Encephalomalacia: Causes, Types, Symptoms, Diagnosis, Treatment, Complications and Prevention

It is a type of severe brain damage that causes the softening or loss of brain tissue.

The causes of encephalomalacia are often related to inflammation or bleeding resulting from cerebral infarction, cerebral ischemia, infection, head trauma, or another injury.

The term encephalomalacia is often used in general pathological inspection since it is much easier to describe better the blurred cortical margins and the decrease in the consistency of brain tissue or the softening of the brain.

The softening can be seen in a localized area, or it can be extended, depending on the underlying cause. It can affect virtually any part of the brain, possibly damaging the frontal lobe, occipital, parietal, and temporal issues. This can present with several motor and sensory deficits.

What causes encephalomalacia?

Considered the most common cause of encephalomalacia, strokes occur due to the interruption of the blood supply to the brain, either due to a lack of blood supply to brain tissue or due to bleeding of a cerebral blood vessel.

Oxygenated blood is vital for the function and maintenance of brain cells, which will be damaged or die if the blood supply is not restored quickly.

Abnormal blood accumulation

It occurs when the blood flow in the brain is interrupted. This may be due to abnormal brain inflammation or the removal of brain tumors that damage the brain.



Damage to brain tissue due to conditions such as a stroke can lead to scar tissue formation. This area of ​​tissue undergoes contractions and finally forms encephalomalacia within the brain.

Traumatic brain injury

If the force is strong enough, the trauma of violent force in the skull will lead to bruises and possibly brain damage. Other forms of penetrating trauma, such as a knife or a bullet in the head, can also lead to the development of encephalomalacia.

Other causes

Encephalomalacia can also be the result of:

  • Degeneration of the brain.
  • Impairment of the brain.
  • Stroke or infection.
  • Blockage of blood supply to the brain.
  • Cerebral ischemia.
  • Biological pathogens release chemical toxins that infect the brain.
  • Cysts leptomeninges.
  • Surgery.

What are the types of encephalomalacia?


Also known as cerebrocortical necrosis or CCN (for its acronym in English), the interruption of thiamine production causes this neurological disease.

Thiamin is a vitamin B (B1) and a key chemical in glucose metabolism. If a person becomes thiamine deficient, significant side effects are likely to develop.

The most threatening is the inhibition of neurological activity. The polioencephalomalacia will result in damage to the gray matter of the central nervous system, where most of the processing of information takes place.

Essential functions such as speech, muscle control, memory, and sensory perception may be affected.


A type of encephalomalacia that mainly affects the white matter of the brain. The white mother is primarily responsible for ensuring communication between the various parts of the brain and the brain’s gray tissue.

The white matter is known to maintain the body’s involuntary actions, which include breathing, heart rate, regulation of body temperature, and blood pressure.

The development of leukoencephalomalacia can cause the deterioration of any of these functions.

There are three types of encephalomalacia, which indicate three levels of brain damage.

They are the following:

Smoothed red

It is commonly seen in cases of hemorrhagic stroke and occurs in regions where the brain tissue has turned red due to blood in the area where it previously was not.

White softening

It occurs due to a lack of blood supply to the affected region of the brain, which gives it a pale white or yellowish appearance. This is often a sign of ischemic damage that indicates brain cells’ imminent injury or death.

Yellow softening

Commonly seen in trauma victims, the appearance of yellow-looking brain tissue indicates plaque buildup in the brain’s arteries.

Symptoms of encephalomalacia

Like any cause of brain damage, the signs and symptoms will depend mainly on the affected brain area. This can result in decreased function on one side of the body or even loss of pain and temperature sensation.

However, the first signs of encephalomalacia can present similarly regardless of the area of ​​brain damage.

These symptoms may include:

  • Severe headaches
  • Vertigo sensation
  • Memory loss and mood swings if the frontal lobe is affected.
  • Clumsiness and decreased coordination.
  • Visual impairment that may be permanent or temporary.
  • Extreme drowsiness

Symptoms can vary from person to person, often presenting unique forms depending on the severity and extent of the damage. Extreme cases of encephalomalacia can potentially lead to terminal coma, depending on the area of ​​the brain’s softening.

Diagnosis of encephalomalacia

Encephalomalacia will often be diagnosed after a particular brain injury, such as a stroke or injury. Several image tests will be ordered to help verify your presence.

These will include:

  • Computed tomography (CT) scan: a noninvasive imaging test that is an excellent way to visualize soft brain tissue. It is done by taking a series of X-ray brain images at different angles.
  • Magnetic resonance imaging: another noninvasive imaging test that is thought to produce the most detailed images of the brain. The test uses strong radio waves and magnetic fields to create an idea of the body’s internal structures.

Encephalomalacia treatment

The brain tissue is not regenerative, which means that once it has gone, it has gone forever since it can not be rebuilt after it has been damaged.

This is the reason why the brain is considered so important. This means that the main focus of brain damage treatment is to reduce the additional damage or prevent it from occurring in the first place.

The treatment of encephalomalacia often involves the following:

  • Determining any underlying conditions that lead to these changes in brain tissue.
  • Elimination of damaged brain tissue in severe cases. However, there is no guarantee of the return of bodily function.
  • Stem cell therapy

Complications and prevention of encephalomalacia

This condition is considered extremely serious and will require the immediate attention of a trained medical professional who specializes in the study of the brain: a neurologist. If left untreated, complications of encephalomalacia may include functional disability, seizures, coma, and even death.

Unfortunately, there is no practical way to prevent encephalomalacia since it is not possible to know precisely when you can suffer a severe head injury or when you will attack.

However, you can do everything possible to avoid these scenarios, which will give you the best chance of preventing the condition, but there is no sure way to do it.