Brain Diseases: Causes, Symptoms & Treatment

The human brain is undoubtedly one of the most complex organs of all and can be affected by a wide range of diseases. Since it forms the body’s central nervous system (CNS) along with the spinal cord, brain diseases usually not only affect localized brain structures and functions, but this is automatically associated with far-reaching physical and psychological effects.

What are brain diseases?

Schematic diagram showing the anatomy and structure of the brain. Click to enlarge. In brain diseases, there is either an injury and consequent failure or death of neurons, or the complex circuitry of the brain is impaired or pathologically altered. Both have a direct effect not only on pure brain function, but are also accompanied by the associated physical and psychological symptoms and changes. Therefore, the spectrum of brain diseases is extremely wide – from traumatic injuries (e.g. accident with severe head and brain injury) to strokes or brain hemorrhages to dementia, multiple sclerosis or even the waking coma (so-called apallic syndrome). These are just a few examples, because there are almost innumerable brain diseases, which can cause a wide variety of symptoms. The brain is the central control unit of the body, which not only processes information and sensory impressions of the environment, but accordingly also issues commands to each cell in order to be optimally adapted and integrated to the outside world. These highly complex and energy-consuming tasks are performed by about (estimated) 100 billion nerve cells and just as many glial cells, which are not only networked with each other, but also connected to every part of the body and are also significantly responsible for its functioning and health. The brain is responsible for controlling vegetative processes (such as breathing, heart rate, wakefulness and recovery phases, sympathetic tone and vagotonia) as well as cognitive performance, sensory perception or emotions. In this context, developmentally older brain parts such as the brain stem, the medulla oblongata (extended spinal cord) or even parts of the midbrain work closely together with younger systems (e.g. cortical or prefrontal areas) to enable perfect physical interaction – and beyond that, from motor and sensory performance to the development of intelligence and personality. This is even more important to understand in order to approach the far-reaching role and complexity of brain diseases in general. Also highly interesting: the brain consumes up to 20% of our energy at rest to perform all its services and functions.

Causes

Therefore, the spectrum of possible brain diseases in general is also very large and complex and affects very many areas of medicine. General functional disorders or pain, but also psychological changes or motor to cognitive losses can be signs of brain diseases. Hormonal changes can also originate in the brain, and the pituitary gland may be involved. For this reason, there is no single cause or definition for brain diseases: These range from exogenous, traumatic influences (e.g., injuries) to circulatory lesions (such as circulatory disorders) to neoplastic changes, i.e., cell proliferations in the brain (e.g., tumors, gliomas, cysts in the brain, etc.). Thus, it can be seen that every brain disease itself is or can be the reason or the beginning for far-reaching physical changes and diseases. Depending on the brain disease, the cause must be investigated: Is there an exogenous trauma? Are circulatory disturbances the reason? Are there inflammatory processes in the brain (such as encephalopathy), which can be caused by viruses, fungi, bacteria, even worms? Is there an oxygen deficiency (e.g. perinatal, i.e. around birth), to which nerve cells in particular react very sensitively, since they are among the cells that perish after only a few minutes of oxygen deprivation? For many brain diseases, the exact etiology, i.e. the concrete causes and origin of the disease are unknown, which is why brain diseases generally involve the localization of the existing functional disorder or disease within the brain, but also its effects on the entire body.Moreover, many brain diseases are not only not yet fully understood in terms of their causes, but are also all the more difficult to treat (and hardly causal) as a result. For example, the cause of multiple sclerosis, a severe chronic inflammatory disease, is still largely unknown; in MS, there is a degenerative change in the myelin sheaths of the central nervous system, resulting in severe motor paralysis and dysfunction. Degenerative brain diseases, the cause of which is largely unknown, also include Alzheimer’s disease, a severe form of dementia, as well as Parkinson’s disease (motor disease, so-called “shaking disease”), epilepsy or the rare disease Huntington’s disease (so-called “St. Vitus’ dance”) with uncontrolled muscle twitching. What is the reproducible cause of vascular occlusion or vascular rupture in the case of stroke, which is widespread in our part of the world, cannot yet be said with absolute certainty. In any case, the cerebral stroke (apoplexy) belongs to the more frequent brain diseases, and the differently pronounced symptoms (among others, suddenly appearing disturbances of consciousness, mostly one-sided paralysis symptoms) are the consequences of the lack of blood and oxygen supply after a vascular occlusion and/or pressure on motor or sensory areas in the brain. Incidentally, when the brain is irreversibly damaged and fails (i.e., brain waves can also no longer be measured), this is referred to as brain death and, which is ethically extremely controversial, is also recognized as a general definition of death.

Typical and common diseases

  • Stroke
  • Epilepsy
  • Brain tumor
  • Dementia
  • Creutzfeldt-Jakob disease
  • Memory gaps
  • Brain hemorrhage
  • Meningitis
  • Migraine
  • Depression
  • Concussion

Symptoms, complaints and signs

The signs of brain disease are extremely diverse and strongly dependent on the type and severity of the disease. For example, stroke is characterized by paralysis, dizziness, and speech and visual disturbances, while epilepsy is typically manifested by seizures, twitching of limbs, and impaired consciousness. Characteristic of meningitis are high fever, headache, neck stiffness, photophobia, and nausea; in meningitis caused by meningococci, tiny hemorrhages in the skin (petechiae) occur in the advanced stages. Dementias such as Alzheimer’s disease are characterized by a progressive loss of mental abilities. At the beginning of the disease, memory disorders, difficulties with temporal and local orientation, and word-finding problems are noticeable; as the disease progresses, even everyday activities can no longer be performed independently. The mental and physical deterioration is often accompanied by severe mood swings and depressive moods. Creutzfeld-Jakob disease presents a similar picture, in which both mental and physical abilities are increasingly impaired: Affected persons suffer from pronounced forgetfulness, paralysis, balance and coordination disorders. In the late stages of the disease, there is usually a pronounced lack of drive and depression. Migraine is a comparatively harmless but nevertheless stressful brain disease: It is manifested by severe, seizure-like headaches that generally occur on one side and are accompanied by nausea and sensitivity to light.

Diagnosis and course

The diagnosis of brain disorders is as varied as the different and numerous forms associated with them. This is because the symptoms range from changes in consciousness to impaired thinking and performance and psychological changes to more or less severe motor or sensory impairments as well as other physical functional deficits, such as visual disturbances, or even severe pain. In diagnosis, a distinction is often made between brain diseases with neurological symptoms and those with psychiatric symptoms. For the respective diagnosis and clarification of a brain disease, precise differential diagnostic examination methods, especially by means of imaging techniques, are therefore indispensable.On the basis of these, not only a clearer diagnosis can be made, but also a possible course can be predicted – depending on the disease – or a close monitoring of the course is possible. The imaging, diagnostic possibilities include magnetic resonance imaging, but also computed tomography of the brain (cerebral computed tomography, CCT – with or without contrast medium). The measurement of brain waves and the respective activity of different brain areas can also be helpful for diagnostic clarification in some cases. The electroencephalogram (EEG) is used for this purpose. Those who, as the saying goes, have something “with the nerves“, do not necessarily only have the narrowly defined brain functions affected, but also far higher functions can be involved, such as consciousness, mood or even cognitive abilities. And brain diseases are not rare: According to estimates, between 400 and 500 million people worldwide are affected by brain diseases, making them one of the central challenges of modern research, diagnostics and also therapy. In WHO statistics, about half of the most common diseases resulting in premature death come from the field of nervous and brain diseases, with the aforementioned far-reaching consequences.

Complications

As a rule, it is not possible to predict the overall complications and complaints of brain diseases. However, these can have a strong negative impact not only on the physical but also on the psychological state of the patient, leading to severe discomfort. In most cases, those affected suffer from epileptic seizures or stroke. Memory lapses or coordination difficulties occur. Furthermore, mental regression and thus retardation may occur, so that the affected person may be dependent on the help of other people in everyday life. It is not uncommon for brain diseases to lead to depression and other psychological complaints. Increased intracranial pressure can lead to headaches, which not infrequently spread to other areas of the body. The brain diseases can also lead to visual disturbances or hearing loss. In the worst case, the patient goes completely blind. Whether treatment leads to a positive course of the disease or is possible at all cannot be predicted in the case of brain diseases. However, treatment is always causal and depends on the underlying disease. In some cases, no treatment is possible, so brain diseases lead to premature death of the patient.

When should you see a doctor?

A visit to the doctor is necessary if there are changes in brain function. If memory lapses, orientation problems or disturbances in memory occur, a doctor is needed. If disorders of consciousness set in, if the affected person complains of a feeling of pressure inside the head, or if he or she suffers from headaches, he or she should see a doctor. If the complaints spread or the intensity of the symptoms increases, a clarification of the signs is necessary. Before taking a painkilling medication, consultation with a doctor should always be sought to avoid complications. In the event of sleep or speech disturbances, confusion, restrictions in vision or reduced hearing ability, a visit to the doctor is advisable. Changes in personality, a behavioral abnormality, or sudden decreased intelligence are uncommon. A physician should be consulted so that an examination and treatment can be initiated. If motor activities can no longer be performed, or if problems begin with the performance of everyday tasks, the affected person needs help. Reduced performance, learning problems or abnormalities in cognitive processing should be investigated. If there are circulatory problems, a pulling sensation in the head or changes in emotional processing, a doctor is needed. If unexplained anxiety sets in, memories are obviously false, or the person suffers from sensory disturbances, a physician should clarify the cause of the symptoms.

Treatment and therapy

As for the therapy of brain diseases in general, this depends on the particular disease, the extent of the brain areas affected, and the age, as well as on the stage and prognosis.In many cases, medical intervention can only be palliative or symptom-oriented, especially in those cases in which the cause of the disease is unclear and thus a causal therapy is (currently still) excluded. In the case of brain diseases in which nerve cells die (e.g. Parkinson’s disease or dementia) and thus motor control and performance or memory functions suffer more and more and are increasingly disturbed, therapy is limited to alleviating the sometimes severe symptoms as far as possible with medication or to slowing down the progression of the disease. The aim of therapy here is to maintain the patient’s quality of life as well as possible and for as long as possible, and to reduce pain or symptoms of failure. The situation is similar with psychiatric brain diseases such as schizophrenia or depression, in which the communication of nerve cells is disturbed and severe mood swings and even delusions can occur as a result. Here, too, causal therapy is not yet possible in most cases, and drug and psychotherapeutic options are available to make the symptomatology manageable. Due to the complexity of the brain, direct intervention is rarely possible without major risks. While drug therapies often cause severe side effects (some of which have unforeseeable long-term consequences), surgical measures are naturally associated with a disproportionately higher risk. However, in the case of acute traumatic injuries and accidents involving the brain, these are in many cases life-saving. In the case of acute traumatic brain injury, emergency medical measures can usually only treat severe cerebral hemorrhage or edema formation by means of surgery, thus treating life-threatening cerebral hypertension. The accident of Michael Schumacher, which has since caused worldwide media attention and sympathy, has shown how “slight” external force is sufficient to cause an acute life-threatening brain injury. In this case, a relatively low speed and a “small” stone were enough to send a high-performance athlete wearing a helmet into a coma. What modern medicine is capable of achieving in such cases really deserves the highest attention, because if left untreated, such a craniocerebral trauma would certainly lead to death as a result of bleeding, edema and pressure formation within the brain. In this case, immediate, and above all prompt, intensive medical therapy is life-saving. Surgical intervention is also possible for many brain tumors, but here the stage of the cancer and especially the localization of the brain tumor play a decisive role for the prognosis and the therapeutic scope. In the case of neoplastic brain diseases, i.e. brain tumors or gliomas, the therapists also have other treatment options, ranging from drug (e.g. chemotherapeutic) therapy to radiation. Here, however, the risk of irreversible brain damage (from invasive or aggressively invasive therapies) must always be weighed against the risk from the primary disease for the patient’s benefit.

Outlook and prognosis

The prognosis for brain disease is unfavorable in most cases. Basically, it depends on the underlying disease present and the patient’s individual overall diagnosis. If a disease with a progressive course is present, the symptoms gradually increase in intensity. In diseases such as dementia or multiple sclerosis, a slow decay of the tissue or nerve cells is to be expected. According to current scientific and medical knowledge, the progress of such a chronic disease cannot be prevented. If damage to brain tissue occurs as a result of a single trigger, improvement in health can be achieved under certain circumstances. This depends on the time of initial treatment and the extent and location of the damaged brain tissue. Nevertheless, a complete recovery is not to be expected. It occurs only in isolated cases. Nevertheless, with optimal medical care, relief of symptoms can be achieved. Since damaged brain tissue cannot be renewed, existing impairments remain constant for life in many patients. This is particularly true if the affected brain areas represent important switching points in the functioning of various systems in the organism.If the affected person suffers from an infection, a complete cure of the brain disease can be achieved with prompt and optimal medical care.

Prevention

Especially as far as the influenceable brain diseases are concerned, i.e., the accident-related lesions and traumas, extensive prevention is possible and urgently recommended: Putting on a helmet during sports activities such as cycling or skating, skiing, tobogganing, etc. should be – especially for children, but of course also for adults – an absolute duty and a matter of course. Serious head and brain injuries can occur even at low speed and at first glance unspectacular accidents and can lead to life-threatening brain diseases and injuries. Of course, in the broadest sense, safety measures to prevent bathing accidents, especially among children, are also part of this. This is because the lack of oxygen supply to the brain cells can also cause irreversible damage to the brain or, of course, there is an immediate danger to life if water enters the lungs. As for the numerous non-accidental brain diseases, preventive measures are difficult to narrow down. A healthy lifestyle, conscious self-monitoring and, in case of doubt, early clarification can certainly be a useful way to detect potential brain diseases early enough to be able to treat them well. However, due to the unclear pathogenesis of many brain diseases, no clearly preventive measures can be recommended. This is also in view of the fact that some brain diseases are genetically determined and therefore may be difficult to influence or prevent by human action. A generally healthy lifestyle, sufficient exercise and recreation, a healthy diet, and the avoidance of too much stress, but also too high electromagnetic influences (keyword: cell phone radiation), are certainly decisive for the health of the brain and are urgently recommended.

Aftercare

In most cases, the person affected by brain diseases has very few or no measures and options for aftercare. In this context, the brain diseases cannot always be treated, so that such a disease may also result in a reduced life expectancy of the affected person. However, an early diagnosis usually always has a very positive effect on the further course of this disease and can limit further complications or a further worsening of the symptoms. In some cases, the symptoms can be alleviated by surgical intervention. After such an operation, bed rest must be observed in any case. The affected person should rest and not exert himself. Since brain diseases can also lead to psychological upsets, depression or an altered personality, most patients are also dependent on the support and help of their own family and friends in everyday life. This is especially true when some bodily functions are restricted by the brain diseases. Even in the case of tumors, most patients are dependent on mental support from those close to them. The further course depends thereby strongly on the exact kind of the illness, so that thereby no general prediction can take place.

What you can do yourself

Brain diseases can occur in a wide variety of forms, so that your own measures for improvement depend on the existing underlying disease. Often there is a brain tumor, which requires medical and drug treatment as soon as possible. Own measures, which contribute to a fast and clear improvement, can be taken with an existing brain tumor only conditionally. Only the early visit to the doctor is important and significant. Home remedies or free drugs will not bring about any improvement in the case of a brain tumor. Only early diagnosis and treatment will have a positive effect on the later course of the disease. Another and also frequently occurring brain disease is dementia. In this case, there is damage to the short-term memory, so that recently received information is directly forgotten. However, people suffering from dementia can also take measures themselves that lead to an improvement. The brain should not always have to process the same sequences. Small brain games, getting to know new people or even normal everyday situations help to slow down dementia significantly.The following therefore applies: In the case of existing brain diseases, there are only limited measures that an affected person can take himself. It is important to see a doctor early on so that suitable therapy can be initiated.