Chem symptoms. Chronic cerebral ischemia in residents of the northern territories (using the example of the Komi Republic). Symptoms and stages

Cerebrovascular insufficiency of the brain - pathological changes in blood vessels that lead to ischemic disease, the development of hypoxia and dysfunction different systems body.
CCVD of the brain is a disease that is characterized by chronic disruption of blood flow and the development of small-focal disorders.

As a result of CRH, discircular disease develops, which affects the brain center due to vascular insufficiency. The disease is common among patients whose age does not exceed 40 years. It depends on the environment and poor nutrition.
Cerebrovascular disease leads to the development various diseases circulatory system, namely:
strokes;
Occlusion or vascular spasms, arthritis;
Hemorrhages in the head;
Atherosclerotic and hypertensive encephalopathy;

Medicine knows the following reasons for the development of the disease:
Cholesterol deposition, thrombus formation, blockage of blood vessels, and as a result - vascular obstruction;
Low level blood clotting, the formation of thrombosis and possible thromboembolism lead to a disorder of brain microcirculation;
Spasms of the arterial walls reduce blood flow in the vessels of the brain;
Vasculitis leads to disruption;
Vertebro-basilar insufficiency develops against the background of osteochondrosis;

Diabetes;
Advanced age;
Overweight;
;
Stressful situations;
;
Previous head injuries;
Hereditary factor
Use of tobacco products;

Cerebrovascular disease of the brain at the initial stage of development has the following manifestations:
Lack of performance, increased fatigue;
Emotional instability;
Increased fussiness;
Lack of sleep;
Feeling hot;
Asthenia;
Increased heart rate;

Brain hypoxia leads to the development dangerous violations and the manifestation of more serious symptoms: lack of ability to concentrate, impaired memory, ability to think, feeling of constant pain in the head, inability to think.

Patients suffer from depression, decreased intellectual capabilities, psychosis and neurosis, and weakness. A tendency to hypochondria appears, convulsive states occur, the gait becomes unsteady, and vision decreases. As a result, development, stroke, pelvic disorders, dysphagia. All of these symptoms give reason to believe that an acute cerebral circulatory disorder is developing - cerebrovascular stroke.

Cerebrovascular disorder is divided into three degrees:
I degree – inconspicuous course, signs give reason to suspect the development of another disease;
II degree – a mental disorder that results in disability, but retains the ability to self-care;
III degree – vascular dementia, leading to the need for constant attention and care for the patient;

Diagnosis procedure

Only a neurologist or vascular surgeon can diagnose and prescribe treatment. General diagnostics includes:

1. Donating blood for biochemical and clinical analysis;
2. Calculation of thrombosed indexation;
3. Purpose of an ECG;
4. Test for syphilis;
5. General urine analysis;
6. Radiography;

Instrumental diagnostics are carried out:

1. Duplex or triplex angioscanning – prescribed for primary diagnostic purposes. A very safe and inexpensive way to study blood vessels without causing harm to health.
2. Angiography is a method of examining vessels with contrast, which allows one to determine their condition, possible pathology, and extent. The method involves the introduction of a contrast agent into the blood to determine thrombosis, damage or narrowing of the vessel;
3. A simple scintigraphy method is a study using a highly sensitive method for diagnosing and identifying circulatory disorders. Special drug is injected into a vein and scanned 15 minutes later. This period allows the radioisotope to spread and accumulate in the altered area of tissue. The radiation dose is harmless;
4. Ultrasound examination using transcranial Doppler sonography evaluates the speed of blood flow and identifies hemodynamic disturbances;
5. Magnetic resonance and computed tomography;

Self-diagnosis and treatment are impossible. Correctly prescribed treatment improves the patient's life and reduces the risk of stroke.
The main goal of therapeutic intervention is to eliminate the dysfunction of the brain. For this purpose, the cause is determined and eliminated. In addition to medication measures, doctors insist on changing lifestyle, that is, getting rid of excess weight, quit smoking and alcohol, accustom yourself to a healthy and balanced diet.

Medication measures

A set of measures that can overcome such an ailment as cerebrovascular disease includes the prescription of antisclerotic, antihypertensive, and hypoglycemic drugs.

Special therapy

The main medications that improve blood circulation in the brain are those aimed at treating chronic cerebrovascular insufficiency. These include:
1. Improving blood flow in the brain, blocking the calcium channel, reducing the speed of signals, improving blood composition. Medicines based on nifedipine promote vasodilation;
2. Antioxidants used, which are prescribed for the treatment of CVD, stroke and encephalopathy;
3. Eliminating affected areas of blood vessels - antihypoxants;
4. Metabolic agents;
5. Nootropics;
6. Dilates the lumen of brain vessels;
7. Having a hypocholesterolemic effect;
8. Antispasmodic action;

Basic treatment

Cerebrovascular disease involves the normalization of respiratory, cardiac and vascular functions, maintaining homeostasis, and neuroprotection.
For this purpose, sanitization of the respiratory tract, tracheal intubation, and artificial ventilation of the lungs are carried out. Swelling of the lungs and signs of heart failure can be eliminated by prescribing Lasix or Pentamin. Those suffering from cardiac arrhythmias undergo antiarrhythmic therapy - they are prescribed Strophanthin and antioxidants. Autonomic functions can be relieved with the help of Seduxen and Diphenhydramine.

The use of osmotic diuretics - Furosemide - will help overcome cerebral edema. Antenolol, Nifelipin, and Dibazol help stabilize blood pressure. Metabolic disorders can be corrected by restoring the volume of extracellular fluid content - plasma, glucose, Ringer's solution. The intensity of convulsive conditions can be reduced with the help of psychotropic drugs, muscle relaxants, analgesics - “Analgin”, “Promedol”.

The use of hyperbaric oxygenation is a method of physiotherapeutic treatment that provides the blood with the required amount of oxygen and promotes its entry into the affected brain tissue. During this procedure, the patient is in a specially designed chamber and inhales pure oxygen.

This method eliminates oxygen deficiency in tissues and helps restore aerobic glycolysis. This procedure helps improve the patient’s standard of living, reduces the symptoms of pathological changes and prevents the development of serious complications.

Surgical method of treatment

Severe pathologies that cannot be treated drug treatment, require surgical intervention. The patient has blood clots and plaque removed from the arteries, thereby increasing the vascular lumen, using a catheter or balloon that is placed in the artery to keep the vessel open. Cerebrovascular diseases, such as intracerebral hemorrhage, require surgical treatment.

Traditional methods

In some cases, cerebrovascular disease can be treated using traditional medicine.

The peony rhizome is dried, crushed, and poured with boiling water. This decoction is infused for 60 minutes, then filtered and taken five times, one spoon at a time.
Using a meat grinder, crush orange (2 pcs.) and lemon (2 pcs.), mix with honey. Afterwards it is infused in a cold room and taken 1 tbsp. spoon three times a day.
Conifer needles are poured with boiling water, infused and added to the boiled lemon juice. This remedy is taken on an empty stomach for three months.
Infused celandine is taken on an empty stomach three times a day for two weeks.

Forecasting

Measures to prevent the development of cerebrovascular disease:

1. Bringing blood pressure levels back to normal;
2. Treatment of parallel developing pathologies;
3. Giving up bad habits;
4. Physical exercise;
5. Rational and balanced diet;
6. Maintaining a daily routine;
7. Weight control;
For the purpose of prevention, patients are prescribed medications that help improve cerebral circulation and eliminating high blood clotting. Timely and correct treatment This disease not only improves the quality of life, but also reduces the risk of stroke and other complications.

Video

When visiting a doctor, quite often people complain of fatigue, memory impairment, headaches, Bad mood, insomnia. Doctors hear about these symptoms every day. After all, from time to time they bother all people. Sometimes these symptoms go away on their own and quickly, but in some cases their duration and progression are noted. Carefully! After all, we can talk about impaired blood circulation in the brain tissue. This disease is called cerebral ischemia. This is one of the serious and dangerous ailments.

What is a disease?

Cerebral ischemia is a chronic, severe disease. It is caused by a disruption in the body's oxygen supply. All human systems suffer from this. But the brain reacts first.

The mechanism of the disease is very simple. The vessels that transport blood are susceptible to the accumulation of cholesterol deposits. It’s not for nothing that nutritionists advocate for limited consumption of foods containing it. Of course, normal blood flow through “clogged” vessels is completely impossible. Chronic atherosclerosis occurs. It is characterized by blockage of blood vessels.

The main function of blood vessels - transport - is lost. Through blood vessels clogged with cholesterol plaques, the blood cannot sufficiently enrich the body with oxygen. Such fasting is a severe stress for all human tissues. It should be noted that the brain is the largest consumer of oxygen. That is why this fasting is destructive for him. Moreover, the consequences provoked by cerebral vascular ischemia can be fatal. After all, these cells are not restored.

Causes

Quite different external and internal factors can provoke the development of such a serious disease as cerebral ischemia. Treatment that is not started in a timely manner ends very badly. This is why it is important to diagnose the disease early stages. And, of course, do not delay treatment.

The main causes of ischemia in adults include:

Atherosclerosis. The buildup of fatty deposits significantly narrows the lumen, impeding blood flow.
The appearance of blood clots. An equally rare cause of the development of the disease. Complete blockage of a cerebral artery by a blood clot completely blocks the necessary transport.
Heart failure. One of the serious provoking factors. Acute failure, disturbances in heart rhythm lead to ischemia.
Hypertension.

However, these are not all the reasons why a serious illness can develop.

Doctors include the following factors as additional sources of the disease:

cardiovascular problems;
blood diseases;
vasculitis;
diseases associated with the spine;
tachycardia;
gas poisoning (carbon monoxide);
anemia.

Doctors include elderly people and patients diagnosed with diabetes. It should be noted that doctors also consider unhealthy diet lovers and smokers to be at risk.

Forms of the disease

In medicine, there are two categories of illness:

Acute cerebral ischemia. Its occurrence is associated with severe oxygen starvation. It requires immediate treatment. Otherwise, ischemic attacks occur. Attacks are possible, characterized by loss of sensitivity in certain areas, paralysis of certain areas of the body, and temporary blindness.
Chronic cerebral ischemia. This form of the disease develops gradually. As a rule, the impetus for its occurrence is acute stage, which was not given due importance in time. Untreated, it gradually progresses and leads to rather undesirable consequences. The apogee of the disease can be a stroke. Sometimes - myocardial infarction.

Characteristic symptoms

The most important symptom of the disease is fatigue during active brain function. Subsequently, forgetfulness and serious memory impairment occur.

The main symptoms of cerebral ischemia:

weakness;
dizziness;
fatigue;
nausea;
fainting;
headaches, often turning into migraines;
sleep disturbance;
irritability;
pressure changes;
increased excitability;
speech disorder.

It is important to understand that the disease has several degrees of development. The above symptoms are the main ones that occur in a person who is diagnosed with cerebral ischemia. Symptoms and treatment directly depend on the degree of the disease. And each new stage adds to the main manifestations additional signs characteristic of this disease.

Degrees of the disease

There are three stages. Each of them is characterized, as already mentioned, by additional symptoms. Accordingly, and necessary treatment also varies. It is extremely important not to let the disease progress. At the first symptoms, you should consult a doctor so as not to miss the moment of development of a serious illness.

Main stages:

1st degree cerebral ischemia. In general, the patient's health is quite normal. Sometimes there is slight malaise, chills, and dizziness. After physical work, pain appears in the hands. In some cases, a change in gait is noticed. The person seems to “shuffle” and takes smaller steps. Those around you may notice a change in the patient’s temperament and character. As a rule, grade 1 cerebral ischemia causes the patient an inexplicable feeling of anxiety, constant irritability, and sometimes even depression. If you observe a person more carefully, you can identify absent-mindedness. It is very difficult for the patient to concentrate and concentrate. Slow thinking is also characteristic.
Cerebral ischemia grade 2. This stage is characterized by an increase in symptoms. The person feels the progression of headaches and nausea. Behavioral disorders are expressed more clearly and are already quite noticeable. There is a loss of everyday and professional skills. The ability to plan actions is increasingly difficult. At the same time, critical self-esteem of behavior decreases.
Cerebral ischemia grade 3. Absolute inaction regarding treatment leads to this stage. Acute damage to almost all neurological functions is detected. The patient exhibits Parkinson's syndrome and is impaired motor functions all extremities, urinary incontinence is observed. Decreased control of the legs and loss of balance lead to difficulty walking. In some cases, movement is completely impossible. Such a patient loses orientation in space. Sometimes he cannot adequately understand whether he is standing, lying or sitting. Speech is severely impaired, memory is lost, and thinking is absent. Mental disorders reach their apogee, sometimes one can observe a complete collapse of personality.

Diagnosis of the disease

Unfortunately, it is very difficult to detect the disease on initial stage. Ischemia of cerebral vessels may not cause any complaints in the patient. It should be understood that blood vessels do not have nerve endings, so the development of the disease within them proceeds quite unnoticed. Unpleasant sensations arise only when unpleasant consequences, as a rule, have already occurred.

To make a diagnosis, the attending physician carefully studies the symptoms based on the patient’s complaints. Checks carefully past illnesses in order to determine whether a person is at risk. In addition, chronic cerebral ischemia is diagnosed using a variety of examination methods:

cardiography;
laboratory tests (the level of cholesterol and sugar in the patient’s blood is determined);
physical examination (pulsation of blood vessels is measured);
ultrasound tomography;
electroencephalography;
Doppler tomography.

The last survey method is quite a unique and important study. Dopplerography involves measuring the speed of blood movement. Thus, it becomes possible to localize cholesterol plaques in areas of slowdown.

Causes of illness in newborns

One of the serious childhood pathologies is ischemia. Until today, medicine has not found effective drugs to get rid of the disease. The causes of the disease in children and adults vary significantly.

Cerebral ischemia in newborns is a consequence of hypoxia that occurs in the prenatal state or during childbirth. Quite often the disease develops in infants whose mothers are over 35 years old.

The main factors provoking the disease:

multiple pregnancy;
toxicosis on later, which occurs in a severe form and is accompanied by an increase in pressure and the presence of protein in the urine;
placental abruption;
illnesses and bad habits of the mother;
the birth of a baby earlier or later than the due date;
disruptions in the uteroplacental circulation, which provokes necrosis of parts of the baby’s brain;
heart defects in a child.

In medicine, there are three degrees of severity:

Mild stage of ischemia. You can observe a pronounced depressed state in the baby. Or, conversely, strong excitement, which lasts up to five to seven days.
Moderate degree of ischemia. This form is usually accompanied by seizures in newborns. Such symptoms can be observed in a child for quite a long period.
Severe ischemia. These babies are immediately placed in the intensive care unit.

No matter how scary the diagnosis of “cerebral ischemia” may sound, treatment carried out by modern medicine allows us to achieve significant success. The main directions are the restoration of blood circulation in the brain and the creation of conditions for the full functioning of areas unaffected by the disease.

The main thing to remember is that only an experienced doctor can evaluate all the signs and choose the right treatment methods to minimize the consequences. In milder cases, timely adoption of measures will completely eliminate hypoxia in the newborn’s brain.

Treatment of the disease

Unfortunately, no sufficiently effective methods have been found to combat the disease. If a patient is diagnosed with chronic cerebral ischemia, treatment should be carried out only by a competent neurologist.

As a rule, the fight against the disease includes the following measures:

Normalization of blood pressure, preventive methods to avoid stroke and ischemic attacks. For these purposes, a variety of blood thinning and vasodilating drugs are used. Such medications include Pentoxifylline, Warfarin, etc.
Restoring blood circulation in blood vessels, improving metabolism. Omaron is considered to be a fairly effective remedy. It contains piracetam. Namely, this substance has a beneficial effect on cells, restoring them and significantly improving oxygen saturation. The drug "Encephabol", which is widely used in the treatment of children with a similar illness, has also proven itself.
Restoration of physiological and behavioral functions. For such purposes, massage, magneto- and electrophoresis, exercise therapy, and restorative therapy are prescribed.

A widely used drug that can improve brain activity is Cerebrolysin. Medicines that are intended to maintain blood circulation - “Bilobil”, “Nimodipine”.

If the patient has fairly advanced cerebral vascular ischemia, treatment consists of surgery. The main goal is the surgical removal of sclerotic plaques. Brain surgery is the most complex look surgical intervention. They require the highest skill from the doctor. At the same time, quite often they are fraught with serious, sometimes completely unpredictable, severe consequences.

This is why surgery is a last resort. It is resorted to only in cases where conservative treatment did not give positive results.

Folk remedies

It is important to understand that without proper medicinal methods cerebral ischemia cannot be stabilized. Folk remedies can only be used as additional methods of treatment. The following are considered quite effective:

oak bark decoctions;
freshly squeezed carrot juice;
mint decoctions;
Adonis;
compresses from various herbs.

Preventive measures

As previously said, there are no ways to completely recover from a severe illness. In this regard, disease prevention becomes quite an important factor.

It perfectly reduces the risk of developing such a serious illness as cerebral ischemia and an active lifestyle. Sports and physical activity increase blood circulation and stimulate metabolism. This prevents the formation of blood clots, the deposition of cholesterol, and therefore protects against the occurrence of plaques.

Quite effective is complete abstinence from nicotine and alcohol. This eliminates some of the serious risk factors for the disease.

Due to the fact that symptoms in the early stages may not appear or be expressed quite weakly, important aspect becomes an annual general medical examination. If necessary, additional diagnostic methods will be prescribed. If a patient is found to have an increased risk of ischemia, the doctor will recommend a course of therapy. As a rule, it involves taking anticoagulants.

Hirudotherapy, undeservedly forgotten by people, is very effective. With the help of medicinal leeches, ischemia and thrombotic formations are prevented.

Great importance is given to the so-called secondary prevention. She means timely treatment heart disease, hypertension.

Proper nutrition

The most important weapon against the formation of cholesterol plaques is to prevent the harmful component from entering the body. In this regard, it is very important to establish proper nutrition. Quite a lot of diets have been developed. Some of them are aimed at reducing cholesterol and blood sugar. A professional nutritionist can help you understand this diversity. There are even special anti-cholesterol diets. We won’t go into specific options.

The main thing is to understand the essence:

The share of fats should not exceed a third of the total diet.
Carbohydrates in the body are replenished only through fruits and vegetables. It is necessary to completely abandon baked goods, sugar, and confectionery products.
Animal fats should be kept to a minimum. Pork should be excluded from your menu, giving preference to lean types of meat such as turkey and chicken.
You should reduce the amount of salt you consume. You need to add very little to your food; it is better to remove the salt shaker from the table altogether.
You should significantly reduce the amount of food consumed at a time, while increasing the number of meals. Nutritionists recommend eating five or six times a day.
It is very important to strictly control your cholesterol intake. To do this, you need to know its content in products. For example, in the liver (100 g) there is 438 mg of cholesterol, and in sour cream, skim milk and kefir - only 2 mg.

Conclusion

A person who spends a lot of time outdoors and eats right is in excellent health. After all, while walking, he inhales fresh air containing oxygen. This component is simply necessary for the proper operation of all internal systems. By establishing an “anti-cholesterol” diet, such a patient will protect his blood vessels from clogging. This means that nothing prevents free blood circulation.

Otherwise, cerebral ischemia may develop. This disease belongs to the group of ailments that are easier to avoid than to try to treat later. Don’t neglect simple prevention methods; move actively. Do not forget that you should take care of your health when it has not yet been lost.

Disturbances in brain function have recently progressed in people. There are many reasons for this. Poor nutrition, an increasing pace of life, organic lesions, stress and other factors affect the condition of blood vessels, the nervous system and the flow of oxygen and blood to various parts of this organ.

The result of such processes is tissue damage and the development of cerebral ischemia.

Stages of development of this disease

Coronary disease of the main thinking organ occurs due to insufficient blood supply to its tissues due to blockage of blood vessels with atheromatous plaques consisting of cholesterol and other fats.

The work of the brain determines the quality of a person’s life, as it stores the information it receives, analyzes it, and reproduces it.

If its function is impaired, the person becomes disoriented in the environment. Patients with IHM are characterized by retardation of thinking and speech. This does not happen immediately, but gradually, depending on the course of the disease and its stage. This disease can occur in both older people and newborns.

Cerebral ischemia has several degrees of development. It depends on the area of damage to the central nervous system. The more the vessels narrow, the more intense the symptoms of the disease appear.

Stages of disease development:

First. At this stage, changes in a person's behavior and health status are reversible. A disorder of cognitive functions occurs, behavior changes, sleep is disturbed, constant discomfort in the head (pain, spinning, noise).
Second. Worsening of symptoms, the patient’s well-being worsens. This degree will be discussed in detail below.
Third. The brain's capabilities are exhausted, decompensation occurs, and the changes are irreversible. Often there are fainting, uncontrolled urination, swallowing, praxis, behavior are impaired, and manifestations of dementia are possible.

Second stage of the disease

The 2nd degree of development of cerebral ischemia is called subcompensation. The changes are still reversible, but the person feels worse, noticeable changes in behavior and reasoning appear.

The overgrowth of blood vessels increases, their patency becomes less, and blood flows poorly to the brain.

Signs and manifestations of the disease at this stage

The symptoms of the first stage of coronary artery disease increase in severity. Among them:

fatigue;
insomnia;
chills;
change of mood;
emotional personality disorders - there may be aggression or tearfulness, irritability, etc.;
depression;
cognitive functions suffer, thought processes are difficult;
gait changes;
coordination problems;
personality degradation, decreased intelligence;
ataxia;
social deprivation, indifference to everything around.

The second degree of the disease is characterized by the fact that an adult loses professional skills and gradually becomes unfit for work.

Reasons for the development of the disease

In medical science, the reasons for the development of cerebral ischemia are usually called risk factors that can be corrected and cannot be corrected.

Correctable factors include atherosclerosis and hypertension.

In turn, the appearance of these two diseases is significantly influenced by:

diabetes;
bad habits (smoking, drinking alcohol);
unhealthy diet leading to obesity;
sedentary lifestyle.

To prevent this complex disease, it is necessary to minimize all these factors, monitor your diet, exercise and not abuse alcoholic beverages.

Uncorrectable factors include heredity, old age, and gender. These are the causes of the development of coronary disease that cannot be influenced. If parents have had a stroke or encephalopathy, children should take all measures to prevent the disease, since they are at risk.

Can it be cured?

Treatment of cerebral ischemia is complex. It is aimed at stabilizing the patient’s condition, stopping the pathological process in the central nervous system, and improving blood flow in the vessels.

Drug prevention of stage 2 stroke is carried out; individual drugs are prescribed to reduce the intensity of specific symptoms of the disease. Sometimes operations are prescribed.

Drug treatment involves:

To achieve a therapeutic effect, the complex prescription should be used for 2 months every six months. This will help restore brain activity to the patient, prevent further rapid development of ischemia, and also protect the nervous system and brain tissue from structural damage.

In some rare cases, doctors prescribe surgical treatment for this disease. It is most often used in the late stages of CCI (chronic cerebral ischemia), if medications are ineffective. In this case, stenting of the carotid arteries and carotid endarterectomy are used.

Stenting of the carotid arteries involves inserting a stent, a special cylinder, into the site of narrowing of the vessel, which prevents the artery from decreasing in diameter.

It is important to carry out special preparation for this manipulation in order to reduce blood clotting. A preliminary examination of the patient, ultrasound and computed tomography are mandatory.

Carotid endarterectomy is the removal of a specific section of the carotid artery. This operation is necessary in case of destruction of the artery or excessive damage to it by atherosclerotic plaques.

Carotid endarterectomy

Carotid endarterectomy is relatively safe and has a long-lasting effect. The examination is identical to the previous one surgical manipulation, but in some cases angiography is also prescribed to analyze the speed of blood flow and its disorders.

Patient Anna, 76 years old. A woman was hospitalized with a diagnosis of chronic cerebral ischemia. Symptoms included difficulty swallowing, diplopia, slurred speech, fatigue, random dizziness, and insomnia.

After examination and confirmation of the primary diagnosis, it was prescribed symptomatic treatment: nootropic drugs, drugs that stimulate metabolic processes, amino acids, diuretics, vitamin B12.

In contact with

Cerebral ischemia is the common name among medical specialists for circulatory failure in the brain. In the literature you can also find the concept of “dyscirculatory encephalopathy”; these terms are identical.

Impaired blood circulation leads to the fact that the brain begins to experience oxygen starvation, neurons experience a deficiency of substances that nourish them, and this leads to signal disturbances. As a result, there are frequent cases of mental disorders and metabolic disorders in the body due to the process of ischemia. During illness, lesions of brain tissue appear in the brain, which gradually expand.

Violations in circulatory system usually occur due to blockage, damage or narrowing, therefore cerebral ischemia is classified as a cerebrovascular disease, and it is quite common.

If the disease is left untreated for a long time, it leads to hypoxia (oxygen starvation) of brain neurons, which can cause cysts to form in the cerebral cortex. and for its vessels - due to insufficient blood saturation nutrients and oxygen, they lose their self-regulation function; they can expand or contract arbitrarily, which in turn leads to headaches and dizziness.

The neglect of chronic cerebral ischemia often leads to disability. Chronic circulatory disorders of the brain cause loss of sensitivity, immobilization, helplessness; it is no coincidence that the disease is classified as a disease of the central nervous system, because in the process of its development the functions for which the brain and nervous system are responsible are disrupted, or, more precisely, their healthy relationship.

With such complications, the patient is usually given the third group of disability; home care, because he may not even be able to eat or go to the toilet on his own.

It must be remembered that the development of cerebral ischemia leads to dangerous and fatal consequences.

You can name a lot of reasons that cause cerebral circulatory problems and chronic diarrhea develops. So, they lie in the following factors:

genetic predisposition. The disease is not inherited, but if a person in his family had relatives suffering from cerebral ischemia, then his risk of getting the disease is much higher;
atherosclerosis. A common cause is atherosclerosis, because with this disease the blood vessels of the brain suffer, atherosclerosis contributes to the formation of plaques on the walls of blood vessels and slows down blood circulation. As a result, brain hypoxia develops;
diabetes;
pathologies in the venous system (thrombophlebitis);
blood diseases. During ischemia, indicators such as blood viscosity and coagulability are important. If they are higher or lower than a certain value, then this is a violation, which will immediately affect general condition blood flow in the body and, in particular, in the brain;
diseases of the spine. It is worth remembering that the main arteries through which blood flows to the brain are located within the spine and neck. Accordingly, poor circulation in the spine immediately affects the condition of the brain and its cells. Diseases of the spine that can have a negative impact on the arteries and blood vessels include osteochondrosis, spondyloarthrosis, etc.;
elderly age. This factor simply shows the pattern that the older a person is, the more he is at risk of circulatory problems;
bad habits and unhealthy diet. Alcohol, smoking, unhealthy fatty or smoked foods - all this contributes to the narrowing of blood vessels, the development of atherosclerosis, and this, as already mentioned, has a very negative effect on the flow of blood to the brain;
constant changes in blood pressure. This reason applies to a lesser extent to people suffering from vegetative-vascular dystonia, and to a greater extent to people who develop hypertension. Constant pressure surges have a detrimental effect on the functionality of blood vessels.

Degrees of ischemia

In medicine, it is customary to distinguish three degrees of development of chronic cerebral ischemia.

cerebral ischemia is characterized emotional disorders and deterioration in general health. The patient may experience headaches, mainly pressing ones, and dizziness. Because of this, problems with hearing and vision often begin at this degree of ischemia, although they are quite short-lived. The stage of chronic cerebral ischemia in the 1st degree is also typical for its neurological disorders. It is important to start treatment in time at the stage of first degree ischemia in order to prevent further development diseases.
Second-degree ischemia is characterized by worsening symptoms, that is, all the same symptoms appear as in the first stage, but they only become more frequent and severe. Neurological disorders are so pronounced that they can be diagnosed by the patient himself. And the most important thing that happens at the second stage of cerebral ischemia is loss of performance (complete or partial). Cerebral ischemia of the 2nd degree gives rise to helplessness in a person; he needs constant help in everyday situations, not to mention the fact that he has to forget about any work - physical or mental;
third degree ischemia is the most dangerous form of the disease, often resulting in death. In the third stage, dementia develops because the brain loses many functions and is not able to communicate normally. nervous system. Memory deteriorates, attention disappears, a person becomes distracted, and his reflexes become completely inhibited. For patients with third degree ischemia, cases epileptic seizures and loss of consciousness.

If ischemic disease brain has reached the third stage, then it has already introduced changes into the human body that cannot be prevented. Treatment of a patient at stage 3 consists of alleviating his symptoms for a while. But a timely visit to the hospital (at the first stage of the disease) has a very good chance of stopping the progression of the disease and its retreat.

Symptoms

In the very embryo of chronic ischemia, one rarely consults a doctor, because its symptoms at the initial stage are reduced to fatigue, tiredness, and headache (mainly in the evening). More serious symptoms appear a little later - these may be dizziness, poor sleep (frequent awakenings), irritability, short-term memory loss. If these signs appear, you should immediately make an appointment with your doctor.

It is also worth examining a specialist if in the recent past there has been a supratentorial brain injury - a blow to the occipital lobe of the skull. The fact is that it is an incompressible liquor fluid. Therefore, when a blow to the back of the head occurs, first of all, it is not cracks and damage that occur, but defects in the blood vessels. Therefore, if a person has had a traumatic brain injury, it is recommended that he undergo an MRI or CT scan of the brain in order to. This is how chronic cerebral ischemia develops.

So, frequent symptoms CICI (chronic cerebral ischemia) are:

pressing headaches. The head feels as if it’s heavy, the pain presses on the forehead, temples;
frequent mood swings, irritability;
unsteady walking (staggering, changes in gait);
hearing, vision, memory impairment;
sleep disorders (frequent awakenings, insomnia and daytime sleepiness, fatigue).

The above symptoms are characteristic of the first and second degrees of cerebral ischemia, but at the third stage of CICG they develop into something more. Patients with the third degree of ischemia may (tremor of the hands and head), dementia, inability to intellectually function, epilepsy.

Initial diagnosis of chronic cerebral ischemia includes:

general clinical examination, questioning the patient about complaints and descriptions of symptoms that have already manifested themselves;
cardiac examination (electrocardiography or echocardiography);
blood chemistry. The patient’s blood is carefully examined, identifying parameters such as viscosity, coagulation, the presence of cholesterol, the content of lipid fractions and glucose;
CT (computed tomography) or MRI (magnetic resonance imaging) of the brain;
Doppler

All these diagnostic methods are mandatory, since circulatory disorders in the brain can only be detected using a set of procedures.

Brain treatment

It is worth remembering that cerebral ischemia is treatable only at its first stage. In the second and third stages, the processes occurring in the body are mostly irreversible and can have fatal consequences.

The first degree of ischemia allows specialists to prevent most serious symptoms. Moreover, timely consultation with a doctor often makes it possible to identify other existing diseases, because ischemia often occurs as a consequence of other ailments that also cause damage and disruption of the blood vessels.

Correct ambulatory treatment includes not only taking medications, but also lifestyle changes and diet. The doctor will definitely recommend not to eat fried, smoked and salted foods - they are harmful to the functioning of blood vessels. You need to eat fresh vegetables, fruits, dairy products, and drink green tea. These ingredients tone the condition of blood vessels and make their walls more elastic.

Among the medications and drugs that doctors usually prescribe are:

Atorvastatin, Simvastatin - for atherosclerosis and the formation of plaques on the vessels of the brain;
Piracetam, Encephabol - to restore normal metabolism inside the brain;
Cardiomagnyl - to reduce blood clotting.

In addition, head and neck massages and physiotherapeutic procedures can become an integral part of the treatment. individual means treatments prescribed by the attending physician.

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Chronic cerebral ischemia is today a special form of cerebrovascular pathology, which is caused by diffuse and gradually progressive insufficiency of blood supply to brain tissue.

The progression of ischemic damage to brain neurons occurs as a result of a significant decrease in the influx arterial blood to brain structures, associated in most cases with complete or partial blockage or prolonged narrowing of cerebral vessels, which over time leads to focal or diffuse damage to brain tissue. Significant disruption of cerebral microcirculation leads to the development of multiple microinfarctions, and occlusive changes in large arteries (aortic arch and carotid arteries) lead to the formation of significant territorial cerebral infarctions.

Main etiological factors of chronic cerebral ischemia

According to statistics, chronic cerebral ischemia occurs in 70-75% of all cases of cerebrovascular diseases, and the relevance of prevention and timely treatment of this pathology is determined primarily by its social significance associated with the development of neurological and mental disorders, which are the main causes of permanent disability in patients.

The main etiological factors in the development and progression of cerebral ischemia are considered to be atherosclerotic lesions vascular wall against the background of arterial hypertension, myocardial diseases and diabetes mellitus. Also important are cerebral microcirculation disorders associated with increased blood viscosity and platelet activation, accompanied by the formation of blood clots and blockage of small arterioles.

Other causes of chronic cerebral ischemia

Today, the progression of chronic cerebral ischemia occurs:

with anomalies in the development of vessels in the systemic circulation (carotid arteries, aorta) and cerebral arteries, which are asymptomatic and progress with pronounced spastic and atherosclerotic changes in the vascular bed;
with pathological processes in the venous system (thrombophlebitis and thrombosis of various localizations);
for inflammatory and destructive diseases of the spine that cause disruption of blood flow vertebral arteries(osteochondrosis, spondyloarthrosis, disc herniation);
with amyloidosis of blood vessels and internal organs;
for collagenosis, vasculitis and other blood diseases.

Pathogenesis of ischemic brain lesions

All these diseases lead to changes in cerebral blood flow with the development of hypoxia of the brain substance, disruption of nutrition and energy supply to neurons, which leads to intracellular biochemical changes and causes the development of diffuse, multifocal changes in brain tissue.

Pathogenesis of damage to cerebral structures in chronic vascular pathology brain consists of a consistent aggravation of a complex of biochemical disorders under the influence of under-oxidized oxygen products and the development of oxidative stress against the background of a slowly progressive disturbance of blood supply nerve cells brain substances with the formation of microlacunar ischemic zones.

Symptoms of chronic cerebral ischemia

Chronic cerebrovascular disorders of the brain cause changes in the white matter with the development of foci of demyelination and damage to oligo- and astrodendroglia with progressive compression of microcapillaries with disruption of cortical-stem and corticostriatal connections of neurons. Chronic cerebral ischemia manifests itself in the form of subjective and subjective symptoms.

The main symptoms of chronic ischemic brain lesions characterize the clinical degrees of chronic cerebral ischemia, on which timely diagnosis and treatment of the pathological process depends.

Chronic cerebral ischemia is clinically manifested by headaches, heaviness in the head, dizziness, a progressive decrease in attention and memory, sleep disturbances, the development of emotional lability and coordination disorders (unsteady gait and unsteadiness when walking). As the blood supply to neurons deteriorates due to the progression of stenosis and spasm of the cerebral arteries, ischemia worsens and foci of infarction of various locations develop with the addition of focal symptoms depending on the degree of cerebrovascular disorders.

Stages of cerebral ischemia

The stages of cerebrovascular insufficiency are determined by clinical manifestations and the presence of objective neurological symptoms.

There are three degrees of chronic cerebral ischemia:

initial stage with the presence of main symptoms in the form of headaches, memory loss, dizziness with moderate sleep disturbances, emotional lability and general weakness without the presence of objective neurological symptoms;
the stage of subcompensation, which is characterized by a gradual progression of symptoms with personality changes - the development of apathy, depression with a decrease in the range of interests and the addition of major neurological syndromes (mild pyramidal insufficiency, reflexes of oral automatism and coordination disorders;
stage of decompensation with severe neurological disorders caused by the development of multiple lacunar and cortical infarctions with clear manifestations of pyramidal, pseudobulbar, discoordination, amyostatic and psychoorganic syndromes with the gradual formation of vascular dementia.

Diagnosis of the degree of chronic cerebral ischemia

Diagnosis of chronic cerebral ischemia is based on an analysis of the disease history, the presence of neuropsychological and neurological symptoms with cardiac examination (electrocardiography, Holter monitoring and echocardiography) to establish the main cause of progression of cerebral ischemia, as well as laboratory research methods to exclude somatic pathology.

The direct examination of the condition of the brain tissue is carried out using paraclinical methods - CT or MRI of the brain, duplex ultrasound scanning, Doppler ultrasound, transcranial Doppler ultrasound with the mandatory determination of rheological and coagulation characteristics of the blood, the content of lipid fractions, cholesterol and blood glucose.

Symptoms of the initial stage of chronic cerebral ischemia

In the initial (stage I) cerebrovascular insufficiency, patients complain of constant headaches, heaviness and noise in the head, dizziness, different kinds sleep disturbances, increased weakness and fatigue, decreased memory and attention, emotional lability, irritability and impaired coordination of movements. IN neurological status minimal organic symptoms are determined, which are manifested by the revival of deep reflexes with their slight asymmetry, the presence of convergence disorders, subcortical reflexes and the presence of moderate cognitive disorders in the form of decreased cognitive activity, impaired attention, decreased memory for current events.

Clinical manifestations of the subcompensation stage

Stage II of chronic cerebral ischemia (subcompensation) is characterized by progression clinical symptoms and the presence of focal neurological symptoms with the formation of pathological clinical syndromes with aggravation of cognitive disorders. They manifest themselves in a progressive decline in memory due to a violation of the active search and reproduction of necessary data with sufficient preservation of anamnestic material. Attention disorders, bradyphrenia (slowing activity) are also observed. mental processes) and limited ability to control and plan. Patients experience emotional personality disorders, which are manifested by pronounced emotional lability, depression and decreased criticism. At this stage of the disease, social and professional adaptation is disrupted, but the ability to self-care is preserved.

Characteristics of the condition of patients in the stage of decompensation

The stage of decompensation (stage III) of chronic cerebral ischemia is characterized by a combination of progressive syndromes in the form of pseudobulbar disorders, extrapyramidal and pyramidal insufficiency with the addition of amyostatic syndrome, which is characterized by hypomimia, muscle rigidity (the “counteraction” phenomenon in lower limbs) and the difficulty of initiating movements.

Cognitive disorders are manifested by a decrease in criticism, the development of subcortical-cortical or subcortical dementia with the presence of paroxysmal conditions in the form of fainting, falls and epileptic seizures. Emotional and personality disorders are expressed by disinhibition and apathetic-abulic syndrome. These patients are unable to work with impairments in everyday life and social adaptation, losing the ability to self-service.

Principles of treatment of chronic ischemia

Treatment of chronic cerebrovascular insufficiency of the brain at any degree of chronic ischemia is aimed at preventing the progression of occlusive and stenotic dyscirculatory disorders of the brain and preventing the occurrence of exacerbations - cerebrovascular crises (transient ischemic attacks) and small strokes.

Therapy for chronic cerebral ischemia is also primary prevention ischemic strokes of the brain and includes:

correction of hyperlipidemia and arterial hypertension;
controlling blood sugar levels and correcting hyperglycemia;
treatment of concomitant somatic pathological processes;
vasoactive therapy;
prescription of cerebroprotectors.

Methods for correcting arterial hypertension

Treatments for hypertension include non-drug and medicinal methods corrections.

Non-drug means of preventing the occurrence of acute disorders of cerebrovascular circulation of the ischemic type and reducing the progression of chronic cerebral ischemia are increasing the physical activity of patients, quitting smoking, limiting the consumption of alcohol and table salt, increasing the content of fruits and vegetables, and fermented milk products in the diet.

Basic treatment for high blood pressure

According to international experts, the main classes of antihypertensive drugs for the treatment of chronic cerebral ischemia are ACE inhibitors, diuretics, calcium channel blockers, beta-blockers and angiotensin II receptor antagonists. At any stage of chronic cerebral ischemia against the background hypertension combination therapy is preferred.

Drug treatment of arterial hypertension also includes the prevention of episodes of spontaneous increases in blood pressure, which often occur in elderly patients, as well as in young people with severe cardiac pathology (after myocardial infarction, endocarditis, cardiomyopathies and significant stenoses). great vessels). For secondary prevention of ischemic strokes, ACE inhibitors, angiotensin II receptor antagonists and diuretics are used, which minimally threaten significant cerebrovascular accident when taken continuously in the event of a decrease in systemic blood pressure.

Correction of hyperlipidemia

To correct hyperlipidemia with a stable increase in cholesterol and/or triglyceride levels above 3.36 mmol/l in the composition of low-density lipoproteins, a special diet is indicated. Balanced diet for chronic dyscirculatory disorders, it is based on a diet low in calories, salt, animal and vegetable fats, fried and spicy foods and the predominance of foods enriched with potassium (dried apricots, raisins, prunes, baked potatoes) and seafood containing iodine, which is additional prevention progression of cardiac pathology.

If there is no effect from non-drug methods lipid-lowering drugs are prescribed: statins, enterosorbents and drugs nicotinic acid. The most popular drugs in this area are statins - modern drugs that effectively reduce plasma lipid levels and inhibit their increased formation.

Constant use of drugs in this group inhibits the development of cholesterol plaques, reducing blood viscosity.

Vasoactive therapy for chronic cerebral ischemia

An important role in the treatment of chronic dyscirculatory disorders is treatment with antiplatelet agents and angioprotectors (vasodilators) - vinpocetine, vasobral, vincamine and nicergoline.

The effectiveness of treatment with these drugs depends on the degree of damage to the cerebral vessels, due to the fact that with severe destructive lesions of the cerebral vessels there is a decrease in sensitivity to angioprotectors. Significant expansion of altered cerebral vessels increases the risk of “cerebral steal”, and the intensity of intracellular dysmetabolic disorders against the background of progressive atrophic changes is at a low level, so increasing cerebral blood flow is inappropriate.

The use of antithrombotic drugs - aspirin ( acetylsalicylic acid), clopidogrel and dipyridamole, should be carried out long-term (over several years) and continuously.

Improving the microcirculation of cerebral vessels is facilitated by giving up bad habits - smoking, drug addiction and drinking alcohol, and trental is also prescribed for this purpose.

Neuroprotection strategy

Neuroprotection is based on providing metabolic protection of brain neurons, preventing the development of ischemic damage to brain structures at the molecular and cellular levels and correcting the consequences of ischemia.

For chronic cerebral ischemia, therapeutic effects are aimed at:

to correct hemodynamics to compensate for cerebral circulatory disorders and sufficiently supply brain structures with oxygen and energy substrates;
to protect nerve cells from ischemic damage while maintaining their structural integrity and functional activity.

Treatment of chronic cerebral ischemia with cerebroprotectors

Improvement in the cognitive functions of patients occurs with a course of use of drugs with neurometabolic effects: piracetam, ginko biloba, encephabol, L-carnitine, actovegin, gliatilin and phenotropil, as well as prescription medicines with a neurotrophic effect: cerebrolysin, cortexin and antioxidants.

The mechanism of action of drugs in these groups is based on pharmacological and biochemical effects:

in the selective improvement of cerebral blood circulation and oxygen consumption by neurons without pronounced changes in central hemodynamics;
increasing the tolerance of brain tissue to hypoxia and ischemic damage to nerve cells;
anticonvulsant effectiveness;
inhibition of phosphodiesterase enzyme;
moderate improvement in blood rheological properties and antiplatelet activity.

Prognosis for chronic cerebral ischemia

Chronic cerebral ischemia today is distinguished by a complex, multidirectional and pathogenetically based approach to therapy. These aspects of the treatment of this disease make it possible to provide timely and adequate compensation for impaired cerebral functions and pathological changes in cerebral circulation and prevent the development acute disorders cerebral circulation of ischemic type - cerebral infarction.

With constant monitoring by a neurologist, timely correction of pathological changes when using medications, general and surgical methods treatment achieves inhibition of progression small focal changes brain structures with restoration of impaired blood supply to neurons - the prognosis of the disease is considered relatively favorable.

Severe course concomitant diseases aggravating cerebral ischemia (malignant arterial hypertension, diabetes mellitus, arrhythmias, cardiomyopathies, endocarditis) contribute to complications and the development of motor and vestibular disorders, the development of massive territorial cerebral infarctions.

When patients present late and/or have severe brain damage with multiple microstrokes and swelling of brain tissue with massive death of nerve cells, the prognosis for the life of patients is unfavorable and ends in severe disability or death.