Brain atrophy

Brain atrophy with emphasis on the cerebral cortex (“cortical atrophy”) in Alzheimer's disease, the furrows ( sulci ) appear deepened and widened, the brain as a whole smaller. Including a healthy brain.

Classification according to ICD-10
G31.-	Other degenerative diseases of the nervous system, not elsewhere classified
ICD-10 online (WHO version 2019)

As brain atrophy (colloquially brain atrophy ) refers to a gradual loss of brain substance . To some extent, a decrease in the volume and mass of the brain with advancing age is normal; from the age of 20 onwards, around 50,000 to 100,000 brain cells are lost every day. Only changes that go beyond age are referred to as brain atrophy. In the long term, brain atrophy can lead to neurological failure symptoms and a progressive loss of cognitive performance . However, there is no linear relationship between the extent of atrophy and impaired performance.

Classification

Often the gray matter of the cerebral cortex in particular recedes; in this case it becomes thinner, the brain convolutions ( gyri ) flatten and clump, the furrows ( sulci ) appear deeper and wider. The technical term for this is cortical atrophy .

If there is more of a breakdown of white matter (medullary deposits), this can be determined in the imaging by an enlargement and coarsening of the ventricular system. There is subcortical atrophy here .

In addition to diffuse brain atrophy, some forms of dementia ( frontotemporal dementia ) show a circumscribed, localized atrophy.

causes

The causes are varied. Often, in the context of primarily neurodegenerative diseases, there is a breakdown of brain matter. This group includes dementias of the Alzheimer's type , in which the pathophysiological basis is a deposition of plaques containing amyloid, Lewy body dementia with deposition of the characteristic Lewy bodies, and Pick's disease , which is characterized by Pick inclusion bodies. On the other hand, repeated small infarcts and vascular changes lead to a predominantly subcortical loss of substance ( Binswanger's disease ). Certain metabolic diseases ( leukodystrophy ) and some chronic infectious diseases ( progressive paralysis ) are rare causes. Brain atrophy, on the other hand, is also one of the changes that occur with chronic alcohol abuse (see Wernicke-Korsakov syndrome ). Even with advanced multiple sclerosis , brain atrophy that extends beyond age can sometimes be observed.

Individual evidence

1. ↑ Alphabetical directory for the ICD-10-WHO Version 2019, Volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 91
2. ↑ AJ Jacobs: Britannica & I . From someone who set out to become the smartest person in the world. Ullstein, 2006, ISBN 978-3-471-79513-2 , pp. 228 (Original title: The Know-It-All .).
3. ↑ Russel Ash: 1001 facts, numbers and records . Arena, 1999, ISBN 3-401-04850-3 , pp. 95 (Original title: Factastic Book of 1001 Lists .).

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