It may arise like healthy people when overworked, and

Arachnoid cystic formations in the head are formed between its surface and the arachnoid, arachnoid, membrane. I find cysts.

Head and neck pain, accompanied by dizziness and nausea, occurring on the second or third day after lumbar puncture, in me.

A condition in which liver function is impaired to varying degrees of severity is called hepatic encephalopathy, the symptoms of which are:

16+ The site may contain information prohibited for viewing by persons under 16 years of age. The information on the pages of the site is provided for educational purposes only.

Do not self-medicate! Be sure to consult a doctor!

Agenesis of the corpus callosum as a multifactorial genetic disease

The corpus callosum is an important anatomical structure that connects the hemispheres of the brain. It is represented by a dense plexus, which consists of two hundred and fifty million nerve cells. Normally, the appearance of the first neurons that provide communication between the cerebral hemispheres occurs as early as one week of intrauterine development. It is extremely rare (approximately 1 case per 2000 newborns) that an anatomical lack of communication between the hemispheres is diagnosed. This condition is called agenesis of the corpus callosum.

Faced with a diagnosis of “agenesis of the corpus callosum,” every parent asks the question: “What is it?” The disease is associated with a hereditary factor. It can occur in isolation or be combined with many other developmental defects. Even if the pathology was not detected during an ultrasound examination of the fetus, it is usually diagnosed in the first two years of the child’s life.

Functions of the corpus callosum

Before we begin to describe the symptoms of the disease, let's look at what functions the corpus callosum performs in the body. The two hemispheres of the brain can work in isolation, each performing its own tasks. It is believed that the right half of the brain is responsible for analytical thinking and the ability to study the exact sciences, and the left half is responsible for creative thinking and imagination. The corpus callosum ensures coordination and cooperative functioning of the entire nervous system:

• allows you to correctly process and perceive information coming from the senses (visual, auditory analyzer);
• provides commonality of thought processes.

In the second half of the twentieth century, scientists conducted a series of experiments during which the corpus callosum was cut on several subjects. The results were surprising: patients began to think and act in completely disjointed and illogical ways. For example, a man hugged his wife with his right hand and pushed him away with his left. Thus, the corpus callosum coordinates the action of two isolated, but at the same time completely conscious areas of the brain.

How does the disease manifest itself?

Since agenesis of the corpus callosum is often combined with other congenital defects of the nervous system, the clinical picture of the disease looks different in each child. The most common symptoms of the pathology are:

• the presence of large and medium-sized cysts in the cerebral hemispheres;
• atrophy of the optic (II pair) and auditory (VIII pair) nerves - a severe developmental defect in which the child can neither see nor hear;
• schizencephaly is a severe disorder of the formation of brain tissue, in which there is a deep cleft in the cerebral cortex, extending from the ventricles to the subarachnoid space. Most often, a fetus with such a developmental defect is born dead;
• neoplasms in the area of ​​the unformed corpus callosum;
• spinal bifida;
• microencephaly – a significant decrease in the size of the head and brain;
• retardation in mental and psychomotor development;
• epileptic seizures;
• combined congenital malformations of the gastrointestinal tract, tumors;
• characteristic facial dysmorphism (changes in the structure of the bones of the facial skull);
• early sexual development.

Diagnosis and treatment

Most often, agenesis of the corpus callosum is diagnosed during ultrasound screening and examination of the fetus. The doctor determines the complete or partial absence of a dense area of ​​nervous tissue connecting the cerebral hemispheres. After the birth of the child, to confirm the diagnosis and exclude other congenital pathologies, additional methods studies: NSG, computed tomography or magnetic resonance imaging. A neurologist treats a child with agenesis of the corpus callosum. You may need to consult a geneticist or neurosurgeon.

Therapy for the condition has not currently been developed. Treatment boils down to eliminating dangerous symptoms such as convulsions, hydrocephalus, and nervous agitation. As a rule, correction of neurological disorders is very difficult to achieve; potent drugs are used in the maximum dosage:

• anticonvulsants (benzodiazepines, phenobarbital);
• glucocorticosteroids (Prednisolone, Dexamethasone);
• neuroleptics for the correction of behavioral disorders;
• nootropics (Nootropil, Piracetam) to improve nutrition of brain tissue.

Forecast

In rare cases, when the defect has developed in isolation, the prognosis is favorable. If a child is diagnosed with only agenesis of the corpus callosum, the health consequences are minimal. Children grow and develop as usual; minor neurological problems and some differences in thinking are possible. With combined congenital defects It is rare to talk about a good prognosis. The consequences of the disease and the tactics of doctors directly depend on the degree of damage to the nervous system.

Corpus callosum, dysgenesis, atrophy, Marchiafava-Bignami disease

The corpus callosum consists of:

Trunk or body (anterior and posterior)

Each section connects the homolateral part of the brain.

Formation of the corpus callosum.

The corpus callosum develops in a special order:

From the knee, then the body, the ridge and at the end the beak develops.

Myelination of the corpus callosum proceeds from the posterior sections to the anterior sections.

This knowledge helps to narrow down the differential diagnosis for pathologies of the corpus callosum.

Dysgenesis vs Atrophy

With dysgenesis of the corpus callosum, the genu and anterior parts of the corpus callosum are well formed, but the splenium and beak are absent. This pathology is congenital. Pathology is presented on the left.

With atrophy of the corpus callosum, the posterior parts of the corpus callosum are well formed (the posterior part of the body and the splenium), but the beak, knee and anterior part of the body are reduced in size. These changes are purchased.

Many diseases affect the corpus callosum, so the presence of lesions is not pathognomonic for a particular disease.

Marchiafava-Bignami disease (central degeneration of the corpus callosum, Marchiafava syndrome, extrapontine myelinolysis).

Occurs in people who abuse alcohol. In these individuals, MRI reveals lesions of the splenium and posterior parts of the trunk (body) of the corpus callosum.

In the chronic stages of Marchiafava-Bignami disease, the corpus callosum is visualized in the form of a sandwich, in which the upper and lower layers of the corpus callosum are preserved, but with necrosis of the middle layers.

Dysgenesis of the corpus callosum

Dysgenesis of the corpus callosum can occur as an isolated abnormality of little clinical significance, but this marker can also be associated with trisomy 13 and 18, but in this case it will rarely be the only disorder. Ultrasound examination in these cases will reveal widening of the interhemispheric fissure, teardrop-shaped lateral ventricles and colpocephaly.

Availability of increased large tank or Dandy-Walker anomalies, both with occlusion of the fluid circulation pathways and the communicating fourth ventricle, may also be a marker of chromosomal disorders. Isolated DandyWalker cysts do not indicate increased risk aneuploidy, but in the presence of combined anomalies the risk increases to approximately 50%, especially for trisomies 13 and 18.

Holoprosencephaly occurs in 1 case of peoples. Fetuses with holoprosencephaly have a higher risk of aneuploidy compared with those with simple ventriculomegaly. If holoprosencephaly is isolated, then chromosomal abnormalities will be found in approximately one third of the fetuses, and when combined with other anomalies, their frequency will be almost 40%. Thus, identifying this defect is a very important sign of the presence of aneuploidies, the most likely of which will be trisomy 13 or 18.

Microcephaly is noted in 10 cases of peoples. This diagnosis can be very difficult to accurately establish. Commonly used criteria for this include a decrease in biparietal size (BPD) of the fetal head below the 1st percentile for the corresponding gestational age or a decrease in head circumference below the 2.5th percentile compared to femur length. Biparietal size is difficult to use as a criterion, since its change is not so pronounced in microcephaly. The criterion can be a relative decrease in the size of the cranial vault in relation to the size of the face, which is most easily detected with a midsagittal scan. Chromosomal abnormalities are present in approximately 20% of fetuses with microcephaly.

Head and neck with congenital pathology

Facial clefts occur in 14 peoples and are found in several aneuploidies, such as trisomies 13 and 18, but can also be detected in other diseases such as 4p- syndrome.

Micrognathia is not a specific feature, but can occur with trisomies 13, 18 and triploidy. This anomaly is most easily detected when scanning the face in the midsagittal plane. Both on the echogram and when assessing it appearance After childbirth, the position of the chin in relation to the midface with micrognathia, which is characteristic of fetuses with trisomy 18, attracts attention.

Macroglossia is an enlargement of the tongue. This symptom is typical of trisomy 21 and Beckwith-Wiedeman syndrome. In healthy fetuses, the tongue should not extend beyond the alveolar arches, but in cases of macroglossia it is located anterior to the border of the tooth buds.

The neck fold is usually considered pathologically enlarged if its thickness exceeds 6 mm between the 15th and 22nd weeks of pregnancy. Although the measurement can be taken from a sagittal scan of the fetal head and neck, the more common method is to measure a transverse (axial) section of the head through the cerebellum. Even an isolated increase in the neck fold is an important feature, mainly as a marker of trisomy 21.

Cystic hygroma is a very common anomaly, occurring in 0.5% of all spontaneous miscarriages. It is combined with polyhydramnios in % of cases, with heart defects in 0-92% and with aneuploidy in 46-90%. Cystic hygroma can be localized to the back of the neck and sometimes protrude downward relative to the surface of the back of the fetus.

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Agenesis of the corpus callosum: what is the danger of the disease?

Among the anomalies of brain development, one of the most common diseases is congenital structural pathology, agenesis of the corpus callosum, in which there is a violation of associative connections between the two hemispheres.

Agenesis of the corpus callosum: causes

A disease associated with abnormal development of the brain, congenital, quite rare, manifested in the complete or partial absence of a structural formation connecting the hemispheres of the brain, is called adhesion of the corpus callosum.

The corpus callosum connects the cerebral hemispheres

Normally, the corpus callosum, or major commissure, is represented by a dense junction of nerve fibers that unites the cerebral hemispheres, left and right, and ensures coordination between them.

From a morphological point of view, the formation of this structure corresponds to the period of one week of pregnancy; the beginning of differentiation of the tissue of the corpus callosum is attributed to the middle of the sixth week.

This pathology can have varying degrees of structural manifestation and be expressed in the form of a total absence, partial (hypogenesis) or incorrect (dysgenesis) formation, underdevelopment (hypoplasia) of the corpus callosum.

Instead of the normal structure, which looks like a wide, flat strip, the large commissure takes on the appearance of shortened septa or transparent pillars of the arch.

As a rule, it is difficult to accurately determine the cause of a congenital structural malformation of the brain.

Predisposing factors

• Heredity (family cases of manifestation, with autosomal or X-linked inheritance)
• Spontaneous mutations
• Chromosome rearrangement
• Intrauterine infections (usually viral) or trauma
• Exposure to toxic substances, teratogenic effect medicines during uterine development
• Fatal fetal alcohol syndrome (due to maternal alcoholism during pregnancy)
• Nutrient deficiency in the fetus
• Metabolic disorders in the mother

To date, it is not possible to unambiguously name the cause of agenesis of the corpus callosum; we can only identify the factors causing its occurrence.

You can get acquainted with the structure of the brain by watching the proposed video.

Symptoms and diagnosis

The clinical manifestations of the disease vary; depending on this, it can be detected in a severe form in childhood, usually up to two years, or in adults, asymptomatically and sometimes completely by accident.

Children whose disease, for one reason or another, was not diagnosed in the prenatal period, appear healthy at birth, and their development is normal until they reach three months.

It is at this stage that the first symptoms of the disease appear, usually in the form of so-called infantile spasms, a type of epileptic seizures.

Symptoms

• Interruption of the formation and further development of the structure of the corpus callosum in the first stages
• Development of porencephaly, a defect in the mantle of the brain
• Hydrocephalus – lack of ability to track with the eyes, later – lack of voluntary movements
• Atrophic phenomena of nerves, visual and auditory
• Microencephaly
• The appearance of neoplasms and cysts in the hemispheres
• Polymicrogyria (underdeveloped gyri)
• Premature, early sexual development
• Manifestation of spina bifida syndrome
• Manifestation of Aicardi syndrome
• Development of lipomas
• Pathology of the gastrointestinal tract, tumor formation
• Slowing and then inhibition of psychomotor development
• Manifestations of varying degrees of retardation, mental and physical
• Coordination problems
• Developmental delays, abnormalities of various organs
• Low muscle tone
• Skeletal abnormalities

In patients with preservation of intelligence and motor functions, the manifestation of the anomaly is a disruption in the exchange of information between the hemispheres, for example, in the difficulties experienced by a right-handed person when asked to name an object in his left hand.

The disease is diagnosed by scanning the brain

Diagnosis of the disease can be detected by performing a brain scan procedure.

Carrying out prenatal diagnosis of such an anomaly as agenesis of the corpus callosum is associated with great difficulties. Most often, the anomaly is diagnosed during the second or third trimester of pregnancy.

The main method used is echography; MRI and ultrasound procedures are also used.

Carrying out an echography procedure in the prenatal period does not allow diagnosing all cases of the disease, including due to the characteristics of fetal presentation.

In addition, with partial agenesis, detecting the defect is even more difficult.

Diagnosis of the disease is complicated by the fact that agenesis is often combined with a number of developmental defects and various genetic symptoms.

To obtain a complete picture of the examination, in case of suspected anomaly, it is necessary to perform karyotyping, as well as a thorough ultrasound analysis and diagnostics using magnetic resonance imaging.

Combination of different modern methods examination makes it possible to more reliably diagnose cases of agenesis of the corpus callosum in the prenatal period.

Agenesis of the corpus callosum: treatment and prognosis

Doesn't exist today effective methods treatment of the disease.

Treatment is aimed at minimizing the symptoms of the disease

Therapeutic measures consist of therapy serious symptoms, reducing them to a minimum manifestation.

Medications

• Antiepileptic series
• From the group of benzodiazepines
• Phenobarbital
• Corticosteroid hormones

Unfortunately, treatment is often ineffective, and even the use of potent medications does not bring the desired results.

To correct the patient's condition, various surgical interventions, application of methods of physiotherapy, physical therapy.

The prognosis for patients with agenesis of the corpus callosum largely depends on the type of anomaly. In the absence of a combination of the disease with any type of pathology, we can speak of a fairly favorable prognosis.

If there is a combination of agenesis and other pathology, we are not talking about a favorable prognosis; in such cases, manifestations of intellectual impairment, neurological problems, developmental delays and other symptoms appear with great frequency.

Treatment of patients with agenesis of the corpus callosum is currently symptomatic and not effective.

Brain pathology, agenesis of the corpus callosum, can be classified as a group of diseases with multiple developmental anomalies and an unfavorable prognosis.

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