Damage to the main arteries, venous and jugular veins, due to the development of thrombosis, embolism, aneurysms, etc. leads to serious oxygen deficiency, tissue death and loss of certain vital functions for the body. Poor blood circulation in the brain is a serious pathology that requires urgent treatment.

Features of blood supply to the brain

According to the most rough estimates, the human brain contains about 25 billion nerve cells. There is a hard and soft shell, gray and white matter.

Signs of circulatory problems in the head

Initially, symptoms of poor circulation are of low intensity or not observed at all. But as the disorders develop, clinical manifestations are becoming more and more obvious.

• Headaches - improvement occurs only after taking analgesics. Pain syndrome tends to increase.

Such violations, as a rule, indicate a number of problems. A doctor's visit is required.

Causes of obstructed blood supply to the brain

The anatomy of the blood supply has a complex structure. Transportation of oxygen and other nutrients carried out through four arteries: vertebral and internal.

• Vascular atherosclerosis is one of the main causes of impaired blood supply in older people, as well as patients with disorders of the cardiovascular system and metabolic disorders. Sclerotic plaques appear in the arteries, leading to a decrease in blood circulation.

Whatever the cause of circulatory failure, the consequences of the disorders are reflected not only in the activity of the brain itself, but also in the functioning of the internal organs. Treatment outcome is influenced by accuracy established cause- catalyst and timely elimination of violations.

What are the dangers of poor blood flow problems in the brain?

A severe disruption of the blood circulation in the brain leads to serious complications. The consequences of an attack can be:

• Ischemic stroke – accompanied by nausea and vomiting. With focal damage, it affects the functioning of individual internal organs. Affects motor and speech function.

A transient attack is observed mainly in elderly patients. The attack is accompanied by motor and visual function, numbness and paralysis of the limbs, drowsiness and other symptoms.

Depletion of peripheral blood flow is most often observed in the old age of the patient and leads to the development of chronic insufficiency of blood supply to the brain. As a result, the patient's mental activity is inhibited. A decrease in intelligence and abilities is diagnosed. The pathology is accompanied by absent-mindedness, irritability, and extremely aggressive behavior.

Cerebral blood flow disorders in children

For children minimum indicators blood flow in the arteries, sufficient for normal brain function, is 50% higher than in adults. For every 100 gr. brain tissue requires about 75 ml. blood per minute.

• The middle cerebral artery supplies blood to the deep parts of the brain and the eyeball. The internal one is responsible for nourishing the cervical region, scalp and face.

In fact, cerebral blood flow is a special system for circulating blood and transferring nutrients and oxygen to brain tissue. The system contains sleepy, cerebral and vertebral arteries, as well as the jugular veins and the blood-brain barrier. The blood supply areas of the cerebral arteries are distributed in such a way as to abundantly supply each area of ​​soft tissue with oxygen.

Why do newborns have problems with blood supply to the brain?

Among the many reasons due to which disturbances in the blood supply to the brain develop, only two main ones can be identified:

• Disturbances in fetal development - intrauterine pathologies are observed in 10% of all pregnancies. Insufficient blood supply is a consequence of injuries, infectious diseases, bad habits the expectant mother, and incompatibility of the Rh factor of the mother and fetus. Another catalyst for deficiency is genetic predisposition.

Why is impaired blood supply to the head dangerous for a baby?

For the normal development of a child, the volume of incoming blood in relation to brain tissue is required to be 50% greater than that of an adult. Deviations from the norm affect mental development.

1. Poor concentration.

Treatment of cerebral circulation begins from the first days of life. There is a possibility of death. Hypoxia negatively affects the functionality of the brain and internal organs.

How to check the blood supply to the brain

Suspicions about insufficient blood supply brain tissue arise when there is neurological symptoms and violations. To determine the factors of damage and prescribe the necessary therapy, additional examination by using instrumental methods circulatory studies:

• MRI – allows you to determine the condition of brain tissue and assess the extent of damage to individual lobes. Magnetic resonance angiography is considered the most informative, allowing one to see the condition of the membranes and nerve trunks.

How and how to improve cerebral circulation

Based on the results of the diagnostic study, we select medications, making cerebral circulation better. Since the cause of disorders is a variety of factors, the course of therapy for one patient may not coincide with what is prescribed for another patient.

What improves blood circulation, what medications

There is no one medicine to improve blood circulation in the brain that can eliminate disorders. For any deviation, a course of therapy is prescribed, including one or more drugs from the following groups:

• Vasodilators - act on smooth muscle blood arteries and blood vessels, have a relaxing effect and increase the lumen. It has been noted that some medications have the opposite effect and impair blood supply, so modern methods of therapy use exclusively drugs that affect the vessels located in the brain (Cinnarizine, Nimodipine).

Some drugs have a special purpose. So, cortexin, in the form intramuscular injections, it is recommended for use during pregnancy and after the birth of a child with pronounced encephalopathy. Emoxipine is used for internal bleeding. Available in the form of intravenous injections.

How to improve blood flow without drugs

At the initial stage, it is possible to improve blood supply to the brain without the help of medications. There are several ways to influence a person’s well-being:

• Ayurvedic remedies are essentially extracts from herbs and other plants that promote general strengthening body. The difference between Ayurveda preparations is that the treatment complex was developed in India, a country known for its long-livers and unique healing methods by restoring the balance of the body. The range of products includes tablets, medicinal teas and other means.

It would be useful to include in your therapy the intake of vitamins E and C, which increase blood flow, and also to visit a nutritionist in order to select an effective therapeutic diet.

Folk remedies for improving blood supply to the brain

Treatment of cerebral circulatory disorders with folk remedies does not eliminate the need to receive professional medical care. Non-traditional methods of therapy are good at relieving symptoms of disorders:

• Noise in the head and dizziness - red clover tincture will help. Pour in vodka so that the liquid covers the flowers a little. Clover is infused for 3 weeks. Take 1-2 teaspoons before meals and at night.

Breathing exercises to improve blood circulation

The set of exercises is aimed at enriching the blood with oxygen. There are several types of breathing exercises.

Exercises and gymnastics

Exercise therapy to improve the patient’s well-being is aimed at the source-catalyst of the problem. During exercise, blood pressure and the functioning of the cardiovascular system are normalized.

Caution when prescribing exercises should be observed in the presence of blood clots or high blood pressure.

Diet for poor cerebral circulation

We are what we eat! Life itself proves the truth of this statement. A person’s diet and eating habits have a negative or positive influence on the blood supply to the brain.

What foods improve blood flow

Products that improve blood counts include:

The diet should include herbal remedies that improve blood circulation: oils (sunflower and olive). Plant food, foods containing zinc are also necessary to restore blood circulation.

Foods that are harmful to the blood supply to the brain

If blood circulation is poor, you should avoid cholesterol-rich and saturated foods. fatty acids products.

A complete list of harmful and beneficial products can be obtained from a neurologist who treats disorders of the blood supply to the brain.

Alcohol and cerebral circulation

Moderate doses of alcohol have a beneficial effect on the blood supply to the brain, preventing blockage blood vessels. We are talking about small or moderate portions.

The cause of disturbances in the venous outflow of the brain and their treatment

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Causes and consequences of changes in the bioelectrical activity of the brain

Is a cerebral pseudocyst dangerous in a newborn and how to get rid of it?

Disorders of arterial circulation of the brain: forms, signs, treatment

In recent years, the percentage of mortality from pathological lesions of cerebral vessels, which were previously associated with the aging of the body and were diagnosed only in elderly people (after 60 years), has increased significantly. Today, the symptoms of cerebrovascular accident have become younger. And people under 40 often die from strokes. Therefore, it is important to know the causes and mechanism of their development, so that preventive, diagnostic and therapeutic measures gave the most effective results.

What are cerebrovascular accidents (CVA)

The vessels of the brain have a unique, perfect structure that ideally regulates blood flow, ensuring the stability of blood circulation. They are designed in such a way that when blood flow into the coronary vessels increases approximately 10 times during physical activity, the amount of circulating blood in the brain, with increasing mental activity, remains at the same level. That is, a redistribution of blood flow occurs. Some of the blood from parts of the brain with less load is redirected to areas with increased brain activity.

However, this perfect circulatory process is disrupted if the amount of blood entering the brain does not satisfy its need for it. It should be noted that its redistribution across brain regions is necessary not only for its normal functionality. It also occurs when various pathologies occur, for example, stenosis of the lumen of the vessel (narrowing) or obstruction (closure). As a result of impaired self-regulation, the speed of blood flow slows down in certain areas of the brain and ischemicity occurs.

Types of MC violations

There are the following categories of blood flow disorders in the brain:

1. Acute (stroke), which occurs suddenly with a long course, and transient, the main symptoms of which (visual impairment, loss of speech, etc.) last no more than a day.
2. Chronic, caused by discirculatory encephalopathies. They are divided into two types: hypertensive in origin and caused by atherosclerosis.

Acute cerebrovascular accidents (ACI)

Acute cerebrovascular accident causes persistent disorders of brain activity. It comes in two types: hemorrhagic (bleeding) and ischemic (also called cerebral infarction).

Hemorrhagic

Etiology

Hemorrhage (hemorrhagic disturbance of blood flow) can be caused by various arterial hypertension, vascular aneurysms, congenital angiomas, etc.

Pathogenesis

As a result of the increase blood pressure There is a release of plasma and the proteins contained in it, which leads to plasma impregnation of the walls of blood vessels, causing their destruction. On vascular walls a peculiar hyaline-like specific substance (a protein whose structure resembles cartilage) is deposited, which leads to the development of hyalinosis. The vessels resemble glass tubes and lose their elasticity and ability to hold blood pressure. In addition, the permeability of the vascular wall increases and blood can freely pass through it, soaking the nerve fibers (diapedetic bleeding). The result of such transformations can be the formation of microaneurysms and rupture of the vessel with hemorrhage and blood entering the white medulla. Thus, hemorrhage occurs as a result of:

• Plasmic impregnation of the walls of blood vessels of the white medulla or visual thalamus;
• Diapedetic bleeding;
• Microaneurysm formations.

Hemorrhage in acute period characterized by the development of hematomas due to wedging and deformation of the brain stem into the tentorial foramen. In this case, the brain swells and extensive edema develops. Secondary hemorrhages occur, smaller ones.

Clinical manifestations

Usually occurs during the day, during physical activity. Suddenly your head starts to hurt and you feel nauseous. Consciousness is confused, the person breathes quickly and whistling, tachycardia occurs, accompanied by hemiplegia (one-sided paralysis of the limbs) or hemiparesis (weakened motor functions). Basic reflexes are lost. The gaze becomes motionless (paresis), anisocoria (pupils of different sizes) or divergent strabismus occurs.

Treatment

Treatment of cerebrovascular accidents of this type includes intensive therapy, the main goal of which is to reduce blood pressure, restore vital (automatic perception of the outside world) functions, stop bleeding and eliminate cerebral edema. The following medications are used:

1. Blood pressure-lowering drugs - ganlioblockers (Arfonad, Benzohexanium, Pentamin).
2. To reduce the permeability of vascular walls and increase blood clotting - Dicinone, vitamin C, Vikasol, Calcium gluconate.
3. To increase blood rheology (fluidity) - Trental, Vinkaton, Cavinton, Eufillin, Cinnarizine.
4. Inhibiting fibrinolytic activity - ACC (aminocaproic acid).
5. Decongestant - Lasix.
6. Sedatives.
7. To reduce intracranial pressure, a spinal puncture is prescribed.
8. All drugs are administered by injection.

Ischemic

Etiology

ischemic cerebrovascular accident due to atherosclerotic plaque

Ischemic circulatory disorders are most often caused by atherosclerosis. Its development can be provoked by severe anxiety (stress, etc.) or excessive physical activity. May occur during night sleep or immediately upon awakening. Often accompanies a pre-infarction condition or myocardial infarction.

Symptoms

They may appear suddenly or grow gradually. They manifest themselves in the form of headaches, hemiparesis on the side opposite to the lesion. Impaired motor coordination, as well as visual and speech disorders.

Pathogenesis

An ischemic disorder occurs when a specific area of ​​the brain receives insufficient quantity blood. In this case, a focus of hypoxia arises, in which necrotic formations develop. This process is accompanied by disruption of basic brain functions.

Therapy

Injections are used in treatment medicines for recovery normal functioning cardiovascular system. These include: Korglykon, Strophanthin, Sulphocamphocaine, Reopoliklyukin, Cardiamin. Intracranial pressure is reduced by Mannitol or Lasix.

Video: causes of different types of strokes

Transient cerebrovascular accident

Transient cerebrovascular accident (TCI) occurs against the background of arterial hypertension or atherosclerosis. Sometimes the reason for its development is their combination. The main symptoms of PNMK are as follows:

• If the focus of the pathology is located in the carotid vessels, the patient becomes numb in half of the body (on the side opposite to the lesion) and part of the face around the lips, paralysis or short-term paresis of the limbs is possible. Speech is impaired and an epileptic seizure may occur.
• If the blood circulation in the vertebrobasilar area is impaired, the patient's legs and arms become weak, he becomes dizzy, it is difficult for him to swallow and pronounce sounds, photopsia occurs (the appearance of luminous points, sparks, etc. in the eyes) or diplopia (doubling of visible objects). He becomes disorientated and has memory lapses.
• Signs of impaired cerebral circulation due to hypertension are manifested in the following: the head and eyeballs begin to hurt very much, the person experiences drowsiness, he or she experiences stuffiness in the ears (like on an airplane during takeoff or landing) and a nauseating urge. The face turns red and sweating increases. Unlike strokes, all these symptoms disappear within 24 hours. For this they received the name “transient attacks”.

Treatment of PNMK is carried out with antihypertensive, tonic and cardiotonic drugs. Antispasmodics that improve blood flow in the brain and blockers are used calcium channels. The following medications are prescribed:

Dibazol, Trental, Clonidine, Vincamine, Eufillin, Cinnarizine, Cavinton, Furasemide, beta-blockers. Alcohol tinctures of ginseng and Schisandra chinensis are used as tonics.

Chronic cerebrovascular accidents

Chronic cerebrovascular accident (CVA), unlike acute forms develops gradually. There are three stages of the disease:

1. At the first stage, the symptoms are vague. They are more like chronic fatigue syndrome. A person gets tired quickly, his sleep is disturbed, he often hurts and feels dizzy. He becomes hot-tempered and absent-minded. His mood often changes. He forgets some minor points.
2. At the second stage, chronic cerebrovascular accident is accompanied by significant memory deterioration, and minor motor dysfunctions develop, causing unsteadiness in gait. It appears in my head constant noise. A person perceives information poorly, having difficulty concentrating his attention on it. He is gradually deteriorating as a person. Becomes irritable and unconfident, loses intelligence, reacts inadequately to criticism, and often becomes depressed. He constantly feels dizzy and has a headache. He always wants to sleep. Efficiency is reduced. He adapts poorly socially.
3. In the third stage, all symptoms intensify. Personality degradation turns into dementia, memory suffers. Having left home alone, such a person will never find his way back. Motor functions are impaired. This manifests itself in hand tremors and stiffness of movements. Speech impairment and uncoordinated movements are noticeable.

The last stage of chronic cerebral obstruction is brain atrophy and neuron death, the development of dementia

Cerebrovascular accident is dangerous because if treatment is not carried out in the early stages, neurons die - the basic units of the brain structure, which cannot be resurrected. Therefore, diagnosing the disease in the early stages is so important. It includes:

• Identification of vascular diseases that contribute to the development of cerebrovascular accidents.
• Making a diagnosis based on patient complaints.
• Conducting a neuropsychological examination using the MMSE scale. It allows you to detect cognitive impairment by testing. The absence of violations is indicated by 30 points scored by the patient.
• Duplex scanning to detect damage to cerebral vessels due to atherosclerosis and other diseases.
• Magnetic resonance imaging, which makes it possible to detect small hypodense areas in the brain (with pathological changes) foci.
• Clinical blood tests: complete blood count, lipid spectrum, coagulogram, glucose.

Etiology

The main causes of cerebrovascular accident are as follows:

1. Age. They mainly occur in people who have entered their fifth decade.
2. Genetic predisposition.
3. Traumatic brain injuries.
4. Overweight. Obese people often suffer from hypercholesterolemia.
5. Physical inactivity and increased emotionality(stress, etc.).
6. Bad habits.
7. Diseases: diabetes mellitus (insulin-dependent) and atherosclerosis.
8. Hypertension. High blood pressure- the most common cause of strokes.
9. In old age, problems with blood flow in the brain can result from:
   • atrial fibrillation,
   • various diseases hematopoietic organs and blood,
   • chronic thrombophlebitis,
   • heart defects.

Treatment

In case of chronic disturbance of blood flow in the brain, all therapeutic measures are aimed at protecting brain neurons from death as a result of hypoxia, stimulating metabolism at the neuronal level, and normalizing blood flow in brain tissue. Medicines for each patient are selected individually. They should be taken in a strictly prescribed dosage, constantly monitoring blood pressure.

In addition, for cerebral circulatory disorders accompanied by neurological manifestations, antioxidants, venotonics, vasodilators, neuroprotectors, drugs that increase blood microcirculation, sedatives and multivitamins are used.

Chronic cerebrovascular accidents can be treated using traditional medicine using various herbal teas and herbal teas. Particularly useful is an infusion of hawthorn flowers and a collection that includes chamomile, cudweed and motherwort. But they should be used as an additional treatment course that enhances the main drug therapy.

People with increased weight who are at risk for developing atherosclerosis due to high cholesterol need to pay attention to nutrition. There are special diets for them, which you can learn about from a nutritionist who monitors the organization of nutrition for patients undergoing treatment in an inpatient department of any hospital. TO dietary products include everything of plant origin, seafood and fish. But milk products, on the contrary, should be low in fat.

If cholesterolemia is significant and the diet does not give the necessary results, medicines, included in the group of statins: Liprimar, Atorvakar, Vabarin, Torvacard, Simvatin. With a large degree of narrowing of the lumen between the walls carotid arteries(more than 70%) requires carotid endarterectomy (surgical operation), which is performed only in specialized clinics. For stenosis less than 60%, conservative treatment is sufficient.

Rehabilitation after acute cerebrovascular accident

Drug therapy can stop the progression of the disease. But she is unable to regain the ability to move. Only special gymnastic exercises can help with this. You need to be prepared for the fact that this process is quite long and be patient. The patient’s relatives must learn to perform massage and therapeutic exercises, since they will have to do them for him for six months or more.

Kinesiotherapy is indicated as the basis for early rehabilitation after dynamic cerebrovascular accident in order to fully restore motor functions. It is especially necessary in the restoration of motor skills, as it contributes to the creation of a new model of the hierarchy of the nervous system for the physiological control of the motor functions of the body. The following techniques are used in kinesitherapy:

1. Gymnastics “Balance”, aimed at restoring coordination of movements;
2. Feldenkrais reflex exercise system.
3. The Voight system, aimed at restoring motor activity by stimulating reflexes;
4. Microkenisotherapy.

Passive gymnastics “Balance” is prescribed to every patient with cerebral circulation disorders as soon as consciousness returns to him. Usually, relatives help the patient perform it. It includes kneading the fingers and toes, flexing and straightening the limbs. Exercises begin to be performed from the lower extremities, gradually moving upward. The complex also includes kneading the head and cervical regions. Before starting the exercises and finishing the gymnastics, you should use light massaging movements. It is imperative to monitor the patient's condition. Gymnastics should not cause him to become overtired. The patient can independently perform eye exercises (squinting, rotating, fixing the gaze at one point, and some others). Gradually, with improvement general condition the patient's load is increased. An individual recovery method is selected for each patient, taking into account the characteristics of the course of the disease.

Photo: basic passive gymnastics exercises

The Feldenkrais Method is a therapy that gently affects the human nervous system. It promotes the complete restoration of mental abilities, motor activity and sensuality. It includes exercises that require smooth movement when performed. The patient must focus on their coordination, making each movement meaningfully (consciously). This technique forces one to divert attention from the existing health problem and concentrate it on new achievements. As a result, the brain begins to “remember” previous stereotypes and returns to them. The patient constantly studies his body and its capabilities. This allows you to find quick ways to get him moving.

The technique is based on three principles:

• All exercises should be easy to learn and remember.
• Each exercise must be performed smoothly, without overstraining the muscles.
• While performing the exercise, the sick person should enjoy the movement.

But most importantly, you should never divide your achievements into high and low.

Additional rehabilitation measures

Breathing exercises are widely practiced, which not only normalizes blood circulation, but also relieves muscle tension that occurs under the influence of gymnastic and massage loads. In addition, it regulates the respiratory process after performing therapeutic exercises and gives a relaxing effect.

In case of cerebrovascular accidents, the patient is prescribed bed rest for a long time. This can lead to various complications, for example, disruption of natural ventilation of the lungs, the appearance of bedsores and contractures (mobility in the joint is limited). Prevention of bedsores involves frequent changes of position of the patient. It is recommended to turn him over on his stomach. At the same time, the feet hang down, the shins are located on soft pillows, and under the knees there are cotton wool discs covered with gauze.

1. Place the patient's body in a special position. In the first days, he is transferred from one position to another by his relatives caring for him. This is done every two or three hours. After stabilizing blood pressure and improving the general condition of the patient, they are taught to do this on their own. Getting the patient into bed early (if well-being allows) will prevent contractures from developing.
2. Perform the massage necessary to maintain normal muscle tone. The first days it includes light stroking (if muscle tone is increased) or kneading (if muscle tone is decreased) and lasts only a few minutes. Subsequently, the massage movements intensify. Rubbing is allowed. The duration of massage procedures also increases. By the end of the first half of the year, they can be completed within an hour.
3. Fulfill physical therapy exercises, which, among other things, effectively combat synkinesis (involuntary muscle contractions).
4. Vibration stimulation of paralyzed parts of the body with an oscillation frequency of 10 to 100 Hz gives a good effect. Depending on the patient’s condition, the duration of this procedure can vary from 2 to 10 minutes. It is recommended to carry out no more than 15 procedures.

For cerebrovascular accidents, alternative treatment methods are also used:

• Reflexology, including:
  1. Treatment with odors (aromatherapy);
  2. classic version of acupuncture;
  3. acupuncture at reflex points located on ears(auricolotherapy);
  4. acupuncture biologically active points on the hands (su-Jack);
• Treatment with leeches (hirudotherapy);
• Pine baths with the addition of sea salt;
• Oxygen baths.

Video: rehabilitation after a stroke, the program “Live Healthy!”

Read more about comprehensive rehabilitation after strokes and ischemic attacks by following the link.

Consequences of NMC

Acute cerebrovascular accident has serious consequences. In 30 cases out of a hundred, people who have suffered this disease become completely helpless.

1. He cannot eat, perform hygiene procedures, dress, etc. on his own. Such people have a completely impaired ability to think. They lose track of time and have absolutely no orientation in space.
2. Some people retain the ability to move. But there are many people who, after a cerebrovascular accident, remain bedridden forever. Many of them maintain a clear mind, understand what is happening around them, but are speechless and cannot put into words their desires and express their feelings.

connection between areas of brain damage and vital functions

Disability is a sad result of acute and in many cases chronic cerebrovascular accident. About 20% of acute cerebrovascular accidents are fatal.

But it is possible to protect yourself from this serious disease, regardless of what category of classification it belongs to. Although many people neglect it. This is an attentive attitude to your health and all the changes occurring in the body.

• Agree that a healthy person should not have headaches. And if you suddenly feel dizzy, it means that some kind of deviation has arisen in the functioning of the systems responsible for this organ.
• Evidence of problems in the body is elevated temperature. But many people go to work when it is 37°C, considering it normal.
• Do you experience short-term numbness in your limbs? Most people rub them without asking the question: why is this happening?

Meanwhile, these are the companions of the first minor changes in the blood flow system. Often an acute cerebrovascular accident is preceded by a transient one. But since its symptoms go away within 24 hours, not every person rushes to see a doctor to undergo an examination and receive the necessary drug treatment.

Today, doctors have effective drugs - thrombolytics. They literally work wonders, dissolving blood clots and restoring cerebral circulation. However, there is one “but”. To achieve maximum effect, they must be administered to the patient within three hours after the first symptoms of a stroke appear. Unfortunately, in most cases, seeking medical help is done too late, when the disease has reached a severe stage and the use of thrombolytics is no longer useful.

Video: blood supply to the brain and the consequences of stroke

Hello, a few months ago I developed severe fatigue and drowsiness, the doctor diagnosed me with chronic fatigue syndrome and prescribed Vasobral, I took the course, my strength returned, the fatigue went away, and I returned to a normal rhythm of life. Now my neck and back of my head hurt, I went for an MRI and was told that my blood flow to the brain was impaired due to cervical osteochondrosis, the vessels are pinched, they prescribed hardware treatment, but somehow it doesn’t help me, I started taking pills again, it became easier. But osteochondrosis must be treated, otherwise I’m afraid it will get even worse. Please advise how to get rid of it and whether it can be treated, otherwise doctors prescribe all the pills and injections, but this only relieves the syndrome.

Hello! You can read information regarding osteochondrosis in the article devoted to this problem. As for treatment, in addition to medications, regular exercise therapy is necessary to strengthen the neck muscles; swimming and wearing a Shants collar are useful. You can consult a rehabilitation specialist or neurologist on these points. Avoid staying in one position for a long time, static loads and heavy lifting.

Cerebrovascular accident in adults and the elderly: symptoms, treatment and prevention

A person should always monitor his health and promptly pay attention to such body signals as frequent headaches or changes in blood composition for no apparent reason.

How to protect yourself from possible circulatory disorders in the brain and what to do if the disease does occur will be discussed in this article.

Cerebrovascular accident

The process when blood moves through the vessels of the spinal cord and brain is called cerebral circulation.

Disruption of proper blood flow can occur, for example, in the following situations:

• The patient has some kind of cerebral vascular pathology.

Such changes can occur if in the vessels:

1. An inflection has occurred.
2. A blood clot has formed;
3. The clearance has decreased;

• A sick citizen has a disruption of blood flow in the main and cerebral arteries.

Any disturbance in the proper movement of blood through the vessels of the brain is explained by the fact that there is a discrepancy between the amount of blood that is necessary for the proper functioning of the brain and the amount of blood that actually enters the brain.

If a patient has a cerebrovascular accident, then he must seek advice and examination from the doctors listed below:

1. Neurologist;
2. Therapist;
3. Angiosurgeon, that is, a surgeon who examines blood circulation in the brain;
4. Cardiologist;
5. Reanimatologist.

Cerebral circulation may be impaired in a patient for a number of reasons:

• High blood pressure (hypertension).
• Special plaques that form in the blood vessels of the brain. Such formations prevent blood from moving properly through these vessels.

• Various head injuries (bruises, concussions).
• Constant (chronic) fatigue.

In adults

In adults, cerebral blood flow may be impaired in situations such as:

• The presence of osteochondrosis, in which compression of the vessels responsible for the proper functioning of the brain occurs.
• There are blood clots in the cerebral arteries that could appear after injury or surgery.
• The person has tumors in the neck or head.

In the elderly

For people of retirement age correct movement blood in the brain vessels can most often be disrupted if they have a history of:

• Disease of the blood or organs that are responsible for the movement of blood;
• Heart problems;
• Inflammatory processes in blood vessels.

Types of cerebrovascular disorders

In medicine, the following types of cerebral circulatory disorders are distinguished:

This type has several stages:

• The initial stage, in which clients often complain of symptoms such as:

1. Fatigue;
2. Dizziness or heaviness in the head;
3. Decreased memory and speed of thinking;
4. Sleep problems.

This feeling unwell may occur in a person if he wants to eat, has drunk alcoholic drink or when weather conditions change. At this stage, the nervous system is not affected.

Discirculatory encephalopathy is divided into three stages:

• The first stage is characterized by such unpleasant symptoms as:

1. Sleep disturbance;
2. Difficulty arising when changing activities;
3. The appearance of a headache in a patient if he for a long time calculated or memorized something. Also, a headache can occur if a person is simply overexcited;
4. Rapid mood changes within a short period of time.

• During the second stage, the sick person will experience the following personal changes:

1. Increased sensitivity and irritability;
2. The patient becomes uninterested in what is happening around. And he does not seek communication;
3. Appear various problems with memory;
4. A person often experiences headaches and blurred vision.

• If the patient already has the third stage of the disease, then he will have the following signs of the disease:

1. The patient cannot criticize himself and often cries;
2. Does not have time to reach the toilet, since such a patient lacks control over his pelvic organs;
3. The patient may experience headaches and memory disorders. Such a person is already considered disabled. And in the current situation, he will be given disability of the first group.

Read more about cerebrovascular diseases in another article on our website.

Leading cerebrovascular accident

A person may experience short-term disturbance in blood circulation in the brain. This disease is called “micro-stroke” or “incoming (leading) circulatory disorder in the brain.”

The main symptoms of a microstroke will be:

1. Dizziness and tinnitus;
2. Pain in the head;
3. Nausea or vomiting;
4. Weakness in the upper or lower extremities;
5. Speech clarity is impaired;
6. Pale skin condition;
7. Increased anxiety;
8. Brief fainting;
9. An inhibited state in which the patient cannot understand the meaning of words spoken to him by another person;
10. Vision problems.

A microstroke can occur if the patient:

• There are vascular spasms. Previously, we wrote in detail about the symptoms of brain spasms;
• Changes in blood quality have occurred (blood clotting readings or blood density have changed). Due to these changes, microthrombi could form in the vessels;
• A blockage in blood vessels (thrombus) has formed.

Microstroke is divided into three types:

1. General cerebral dysfunction. With this type of disease, a person may lose consciousness with a sudden movement, which then returns after some time;
2. Hypertensive cerebral crisis is sharp jump pressure, which may be accompanied severe vomiting, drowsiness or throbbing headache;
3. A transient ischemic attack can be manifested by partial loss of motor function in the upper or lower extremities, and the person may also have impaired speech and problems with consciousness.

Acute disorder

If poor circulation in the brain is characterized as an acute disorder, then the patient may experience the following health problems:

• Strokes, which in turn are divided into two types:

1. Ischemic. Such a stroke occurs if the brain does not receive oxygen in the required amount at any time. This can happen when the vessel that is responsible for supplying blood to a specific area of ​​the brain has been completely blocked by a blood clot. With this type of stroke, the patient may experience nausea;
2. Hemorrhagic. This condition may occur in a patient if a vessel has burst. And so the person suffered a cerebral hemorrhage.

• Microstroke, which is some disturbance of blood circulation through the vessels of the brain.

Symptoms

Symptoms of improper blood flow through the vessels of the brain are the following:

• Partial or complete violations motor function of a person’s arms or legs;
• The functionality of some organs, such as ears or eyes, decreases;
• The patient experiences a sensory disturbance;
• The patient often experiences dizziness or headache;
• Memory decreases;
• Absent-mindedness appears;
• Seizures may occur if a person has epilepsy;

Diagnostics

The attending physician can diagnose the patient in the following cases:

1. The patient already has a history of diseases such as, for example, high blood pressure or diabetes;
2. After a duplex scan, which will help find diseased vessels;
3. If the patient has previously had an MRI, then such a study will provide clearer information about the condition of the vessels of his brain.

Read about which doctor checks blood vessels in our similar article.

Treatment

Treatment options will depend on the diagnosis made by the doctor.

• For chronic disorders, the patient will be prescribed special tablets that will prevent the formation of blood clots in the blood vessels, and the doctor will also give advice on how to normalize blood pressure and cholesterol levels in the blood;
• If the disease is already acute, then in this case the patient will need urgent help doctors

If a stroke occurs, treatment will be carried out according to the following scheme:

1. The patient will be ensured proper blood circulation in the body and normal breathing;
2. Special procedures will be carried out to lower blood pressure;
3. If the patient has cerebral edema, then this edema will need to be reduced;
4. A special set of measures will restore brain functions that were impaired due to the attack.

What are the dangers of cerebrovascular accidents?

Impaired blood circulation in the brain is fraught with the following problems for a person:

1. Blood clots can form in the vessels, which will lead to brain hypoxia. Even if doctors can help the patient come to his senses, there is still no guarantee that the person will remain competent after the attack.
2. A vessel may rupture, followed by hemorrhage in the brain. With such a disorder, swelling may appear in the brain, due to which it is quite possible death patient.

Prevention

In order to prevent this type of disease, a person needs to take special preventive measures:

• It is necessary to combine mental and physical work.
• Any work that a person performs should bring him, if possible, only positive emotions.
• It is important to establish a sleep schedule. For an adult, sleep should last no more than eight hours a day.
• You need to spend more time in nature.
• We must try to be less nervous, then there will be no disturbances in the brain, and the nervous system will be healthy.
• It is imperative that a person eats a balanced diet and on a schedule. Fasting days will also be beneficial. On such days, you can replace everyday food with, for example, prunes and apples, as well as cheese and a chicken egg.
• And it is imperative to drink enough water per day. In this case, ordinary water can be replaced with mineral water. On all other days, you should not neglect foods such as cabbage, tomatoes, carrots, greens (parsley and dill).

You can also eat every two days:

1. Boiled or fried meat and broths on it.
2. Foods that are rich in cholesterol, namely fish roe, chicken egg, liver or heart of animals.
3. The consumption of sweets should be reduced to one hundred grams per day.

As can be seen from what was written above, preventing a disease is much easier than treating it later, if it is not too late.

And of course, we should not forget about prevention, by carrying out which a person can protect himself from many health problems. After all, you need to take care of yourself and your health.

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Modern life moves at such a crazy pace that an ordinary person has to speed up his actions more and more, sleep less, work seven days a week, and stress has long become an integral part of our existence.

And in this rush, we sometimes have no time to look back and listen to the complaints of loved ones about poor health or to think about our own.

Therefore, is it any wonder that today the mortality rate associated with damage to the blood vessels of the brain has increased significantly, and it is already diagnosed in those who are not even 40 years old.

In order not to fall into this avalanche, which is taking over more and more lives, let’s try to understand what cerebral circulation is and what causes and mechanisms cause its disruption. This will give us the opportunity to take protective measures.

What is cerebral circulation?

So, the blood circulation that occurs in the vascular system of the spinal cord and brain is called cerebral circulation (CB).

The vessels of the brain themselves have such a unique and impeccable structure that it allows for constant blood circulation and excellent regulation of blood flow.

For example, if mental activity increases, the amount of blood that circulates in the brain does not change. This is achieved due to good redistribution of blood flow.

Blood is sent to areas with intense brain activity from areas of the brain that experience less stress.

If the brain is not filled with enough blood, this ideal form of blood supply to the brain begins to fail.

Causes of cerebrovascular accidents

Causes of cerebrovascular accidents may be:

• arterial hypertension;
• atherosclerosis;
• degenerative disorders of the cervical spine;
• physical strain and stress;
• changes in heart valves;
• rheumatic heart disease;
• diseases of the heart and blood vessels.

Also, cerebrovascular accident may be caused by:

• radiation sickness;
• complicated migraine;
• brain bleeding;
• and other factors.

Let us consider in more detail the factors causing MC disorders.

Arterial hypertension

So, hypertension, or more correctly, arterial hypertension.

This disease is characterized by the fact that during the day there are sudden changes blood pressure. It can be either excessively low or high.

Therefore, modifications occur in the walls of small vessels that nourish the deep parts of the brain. All this leads to gradual narrowing of blood vessels, and sometimes to their closure.

In the event of another jump in high blood pressure, a vessel may rupture. As a result, blood penetrates into the brain matter - an intracerebral hematoma (bleeding into the brain) occurs.

The next factor is vascular atherosclerosis. As the disease progresses, cholesterol plaques clog the blood vessels. Controlling blood cholesterol levels in this case is very important.

Where there is narrowing and obstruction of blood flow, platelets gradually accumulate, then blood clots form. When a blood clot breaks off, it can block a blood vessel in the brain. This causes a violation of MC.

Changes in the cervical spine

As for changes in the cervical spine, diseases such as osteochondrosis and scoliosis are quite well known. But not everyone understands how serious the consequences of such diseases can be.

Since the functioning of the human body largely depends on changes in the spine, diseases of the cervical spine can eventually lead to disruption of the cervical spine.

This problem should not be dismissed as excessive physical activity or excessive tension in the muscles of the neck and back, especially when you have a sedentary job - they can also cause a violation of the MV.

Against the backdrop of stressful situations, especially if they are often repeated, an unexpected increase in blood pressure is quite a serious reason for MB disturbances.

Also one of possible reasons cerebral circulatory disorders are considered to be present traumatic brain injury, which may result in intracranial hemorrhage.

The extent of the disturbance in the circulatory process in the vessels of the brain depends on its extent.

Types of violations

Disorders of blood flow in the brain can be acute or chronic.

Acute) – begins unexpectedly and is accompanied by a long course of the disease. It is characterized by a persistent disorder of brain activity and the presence of two varieties:

• ischemic disorder (so-called cerebral infarction);
• hemorrhagic (bleeding in the brain).

Atherosclerosis very often serves as a reason for the development of ischemic circulatory disorders. It occurs during times of intense physical activity or stress and severe anxiety.

Accompanying pre-infarction state or myocardial infarction itself. As a rule, it occurs at night when a person is sleeping or immediately after waking up.

The development of hemorrhagic blood flow disorders, or hemorrhages as they also say, can be facilitated by the presence of vascular aneurysms, congenital angiomas, and various arterial hypertension.

Cerebrovascular accident chronic type, or - represents insufficient blood circulation in the brain.

It, slowly progressing, leads to the formation of a mass of small-focal necrosis of brain tissue and disruption of brain functions. Over time, the disease intensifies both quantitatively and qualitatively.

There are violations two types: associated with atherosclerosis and hypertensive origin.

Symptoms and signs

What are the symptoms and signs of cerebrovascular accident?

Signs of acute disorder

Acute cerebrovascular accident has symptoms such as transient ischemic attacks and hypertensive cerebral crises.

As for transient ischemic attacks, symptoms occur unexpectedly and increase gradually. They are expressed:

• difficulty speaking;
• in violation of movement coordination;
• weakness and numbness of the limbs.

In case of hypertensive cerebral crises, occurs:

Chronic disorder

Chronic urinary function disorder differs from acute forms in its gradual development. There are three stages to this diseases:

1. On the first- symptoms are not pronounced, the patient complains of fatigue, frequent dizziness, headache, restless sleep, increased mood swings, absent-mindedness, and forgetfulness.
2. Second stage is accompanied by some changes in gait, unsteadiness appears in movement, memory deterioration progresses, insufficient concentration of attention and perception of information is added to this, drowsiness, irritability, and decreased performance are further enhanced.
3. Third stage represents a noticeable impairment of the motor functions of the arms and legs, a striking impairment of speech and memory, and severe dementia.

Diagnostics

The threat of MC disruption is that if treatment is not carried out in the early stages, the main elements of the brain structure - neurons - die, and they cannot be revived. Therefore, it is necessary to carry out diagnostics in the early stages of the disease.

This includes making a diagnosis based on from:

• patient complaints;
• a set of blood tests: glucose, lipid spectrum, general analysis blood, coagulogram and others;
• examination by an ophthalmologist and diagnostics of the fundus;
• data on the detection of diseases such as atherosclerosis, diabetes mellitus, blood diseases, and hypertension in the early stages or those that have already existed for a long time;
• data obtained through testing on a special neuropsychological examination;
• data from a special scan that allows you to determine the presence of cerebral vascular lesions;
• and, if necessary, data from the examination performed using magnetic resonance imaging.

A severe result of acute and, in many cases, chronic urinary function disorders is disability. 20% of acute MV disorders end in death.

Video: Cerebrovascular accident

An educational video about how blood circulation occurs in the brain. What happens if cerebral circulation is impaired?

The brain is a “mystical” organ that can fill us with incredible sensations, show us our own “movie”, dreams, accumulate experience and wisdom that allows us to think. This is an organ that controls and regulates the functioning of the entire organism as a whole and each organ and system separately; providing the balance, protection, and compensatory reactions to disturbances necessary for our body. This small organ, weighing about 1400-1500 g (2% of body weight), has incredible abilities that have not yet been fully studied.

What does the brain need? Working without rest, day and night, he is in dire need of oxygen (the brain consumes 20% of all oxygen entering the body) and nutrients, without which he cannot live even for a few minutes. It is a known fact that oxygen reserves are not created in the brain, and there are no substances that can nourish it under anaerobic (in the absence of oxygen) conditions. That is, the nerve cells of the brain constantly need oxygen, glucose and “cleaning” (cleansing of cell waste products).

Excursion into physiology

The uninterrupted supply of substances necessary for the nerve cells of the brain and the cleansing of waste are carried out by the cerebral circulatory system, where arterial blood carries oxygen and nutrition to the brain, and venous blood removes toxins and metabolic products.

The vessels of the brain have a unique, perfect structure that ideally regulates blood flow, ensuring its stability. They are designed in such a way that with increased blood flow into large vessels, a strong pulse impulse of blood coming from the heart is weakened due to numerous bends (siphons) of vessels along the vascular bed, which contribute to the pressure drop and smoothing of the pulsating blood flow. Due to complex mechanisms regulation when total blood pressure increases, the pressure in the brain remains stable for a long time. Regulatory systems allow blood flow to be redistributed from parts of the brain with less load to areas with increased brain activity.

The brain has an autonomous regulatory system, which allows it to be in a healthy functional state and control the processes of continuous adaptation of the body to constantly changing conditions of the external and internal environment. In a state of functional rest, the brain receives 750 ml of blood per minute, which is 15% of cardiac output. In children, blood flow activity is 50-55% higher, and in the elderly it is 20% lower than in a person in adulthood.

It should be noted that the gray matter of the brain (cell bodies of neurons) is supplied with blood more intensively than the white matter (conducting pathways), which is due to greater cell activity. Thus, during intense mental work, local blood flow in the cerebral cortex can increase 2-3 times compared to the resting state.

The brain has the richest capillary network. Nerve cells not only are they intertwined, but also penetrated by capillaries. The vessels of the brain are connected to each other by collaterals (“bridges”). Arterial collateral circulation of the brain, important for maintaining normal blood flow, plays a particularly significant role in compensating for circulatory disorders when one of the cerebral arteries is blocked.

With high intensity of blood flow in the vessels of the brain, the blood pressure in them is maintained relatively constant. A complex chain of regulatory mechanisms protects the brain from a drop in blood pressure and hypoxia (decreased oxygen). Along the path of blood flow to the brain, there are many sensitive cells (pressoreceptors, chemoreceptors) that can respond to blood pressure and regulate heart rhythm and vascular tone.

The activity of the vasomotor centers of the brain is associated not only with nervous and humoral regulation mechanisms, but also with the autonomic regulation system, which allows, despite significant fluctuations in total blood pressure, to maintain cerebral blood flow at a constant level.

Thus, cerebral circulation is provided with complex regulatory mechanisms that make it possible to maintain a constant supply of the substances it needs.

With excessive blood supply to the brain, excessive hydration (fluid accumulation) may occur, followed by the development of edema and damage to vital tissues. important centers, incompatible with life. The cause of excess blood supply can be, for example, an increase in systemic blood pressure to 160-170 mm Hg. Art. and above.

In the problem of impaired blood supply to the brain, much attention is paid to arteries. But venous circulation is no less important. The veins carry out the removal of waste substances (toxins) with the blood - that is, cleansing the brain. Thanks to these vessels, constant intracranial pressure is maintained.

Violation of the venous outflow leads to stagnation of blood and accumulation of fluid in the brain, causes hydrocephalus with compression of the brain centers, and contributes to the occurrence of phlebitis and thrombophlebitis.

There is one more feature of the cerebral veins that must be taken into account. Wall venous vessel the brain does not have a valve apparatus, unlike, for example, the veins of the extremities (valves help withstand loads, moving blood upward and preventing it from moving in the opposite direction). That's why venous blood in the vessels of the brain it passes freely in both directions depending on the pressure that arises. This creates a danger of rapid spread of infection from the sinuses and eye sockets, which is facilitated by the atomic structure of the nose and its paranasal sinuses, located in close proximity to the brain. When coughing, venous pressure increases, reverse venous flow, congestion, and brain hypoxia become possible. There are known cases of loss of consciousness during a coughing attack in the presence of a chronic disease respiratory tract and in small children, when they “go into a fit” of coughing due to illness and crying and screaming until they cough.

It becomes clear why long-term respiratory problems, accompanied by constant swelling and coughing, can cause cerebrovascular accidents. Because they not only cause brain hypoxia, but also disrupt venous outflow and, being a constant source of infection, contribute to its penetration into the brain.

An ophthalmologist, for example, can observe manifestations of congestion in the brain (dilated, blood-filled vessels of the fundus). But this is also visible to the naked eye: red, puffy eyes after sleep (due to drinking alcohol the night before, overeating at night, lack of sleep) are a symptom of congestion in the brain.

After a brief excursion into physiology, it becomes clear that the reasons for the deterioration of cerebral circulation may be associated with disturbances in the flow of blood to the brain and the outflow of blood from the brain.

What happens when blood pressure rises?

At first, vascular tone is slowly disrupted. Over time, if elevated blood pressure (BP) persists, minor cerebral hemorrhages and strokes may occur.

As a result of a constant increase in blood pressure with hypertension plasma is released (part of the blood without shaped elements), which ultimately leads to the destruction of the walls of blood vessels.

How does this happen? A specific protein (hyaline-like substance, similar in structure to cartilage) is deposited on the walls of blood vessels, which leads to the development of hyalinosis. The vessels become like glass tubes, lose their elasticity and ability to hold blood pressure. In addition, the permeability of the vascular wall increases, and blood can freely pass through it, soaking the nerve fibers (diapedetic bleeding). The result of such transformations can be the formation of microaneurysms and rupture of the vessel with hemorrhage and blood entering the white medulla. The resulting swelling and hematomas lead to further hemorrhages (hemorrhagic stroke).

Atherosclerosis that accompanies hypertension, or exists without it (which is rare), contributes to cerebral ischemia - insufficient supply of nutrients and oxygen to the tissues (except for atherosclerotic plaques that narrow the lumen of the arteries, the blood itself can be thick and viscous).

Acute circulatory disorders are strokes (hemorrhagic and ischemic). But it all starts with transient cerebrovascular accidents against the background of hypertension and atherosclerosis, as well as obesity, diabetes mellitus, and respiratory diseases that often accompany them.

Symptoms of cerebrovascular accident

When a lesion forms in the brain with impaired blood supply, the patient may experience numbness in half of the body (on the side opposite to the lesion) and part of the face around the lips; short-term paresis of the limbs or other parts of the body and face is possible. Speech is impaired and an epileptic seizure may occur.

If there is a circulatory disorder, depending on the location of the lesion, the legs and arms may become weak, the head may become dizzy, the patient may have difficulty swallowing and pronouncing sounds, photopsia (appearance of luminous spots, sparks, etc. in the eyes) or diplopia (doubling of visible objects) may occur. . The person loses orientation and has memory lapses.

Signs of impaired cerebral circulation due to hypertension are manifested in the following: the head and eyeballs begin to hurt very much, the person experiences drowsiness, he experiences stuffiness in the ears (like on an airplane during takeoff or landing) and attacks of nausea. The face turns red and sweating increases.

Unlike strokes, all these symptoms, which are called “transient attacks,” disappear within 24 hours.

Chronic cerebrovascular accident (CVA), unlike acute forms, develops gradually. There are three stages of the disease:

1. At the first stage, the symptoms are vague. They are more like chronic fatigue syndrome. A person quickly gets tired, becomes hot-tempered and absent-minded, and forgets some minor points. His sleep is disturbed, his mood often changes, his head hurts and he feels dizzy.
2. At the second stage, chronic cerebrovascular accident is accompanied by significant memory deterioration, and minor motor dysfunctions develop, causing unsteadiness in gait. There is a constant noise in my head. A person perceives information poorly, having difficulty concentrating his attention on it. Becomes irritable and unconfident, loses intelligence, reacts inadequately to criticism, and often becomes depressed. He gradually degrades as a person and adapts poorly socially. He constantly feels dizzy and has a headache. He always wants to sleep. Performance is significantly reduced.
3. In the third stage, all symptoms intensify. Personality degradation turns into dementia, memory suffers. Having left home alone, such a person will never find his way back. Motor functions are impaired, which manifests itself in hand tremors and stiffness of movements. Speech impairment and uncoordinated movements are noticeable.

Consequences of cerebrovascular accidents

Disability is a sad result of acute and in many cases chronic cerebrovascular accident.

Acute cerebrovascular accident has serious consequences. In most cases, a person who has suffered a stroke becomes completely helpless. He cannot eat, perform hygiene procedures, dress, etc. on his own. Such people have a completely impaired ability to think. They lose track of time and have absolutely no orientation in space.

Some people retain the ability to move. But many people, after a cerebrovascular accident, remain bedridden forever. Many of them maintain a clear mind, understand what is happening around them, but are speechless and cannot express their desires and feelings in words.

How to prevent cerebrovascular accidents

The opportunity to protect yourself from this serious disease, regardless of what category it belongs to, exists. Only many people neglect it.

This is an attentive attitude to your health and all the changes occurring in the body.

Agree that a healthy person should not have headaches. And if you suddenly feel dizzy, it means that there is some kind of deviation in the functioning of the systems responsible for this organ.

An increase in temperature is evidence of problems in the body. But many people go to work with a temperature of 37°C, considering it normal (explaining this by the fact that the tests did not reveal anything).

Do you experience short-term numbness in your limbs? Most people rub them without asking the question: why is this happening?

It's not normal to live permanently drug treatment at chronic diseases nose and respiratory tract, do not associate them with existing internal disorders and do not think about the consequences (because there is no time, because the ENT doctor will perform the procedure and it will become easier for a while).

It is not normal to live with obesity and diabetes without thinking about the consequences while indulging in your eating habits.

After all, all this is a companion to the first minor changes in the cerebral blood flow system.

Often an acute cerebrovascular accident is preceded by a transient one. But since its symptoms go away within 24 hours, not every person rushes to see a doctor to undergo an examination and receive the necessary drug treatment.

Today, doctors have effective drugs - thrombolytics. They literally work wonders, dissolving blood clots and restoring cerebral circulation. However, there is one “but”. To achieve maximum effect, they must be administered to the patient within three hours after the first symptoms of a stroke appear. Unfortunately, in most cases, seeking medical help is done too late, when the disease has reached a severe stage and the use of thrombolytics is no longer useful. In the case of chronic disorders, taking only thrombolytics and blood thinning drugs does not give the desired result, since it is necessary to identify and eliminate the true causes leading to these disorders.

And here again we recall the instructions of the great Avicenna: “Establish nutrition, sleep, wakefulness... and the disease will recede.”

Chronic cerebral circulatory failure (CCF) is a brain dysfunction characterized by slow progression. It is one of the most common pathologies in neurological practice.

Etiological factors

The cause of the development of insufficiency, which is especially common in elderly and senile patients, is small-focal or diffuse damage to brain tissue. It develops against the background of a long existing problems with cerebral circulation, since during ischemia the central nervous system does not receive enough oxygen and glucose.

Most common reasons chronic ischemia:

One of the etiological factors is considered to be anomalies in the development of the aortic arch and vessels of the neck and shoulder girdle. They may not make themselves felt until development and. Certain importance is attached to compression of blood vessels bone structures(with curvature of the spine and osteochondrosis) or tumors.

Blood circulation may also be impaired due to deposits of a specific protein-polysaccharide complex, amyloid, on the vascular walls. Amyloidosis leads to dystrophic changes in blood vessels.

In older people, one of the risk factors for CNMC is often low blood pressure. With it, arteriosclerosis is not excluded, i.e. damage small arteries brain.

Symptoms of chronic cerebrovascular insufficiency

Important:The main clinical features of CNM include syndromicity, stages and a progressive course!

It is customary to distinguish 2 main stages of chronic cerebral ischemia:

1. initial manifestations;
2. dyscirculatory encephalopathy.

The initial stage develops when the flow of blood decreases from normal levels of 55 ml/100 g/min to 45-30 ml.

Typical patient complaints:

In the early stages of cerebral blood flow insufficiency, symptoms appear after exercise or psycho-emotional stress, fasting and drinking alcohol.

During the examination, when determining the neurological status, no signs of focal changes in the central nervous system are revealed. Special neuropsychological tests can identify disorders of thinking functions (in a mild form).

Please note:Every year in our country, up to 450 thousand cases of acute cerebrovascular accidents - strokes - are diagnosed. According to various sources, vascular dementia affects from 5% to 22% of elderly and senile people.

Discirculatory encephalopathy (DE) develops against the background of a decrease in blood flow to 35-20 ml/100 g/min. Changes, as a rule, occur due to general vascular pathologies.

Please note:significant changes in hemodynamics are noted if there is a narrowing of the great vessels to 70-75% of normal.

DE forms:

• venous;
• hypertensive;
• atherosclerotic;
• mixed.

Discirculatory encephalopathy is divided into 3 stages depending on the severity of neurological symptoms.

Signs of stage 1:

• (there are problems with remembering new information);
• decreased ability to concentrate;
• decreased mental and physical performance;
• high fatigue;
• dull (cephalgia), increasing with psycho-emotional experiences and mental stress;
• problems with switching from one task to another;
• frequent;
• unsteadiness when walking;
• worsening mood;
• emotional instability.

The working capacity of patients with stage 1 is preserved. A neurological examination reveals moderate memory impairment and decreased attention. Reflexes are moderately increased; their intensity on the right and left is slightly different.

Signs of stage 2:

• progression of memory disorders;
• severe deterioration in sleep;
• frequent cephalgia;
• transient dizziness and instability in a vertical position;
• darkening of the eyes when changing body position (standing up);
• touchiness;
• irritability;
• reduction of needs;
• slow thinking;
• pathological attention to minor events;
• obvious narrowing of the circle of interests.

Stage 2 is characterized not only by decreased ability to work (disability group II-III), but also by problems with the patient’s social adaptation. During the examination of the neurological status, vestibulo-cerebellar disorders, poverty and slowdown of active movements with a specific increase in muscle tone are revealed.

Signs of stage 3:

• thinking disorders increasing to dementia ();
• tearfulness;
• sloppiness;
• (not always);
• a pronounced decrease in self-criticism;
• pathological lack of will;
• weakening of sphincter control (involuntary urination and defecation);
• frequent drowsiness after eating.

Please note:For patients at this stage of development of the pathology, the Winscheid triad is very characteristic, i.e., a combination of memory impairment, headaches and episodes of dizziness.

Patients with stage 3 discirculatory encephalopathy are disabled; they are given disability group I.

Diagnostics

The diagnosis is made based on the clinical picture, the patient’s complaints, and the results obtained from examining the brain and blood vessels.

Please note:There is an inverse relationship between the number of patient complaints about decreased memory ability and the severity of chronic ischemia. The greater the impairment of cognitive functions, the fewer complaints.

Fundus examination reveals disc pallor optic nerve and atherosclerotic changes in blood vessels. Upon palpation, compaction of the arteries supplying the brain - carotid and temporal - is determined.

The instrumental research methods necessarily used to verify the diagnosis include:

• dopplerography;
• angiography;
• rheoencephalography with additional tests;
• aorta and other great vessels;
• brain and vessels of the “cerebral basin” (the main method of neuroimaging);
• electroencephalography.

Additional data is obtained from laboratory tests for the metabolism of lipid compounds, an electrocardiogram and biomicroscopy of the conjunctival vessels.

Important:atherosclerosis cerebral vessels often combined with atherosclerotic lesions of the arteries of the legs and coronary vessels.

The task differential diagnosis is to exclude brain diseases that do not have a vascular etiology. It is known that the functions of the central nervous system can be secondarily impaired due to diabetes mellitus, damage to the respiratory system, kidneys, liver and digestive tract.

Measures for the treatment and prevention of CNMK

When identifying the first symptoms of chronic cerebral ischemia, it is strongly recommended to periodically carry out a comprehensive course of treatment. It is necessary to prevent or slow down the development of pathological changes.

Primary prevention of CNM is within the competence of specialists general practice – family doctors and local therapists. They must carry out explanatory work among the population.

Basic preventive measures:

• maintaining a normal diet;
• making adjustments to the diet (reducing the amount of carbohydrates and fatty foods);
• timely treatment of chronic diseases;
• giving up bad habits;
• regulation of work schedule, as well as sleep and rest;
• combating psycho-emotional stress (stress);
• active lifestyle (with dosed physical activity).

Important: primary prevention pathology should begin in adolescence. Its main focus is eliminating risk factors. It is necessary to avoid overeating, and. Secondary prevention is needed to prevent episodes of acute cerebral blood flow disorders in patients with diagnosed chronic ischemia.

Treatment vascular insufficiency involves rational pharmacotherapy. All medications should be prescribed only by a local doctor or specialist, taking into account the general condition and individual characteristics of the patient’s body.

Patients are advised to take a course of vasoactive drugs (Cinnarizine, Cavinton, Vinpocetine), antisclerotic drugs and antiplatelet agents to reduce blood viscosity (Acetylsalicylic acid, Aspirin, Curantil, etc.). Additionally, antihypoxants are prescribed (to combat oxygen starvation of brain tissue), and vitamin complexes(including and ). The patient is recommended to take neuroprotective drugs that contain amino acid complexes (Cortexin, Actovegin, Glycine). To combat certain secondary disorders of the central nervous system, the doctor may prescribe drugs from the group of tranquilizers.

Important:is of great importance for maintaining blood pressure levels at the level of 150-140/80 mm Hg.

It is often necessary to select additional combinations of drugs if the patient is diagnosed with atherosclerosis, hypertension and (or) coronary insufficiency. Making certain changes to the standard treatment regimen is necessary for diseases endocrine system and metabolic disorders - diabetes mellitus, thyrotoxicosis and obesity. Both the attending physician and the patient must remember: the medications should be taken in full courses, and after a break of 1-1.5 weeks, begin a course of another medication. If there is an obvious need to use different drugs on the same day, it is important to maintain a time interval of at least half an hour between doses. Otherwise, their therapeutic activity may decrease, and the likelihood of developing side effects (including allergic reactions) may increase.

People who have clinical signs cerebrovascular insufficiency, it is recommended to refrain from visiting baths and saunas to avoid overheating of the body. It is also advisable to reduce your time in the sun. Climbing into the mountains and staying in areas at an altitude of over 1000 m above sea level poses a certain danger. It is necessary to completely abandon nicotine, and reduce the consumption of alcohol-containing drinks to a minimum (no more than 30 ml of “absolute alcohol” per day). Consumption strong tea and coffee should be reduced to 2 cups (approximately 100-150 ml) per day. Excessive physical activity is unacceptable. You should not sit in front of a TV or PC monitor for more than 1-1.5 hours.

Plisov Vladimir, medical observer

It is customary to distinguish the initial manifestations of cerebrovascular accident as an early stage of CNM and DE (dyscirculatory encephalopathy) - multifocal brain damage caused by chronic circulatory failure.

In turn, the following forms of DE are distinguished:

• atherosclerotic;
• hypertensive;
• venous;
• mixed.

Causes and pathogenesis of CNM

As a rule, chronic cerebrovascular accident is a consequence of cardiovascular pathology. Typically, CNM develops against the background of:

• vegetative-vascular dystonia;
• atherosclerosis, hypertension;
• diabetes;
• heart diseases of various etiologies;
• vasculitis;
• blood diseases accompanied by a violation of its rheological properties.

These pathologies change general and cerebral hemodynamics and lead to a decrease in cerebral perfusion (less than 45-30 ml/100 g per minute). The most important factors involved in the pathogenesis of CNM include:

• changes in the extra- and intracranial sections of the vessels of the head;
• insufficiency of collateral circulation;
• violation of autoregulation of blood circulation;
• violation of rheology.

Obesity, physical inactivity, alcohol abuse and smoking play a significant role in the progression of CNM.

Symptoms of chronic cerebrovascular accident

In the early stages of CNM, the picture is characterized by patient complaints of a feeling of heaviness in the head, mild dizziness, instability when walking, noise in the head, fatigue, decreased attention and memory, and sleep disturbance. Initial manifestations of circulatory failure occur after psychoemotional and/or physical stress, against the background of alcohol consumption, and under unfavorable meteorological conditions. Patients show signs of vegetative-vascular and emotional lability, some slowness of thinking processes, and possible convergence insufficiency. The progression of the initial manifestations of circulatory failure leads to the formation of the next stage - DE.

Depending on the severity of manifestations, three stages of chronic cerebrovascular accident are distinguished. In stage I, symptoms are mild, patients usually remain able to work; in stage II the symptoms are moderate, and in stage III patients become unable to work.

With atherosclerotic encephalopathy, i.e. with DE caused by atherosclerotic damage to the vessels supplying blood to the brain, in stage I there is a decrease in attention and memory, especially in current events, it becomes difficult to memorize new information, and it is difficult for the patient to switch from one activity to another. At the same time, mild cognitive impairment, as a rule, is compensated by the remaining everyday and professional skills, as well as intellectual capabilities. Patients often complain about increased fatigue and decreased performance, emotional lability with a decrease in psycho-emotional background is often observed. Diffuse noise in the head is noted. Patient complaints of instability when walking are typical. The neurological status reveals minor scattered symptoms in the form of moderate signs of pseudobulbar syndrome, tendon hyperreflexia and anisoreflexia, as well as postural instability.

In stage II, clinical manifestations progress, cognitive impairment increases, performance decreases, patients become touchy and irritable. A narrowing of interests is noted, and memory disorders increase. Dull headaches, dizziness, and unsteadiness when walking are often present. Neurological status reveals anisoreflexia, pseudobulbar symptoms, vestibulo-cerebellar disorders and subcortical symptoms.

In stage III, further worsening of neurological manifestations is noted. Patients exhibit significant scattered neurological symptoms in the form of an increase pyramidal insufficiency, pseudobulbar disorders, cerebellar and extrapyramidal symptoms, and control disorders pelvic organs. Possible epileptic seizures. Stage III is characterized by pronounced disturbances of higher mental functions: significant cognitive impairment to dementia, the likely development of apatoabulic syndrome, pronounced emotional and personal changes. In later stages, patients lose self-care skills. Drowsiness after eating, Windscheid's triad, are typical for atherosclerotic encephalopathy. In stage III, Hackebusch's disease, or pseudo-Alzheimer's form of atherosclerosis, can be observed - a symptom complex, the main manifestation of which is dementia. At the same time, they note a decrease in memory, confabulation, a pronounced narrowing of the range of interests, uncriticality, speech disorders, gnosis and praxis. In addition, in the late stage of atherosclerotic encephalopathy, the formation of Demaget-Oppenheim syndrome, which is characterized by gradually developing central tetraparesis, is possible.

Chronic hypertensive encephalopathy is a form of DE caused by arterial hypertension. Arterial hypertension leads to diffuse damage to brain tissue; the disease progresses quite quickly with significant fluctuations in blood pressure and repeated hypertensive crises. The disease can manifest itself at a fairly young age, on average at 30-50 years. IN initial stages The clinical picture of hypertensive encephalopathy is characterized by sufficient dynamics and reversibility of symptoms. Characterized by a neurosis-like syndrome, frequent headaches, predominantly in the occipital region, and noise in the head. In the future, signs of bilateral pyramidal insufficiency, elements of akinetic-rigid syndrome, tremor, emotional-volitional disorders, decreased attention and memory, and slow mental reactions may appear. As it progresses, personality disorders arise, the range of interests narrows, speech intelligibility is impaired, anxiety increases, and weakness is noted. Patients are characterized by disinhibition.

In stage III hypertensive encephalopathy, patients, as a rule, develop severe atherosclerosis; the condition is characterized by features typical of atherosclerotic encephalopathy - developing dementia. In an advanced stage, patients lose the ability to self-care, control pelvic functions, and signs of apatho-abulic or paranoid syndromes may appear.

A variant of hypertensive encephalopathy in combination with atherosclerotic brain damage is Binswanger encephalopathy (progressive vascular leukoencephalopathy). It usually manifests itself at the age of 50 years and is characterized by memory loss, cognitive impairment, and motor impairment in chronic cerebrovascular accident of the subcortical type. Sometimes there are epileptic seizures. As a rule, encephalopathy in chronic cerebrovascular accident develops gradually, although stepwise progression associated with vascular crises, blood pressure fluctuations and cardiac disorders is also possible.

Venous DE is characterized by venous congestion in the skull, chronic hypoxia and intracranial hypertension. Venous DE more often develops in patients with cardiopulmonary diseases, as well as with arterial hypotension.

Diagnostic procedures for CNMC include collecting anamnesis, taking into account information about somatic pathology (especially cardiovascular diseases), analysis of patient complaints, neurological, neuropsychological examination. Instrumental examination involves Doppler ultrasound (USDG), rheoencephalography, CT) or MRI, ophthalmoscopy and angiography. As a rule, an examination of the heart is necessary (electrocardiography - ECG, echocardiography), as well as a study of the rheological properties of blood.

Treatment of chronic cerebrovascular accident

Arterial hypertension is one of the most important risk factors for CUI, but episodes of hypotension are also unfavorable for patients with DE. During the correction process, it is advisable to maintain blood pressure at a stable level, slightly higher than the “optimal” indicators: 140-150 mm Hg. Medications for chronic cerebrovascular accidents should be selected taking into account the characteristics of the patient and his reaction to prescribed medications. For the treatment of arterial hypertension, angiotensin-converting enzyme inhibitors are used - ACE (captopril, perindopril, enalapril, enalaprilat), angiotensin II receptor antagonists (candesartan, eprosartan), β-blockers (in particular, atenolol, labetalol, metoprolol, propranolol, esmolol), agonists central α-adrenergic receptors (clonidine), slow calcium channel blockers (nifedipine). Diuretics used as antihypertensive therapy only when indicated (for example, heart failure, ineffectiveness of other antihypertensive drugs) due to a possible deterioration in blood rheology.

Forecast

Typically, chronic cerebrovascular accident is characterized by a slowly progressive course, although stepwise progression is possible (usually after vascular crises). In stage I, ability to work and household adaptation In most cases, patients are preserved; in stage II, there is a slight or moderate decrease in working capacity; in stage III, patients are disabled and often incapable of self-care.

The article was prepared and edited by: surgeon