Encephalomalacia: Description, Causes and Risk Factors:

The abnormal softness of the cerebral parenchyma often due to ischemia or infarction.

Encephalomalacia is a medical term referring to a condition that causes the brain to become soft. Also referred to as cerebromalacia or cerebral softening, this abnormal change of the brain is caused by some sort of injury. Upon injury to the brain, swelling, and inflammation, the protective, healing process of the body, is initiated. In some cases, this variation in brain size triggers an alteration in the brain's pliability.


A softening of the brain can occur in a specific area or can be widespread. A hemorrhage or bleed into the brain can cause encephalomalacia, which is typically seen in a localized area where there is an abnormal collection of blood. Though rare, extensive softening of the brain can also be caused by degeneration or deterioration of the brain. This decline in brain tissue could be the result of a health condition or disease process.

Encephalomalacia can result from natural causes, such as infarction; therefore, not all cases of encephalomalacia or similar injuries are compensable. However, the condition can also be caused by trauma, which in turn may be the result of negligence or reckless conduct. In adults, another common cause of encephalomalacia is complications from surgery, particularly brain surgery to correct other problems, such as tumors.

Particularly common in newborns and infants is multicystic encephalomalacia or the formation of cavernous cystic in the brain after an injury. The most common cause of multicystic encephalomalacia, especially in infants is hypoxia. However, infants can also suffer encephalomalacia due to trauma from, for example, the improper use of forceps at delivery.

Millard-Gubler syndrome, a rare circumstance of compromised physical wellbeing, is an example of encephalomalacia. This disorder of unknown origin results in a one-sided change in the consistency of the brain. This health condition is caused by an obstruction of blood flow to the pons.

The pons is a part of the brain located on the brain stem. It is composed of small paired trunk-like structures that form a bridge to connect the different areas of the brain. It also serves as a pathway for neurological or nerve signals to relay information to various areas of the body. The pons controls bodily functions such as bladder control, sleep, breathing and equilibrium. It also is responsible for controlling the sensations and movements of the face.

Since the pons is connected to several cranial nerves, brain softening due to Millard-Gubler syndrome and its related encephalomalacia is considered a neurological disorder. Problems may irritate the nerves of the face which in turn can affect the movement of the eyes and facial sensations or feelings. In extreme cases, it may even bring about a condition called contralateral or crossed hemiplegia. This form of paralysis or inability to move affects the side opposite the encephalomalacia.


An individual suffering from encephalomalacia will experience a number of symptoms, all of which involve a loss of function. These symptoms can include somnolence (extreme drowsiness), blindness, ataxia (wobbliness and lack of coordination), sleepwalking, head pressing, circling, and, eventually, terminal coma. Also, depending on the location of the softened tissue, there can be different effects. For example, softening in the frontal lobe can lead to memory loss and mood swings.


Diagnosis of the condition is characterized by the presence of multiple, thin-walled cysts replacing the brain parenchyma. There may or may not be associated with ventriculomegaly or intraventricular hemorrhage. If the encephalomalacia is secondary to intracranial infections, calcifications may be seen. Assess the size of the cysts and the need for cyst shunts.


Treatment of encephalomalacia consists of finding and treating the underlying cause of the change in the brain mass or consistency. In severe cases, removal of the softened brain material may be necessary. It is unclear whether the soft brain tissue can ever return to normal. It is also unclear if functional mobility or sensations impaired by changes of the brain consistency will return to normal once those areas are removed.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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