Cerebral Atrophy: Is Your Brain Shrinking?

Symptoms, Causes, and Possible Treatments

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Brain atrophy, also described as cerebral atrophy, is a condition in which the brain or regions of the brain literally shrink in size. It sounds terrifying to hear that you have brain atrophy, but there is a range of brain atrophy, and a mild degree is not always something to worry about.

Substantial brain atrophy can be associated with major neurological diseases, such as a large stroke or progressive dementia. In some instances, it isn't clear whether the atrophy caused the medical condition or whether the medical condition caused the atrophy.

Based on what we know about brain atrophy, there may be some ways of preventing it or slowing it down. If you or a loved one has been diagnosed with cerebral atrophy, it helps to understand the implications and to learn if there is anything you can do about your condition.

Symptoms

Atrophy in the brain can be focal or generalized. Focal brain atrophy affects one or more specific regions, while generalized cerebral atrophy affects the whole brain about equally throughout all regions.

It can occur slowly with a progressive illness, or it can happen with a sudden condition, such as a stroke. Sometimes, cerebral atrophy is present at birth.

Brain atrophy essentially means that neurons and their connections to each other have undergone necrosis (cell death). The affected areas cannot function as they should. Usually, with cerebral atrophy, there are still some functioning neurons among those that have undergone necrosis, so the symptoms may be partial rather than complete.

Progressive Brain Atrophy

Progressive atrophy typically occurs during adulthood, manifesting with a loss of skills. Progressive atrophy tends to be generalized, although there may be areas of the brain that are more affected than others. The symptoms tend to slowly worsen over the course of months or even years.

Symptoms of progressive brain atrophy include:

Congenital Brain Atrophy

Congenital brain atrophy may be present at birth and it tends to affect certain areas of the brain rather than the whole brain equally. Symptoms may be noticeable during infancy or early childhood and can include:

  • Seizures
  • Trouble walking
  • Delayed speech
  • Learning difficulties

Acute Focal Brain Atrophy

Focal brain atrophy can occur weeks after the sudden symptoms of a stroke, head trauma, or infection.

Effects of acute cerebral atrophy can include:

  • Weakness of the face, arm and/or leg
  • Numbness
  • Vision changes
  • Problems with balance

Causes

Atrophy can occur due to a disease process that damages brain cells, such as Alzheimer's disease, frontotemporal dementia, or Parkinson's disease. Or it can occur due to brain damage caused by a brain injury or illness.

Some experts suggest that aging is associated with slowly progressive atrophy, and researchers aren't sure whether this has any effects on a person's abilities or not.

Neurological Conditions

A number of neurological syndromes are characterized by degeneration of certain cells in the brain. Parkinson's disease and Alzheimer's disease are the most recognized neurodegenerative conditions that affect the brain. Others include Lewy body dementia, Huntington's disease, and normal pressure hydrocephalus (NPH). It is not clear why these conditions develop, and experts suggest that there may be a mix of genetic and environmental factors.

Sometimes, an acquired condition, such as AIDS, can be associated with cerebral atrophy and degenerative dementia. And Wernicke-Korsakoff syndrome can cause brain progressive atrophy and behavioral changes in association with alcohol abuse.

Brain Damage

In some instances, cerebral atrophy occurs due to sudden brain damage, such as a stroke, head trauma, a brain infection (encephalitis), or a brain tumor. These causes differ from degenerative neurological disease because they involve an episode of brain damage rather than a progressive condition.

Recurrent head trauma can cause multiple episodes of brain damage, resulting in severe cerebral atrophy and a condition described as chronic traumatic encephalopathy (CTE). And recurrent strokes can cause multiple areas of atrophy, typically with behavioral changes and vascular dementia. Sometimes multiple sclerosis (MS) can cause areas of brain atrophy as well.

After a region of the brain becomes damaged, the area may be exposed to inflammation and swelling. Eventually, this can cause necrosis of the affected brain cells.

Cerebral palsy (CP), a congenital condition, may also be associated with cerebral atrophy, but brain atrophy is not always present in CP.

Diagnosis

Typically, cerebral atrophy is identified with brain imaging tests. These tests can include computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or single-photon emission computerized tomography (SPECT) scan.

Your medical team might request that you have a brain CT or MRI if you develop symptoms such as weakness, numbness, vision, loss, or personality changes. In general, PET and SPECT are often done for research purposes rather than in the clinical setting. These tests may identify generalized cerebral atrophy or areas of focal cerebral atrophy.

Focal Atrophy

The location of cerebral atrophy within the brain may correspond to the clinical symptoms. Sometimes when regions of atrophy are noted on a brain imaging examination, it can help in diagnosing the medical condition.

  • Alzheimer's disease: The hippocampus, which helps form new memories, and the cerebral cortex, which helps us think, plan and remember, are affected by atrophy. Additionally, the whole brain may shrink as well.
  • Frontotemporal dementia: The frontal and temporal lobes are the most severely affected by atrophy.
  • Lewy body dementia: The midbrain, hypothalamus, and substantia innominata are the areas with the most atrophy in this condition.
  • Parkinson's disease: The substantia nigra and midbrain may appear smaller at late stages.
  • Stroke: Areas of the brain that have been damaged by bleeding or loss of blood supply may undergo atrophy, producing small "holes" in the brain.

Some other types of atrophy, such as vascular dementia, CTE, MS, and atrophy due to encephalitis or AIDS may result in cerebral atrophy in several regions of the brain—and it can be difficult to distinguish one of these conditions from the others based on the imaging alone.

Treatment

It is not possible to reverse brain atrophy after it has already occurred. However, preventing brain damage, especially by preventing a stroke, may reduce the amount of atrophy that you develop over time.

Some researchers suggest that healthy lifestyle strategies could minimize the atrophy that is normally associated with aging.

Medications

Prescription medications used for the prevention of strokes such as blood thinners, cholesterol-lowering agents, and antihypertensive medications may help prevent atrophy. These medications are not for everyone, but they can be beneficial if you have certain risk factors.

There are also medications used to treat and delay Alzheimer's disease, including Aricept (donepezil) and Namenda (memantine). They may help slow down atrophy, but the effect is believed to be small.

Lifestyle Strategies

Maintaining a lifestyle that includes physical exercise, a low cholesterol diet, blood sugar control, and a healthy weight can prevent or reduce the speed of cerebral atrophy by reducing the effects of inflammation on the brain.

Certain fats, specifically trans fats, have a harmful effect on the body and can increase the risk of strokes—avoiding trans fats can help prevent cerebral atrophy.

Stress management may also reduce brain atrophy because emotional stress is associated with conditions such as hypertension, heart disease, and stroke—all of which lead to vascular dementia. Furthermore, researchers are starting to see evidence that stress may contribute to dementia as well.

A Word From Verywell

Cerebral atrophy isn't always something to panic about. While there is no benefit to experiencing cerebral atrophy, a very slow and steady rate of brain atrophy may not cause any effects at all.

However, if you have substantial brain atrophy or focal brain atrophy, you may experience symptoms. Be sure to follow up with your doctor and to use medications and/or lifestyle strategies to reduce the impact and progression of cerebral atrophy.

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