Encephalomalacia from Physical Trauma in an Adult: A Case Report and Review of Literature

Encephalomalacia is the loss of brain tissue caused by an insult to the cerebral matter. Encephalomalacia is not frequently described in literature, with most focusing on infants and children, and rarely on the adult population. When described in the adult population, encephalomalacia is most commonly described following a cerebrovascular event. Reports of trauma-induced encephalomalacia in adults are uncommon, making such cases clinically significant. Despite some identified etiology in infants and children, our understanding of adult risk factors besides a cerebrovascular event remains limited. The following report describes a case of encephalomalacia in a young adult resulting from an atypical predisposing etiology.

Our case is of a twenty-eight-year-old male who presented with non-specific and abrupt symptoms of chest tightness, dyspnea, and aphasia after an apparent episode of alcohol intoxication. Further investigations and pertinent history-taking revealed a chronic history of similar symptoms traced back to a severe head trauma five years prior. The symptoms were ultimately attributed to left temporal lobe encephalomalacia, as evidenced by neuroimaging with CT and MRI. The patient received symptomatic treatment for possible alcohol withdrawal and was hospitalized until his symptoms improved. He was then discharged for continued outpatient follow-up care.

This case report aims to identify the unknown cause of neurobehavioral deficits in adults and highlight physical trauma as the probable etiology of encephalomalacia in such patients. It underscores the potential for early identification through neuroimaging and appropriate symptomatic management, offering hope for mitigating the impact on the patient's quality of life.