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

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

What is cerebrovascular accident (MK)

The vessels of the brain have a peculiar, perfect structure that ideally regulates blood flow, ensuring the stability of blood circulation. They are designed in such a way that with an increase in blood flow to the coronary vessels by about 10 times during physical activity, the amount of circulating blood in the brain, with an increase in mental activity, remains at the same level. That is, there is a redistribution of blood flow. Part of the blood from parts of the brain with a lower load is redirected to areas with enhanced brain activity.

However, this perfect process of blood circulation is disturbed if the amount of blood entering the brain does not satisfy its need for it. It should be noted that its redistribution among brain regions is necessary not only for its normal functionality. It also occurs when various pathologies occur, for example, (narrowing) or obturation (closure). As a result of impaired self-regulation, there is a slowdown in the speed of blood movement in certain parts of the brain and them.

Types of violations of MK

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

1. Acute (strokes) that occur 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. They are divided into two types: origin and caused.

Acute disorders of cerebral circulation (ACC)

Acute cerebrovascular accident causes persistent disorders of brain activity. It is of two types: and (it is also called a cerebral infarction).

hemorrhagic

Etiology

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

Pathogenesis

As a result of an increase in blood pressure, the plasma and proteins contained in it are released, which leads to plasma impregnation of the walls of blood vessels, causing their destruction. A peculiar hyaline-like specific substance (a protein resembling cartilage in its structure) is deposited on the vascular walls, which leads to the development of hyalinosis. Vessels resemble 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 a transformation 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:

• Plasma impregnation of the walls of the vessels of the white medulla or visual tubercles;
• diapedetic bleeding;
• formation of microaneurysms.

Hemorrhage in the acute period is characterized by the development of hematomas during wedging and deformation of the brain stem into the tentorial foramen. At the same time, the brain swells, extensive edema develops. There are secondary hemorrhages, smaller ones.

Clinical manifestations

Usually occurs during the day, during a period of physical activity. Suddenly, the head starts to hurt badly, there are nauseating urges. Consciousness is confused, a person breathes often and with a whistle, occurs, accompanied by hemiplegia (unilateral paralysis of the limbs) or hemiparesis (weakening of motor functions). Lost basic reflexes. The gaze becomes motionless (paresis), anisocoria (pupils of different sizes) or divergent strabismus occurs.

Treatment

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

1. Decreasing - ganglionic blockers ( Arfonad, Benzohexanium, Pentamine).
2. To reduce the permeability of the walls of blood vessels and increase blood clotting - Dicynon, vitamin C, Vikasol, Calcium gluconate.
3. To increase the rheology (fluidity) of blood - Trental, Vinkaton, Cavinton, Eufillin, Cinnarizine.
4. Inhibiting fibrinolytic activity - ACC(aminocaproic acid).
5. Decongestant - Lasix.
6. Sedative drugs.
7. A lumbar puncture is prescribed to reduce intracranial pressure.
8. All drugs are administered by injection.

Ischemic

Etiology

ischemic NMC due to atherosclerotic plaque

Ischemic circulatory disorders are most often caused by atherosclerosis. Its development can provoke strong excitement (stress, etc.) or excessive physical activity. It can occur during a night's sleep or immediately after waking up. Often accompanies a pre-infarction state or.

Symptoms

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

Pathogenesis

An ischemic disorder occurs when an area of ​​the brain does not receive enough blood. In this case, a focus of hypoxia arises, in which necrotic formations develop. This process is accompanied by a violation of basic brain functions.

Therapy

The treatment uses injections of drugs to restore the normal functioning of the cardiovascular system. These include: Corglicon, Strofantin, Sulfocamphocaine, Reopoliklyukin, Cardiamin. Intracranial pressure decreases Mannitol or Lasix.

Transient cerebrovascular accident

Transient cerebrovascular accident (TIMC) occurs against the background of arterial hypertension or atherosclerosis. Sometimes the cause of its development is their combination. The main symptoms of PNMK are manifested in the following:

• If the focus of the pathology is located in the basin of the carotid vessels, the patient becomes numb half of the body (on the opposite side of the focus) and part of the face around the lips, paralysis or short-term paresis of the extremities is possible. Speech is impaired, an epileptic seizure may occur.
• In case of circulatory disorders, the patient's legs and arms weaken, it is difficult for him to swallow and pronounce sounds, photopsia occurs (appearance of luminous points, sparks, etc. in the eyes) or diplopia (doubling of visible objects). He loses his bearings, he has memory lapses.
• Signs of cerebrovascular accident against the background of hypertension are manifested in the following: the head and eyeballs begin to hurt badly, the person experiences drowsiness, he has stuffy ears (as in an airplane during takeoff or landing) and nauseating urges. The face turns red, sweating increases. Unlike strokes, all these symptoms disappear within a day. For this they received the name.

PNMK is treated with antihypertensive, tonic and cardiotonic drugs. Antispasmodics are used, and. The following medications are prescribed:

Dibazol, Trental, Clonidine, Vincamine, Eufillin, Cinnarizine, Cavinton, Furasemide, beta-blockers. As tonic - alcohol tinctures of ginseng and Schisandra chinensis.

Chronic disorders of cerebral circulation

Chronic cerebrovascular accident (CIC), in contrast to acute forms, develops gradually. There are three stages of the disease:

1. In the first stage, the symptoms are vague. They are more like chronic fatigue syndrome. A person quickly gets tired, his sleep is disturbed, he often hurts and his head is spinning. He becomes short-tempered and distracted. He often changes his mood. He forgets some minor things.
2. In the second stage, chronic cerebrovascular accident is accompanied by a significant deterioration in memory, minor motor dysfunctions develop, causing unsteady gait. There is constant noise in the head. A person does not perceive information well, with difficulty concentrating his attention on it. He is gradually degrading as a person. Becomes irritable and insecure, loses intelligence, reacts inadequately to criticism, often becomes depressed. He is constantly dizzy and has a headache. He always wants to sleep. Efficiency - reduced. He does not adapt well socially.
3. In the third stage, all symptoms intensify. Personality degradation turns into, memory suffers. Leaving the house alone, such a person will never find his way back. Motor functions are impaired. This is manifested in the tremor of the hands, stiffness of movements. Speech impairment, uncoordinated movements are noticeable.

Violation of cerebral circulation is dangerous because if treatment is not carried out in the early stages, neurons die - the main units of the brain structure, which cannot be resurrected. Therefore, early diagnosis of the disease is so important. It includes:

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

Etiology

The main causes of cerebrovascular accident are as follows:

1. Age. Basically, they occur in people who have stepped into their fifth decade.
2. genetic predisposition.
3. Traumatic brain injury.
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 is the most common cause of strokes.
9. In old age, blood flow disorders in the brain can lead to:
   • shimmering ,
   • various diseases of the hematopoietic organs and blood,
   • chronic,

Treatment

In chronic disorders of blood flow in the brain all therapeutic measures are aimed at protecting the neurons of the brain from death as a result of hypoxia, stimulate metabolism at the level of neurons, normalize blood flow in brain tissues. Medicines for each patient are selected individually. They should be taken in a strictly specified dosage, constantly monitoring blood pressure.

In addition, with disorders of cerebral circulation, accompanied by manifestations of a neurological nature, antioxidants, vasodilators, drugs that increase blood microcirculation, sedatives and multivitamins are used.

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

Overweight people who are at risk for developing atherosclerosis due to need to pay attention to nutrition. For them, there are special diets, which you can learn about from a dietitian who monitors the organization of nutrition for patients who are being treated in a hospital at any hospital. Dietary products include everything of vegetable origin, seafood and fish. But milk products, on the contrary, should be low in fat.

If the cholesterolemia is significant, and the diet does not give the desired results, the drugs included in the group are prescribed: Liprimar, Atorvakar, Vabarin, Torvakard, Simvatin. With a large degree of narrowing of the lumen between the walls of the carotid arteries (more than 70%), a carotid (surgical operation) is required, which is performed only in specialized clinics. With stenosis less than 60%, conservative treatment is sufficient.

Rehabilitation after acute cerebrovascular accident

Drug therapy can stop the course of the disease. But she cannot return the opportunity to move. Only special gymnastic exercises can help with this. We must be prepared for the fact that this process is quite lengthy and be patient. Relatives of the patient should learn how to perform massage and therapeutic exercises, since it is they who will have to do them to him for six months or more.

Kinesiotherapy is shown as the basis for early rehabilitation after a dynamic violation of cerebral circulation 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 body's motor functions. The following methods are used in kinesitherapy:

1. Gymnastics "Balance", aimed at restoring coordination of movements;
2. The Feldenkrais Reflex System.
3. Vojta system, aimed at restoring motor activity by stimulating reflexes;
4. Microkenisotherapy.

Passive gymnastics "Balance" is assigned to every patient with impaired cerebral circulation, as soon as consciousness returns to him. Usually relatives help the patient to perform it. It includes kneading the fingers and toes, flexion and extension of the limbs. Exercises begin to be performed from the lower extremities, gradually moving up. The complex also includes kneading the head and cervical regions. Before starting the exercises and finishing the gymnastics should be light massaging movements. Be sure to monitor the patient's condition. Gymnastics should not cause him overwork. The patient can independently perform exercises for the eyes (squinting, rotation, fixing the gaze at one point, and some others). Gradually, with the improvement of the general condition of the patient, the load is increased. For each patient, an individual recovery method is selected, taking into account the characteristics of the course of the disease.

Photo: basic exercises of passive gymnastics

The Feldenkrais Method- This is a therapy that gently affects the human nervous system. It contributes to the complete restoration of mental abilities, physical activity and sensuality. It includes exercises that require smooth movement during execution. The patient must focus on their coordination, make each movement meaningful (consciously). This technique forces you to divert attention from the existing health problem and focus it on new achievements. As a result, the brain begins to "remember" the old stereotypes and returns to them. The patient is constantly exploring his body and its capabilities. This allows you to find quick ways to get him moving.

The methodology is based on three principles:

• All exercises should be easy to learn and remember.
• Each exercise should be performed smoothly, without muscle strain.
• Performing the exercise, a 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 arising under the influence of gymnastic and massage loads. In addition, it regulates the respiratory process after performing therapeutic exercises and gives a relaxing effect.

With disorders of cerebral circulation, the patient is prescribed bed rest for a long time. This can lead to various complications, for example, a violation of the natural ventilation of the lungs, the appearance of bedsores and contractures (mobility is limited in the joint). Prevention of bedsores is the frequent change of position of the patient. It is recommended to turn it over on the stomach. At the same time, the feet hang down, the shins are located on soft pillows, under the knees there are cotton pads lined with gauze.

1. Give the patient's body a special position. In the first days, he is transferred from one position to another by 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 it themselves. Early seating of the patient in bed (if health permits) will not allow contractures to develop.
2. Do the massage necessary to maintain normal muscle tone. The first days it includes light stroking (with increased tone) or kneading (if muscle tone is reduced) and lasts only a few minutes. In the future, massage movements are intensified. 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. Perform exercise therapy exercises, which, among other things, effectively fight synkinesis (involuntary muscle contractions).
4. Vibrostimulation of paralyzed parts of the body with an oscillation frequency of 10 to 100 Hz gives a good effect. Depending on the condition of the patient, 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 methods of treatment are also used:

• Reflexology including:
  1. Treatment with smells (aromatherapy);
  2. classic version of acupuncture;
  3. acupuncture to reflex points located on the auricles (auricol therapy);
  4. acupuncture of biologically active points on the hands (su-Jack);
• Coniferous 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.

Consequences of NMK

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

1. He cannot eat, perform hygiene procedures, dress himself, etc. on his own. Such people have a completely impaired ability to think. They lose track of time and do not orient themselves in space at all.
2. Some people still have the ability to move. But there are many people who, after a violation of cerebral circulation, forever remain bedridden. Many of them keep a clear mind, understand what is happening around them, but are devoid of speech and cannot put into words their desires and express feelings.

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

But it is possible to protect yourself from this serious disease, regardless of which category of classification it belongs to. Although many people neglect it. This is an attentive attitude to your health and all the changes that occur 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.
• Elevated temperature is an indication of a malfunction in the body. But many go to work when it is 37 ° C, considering it normal.
• Does it happen for a short time? Most people rub them without asking the question: why is this happening?

Meanwhile, these are the satellites 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 disappear within a day, not every person is in a hurry to see a doctor in order to be examined and receive the necessary medical treatment.

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

Video: brain blood supply and the consequences of a stroke

Violation of hemodynamics even in the basin of a small blood vessel is a serious problem for the whole organism, since it can lead to dangerous, life-threatening complications.

Each case of detection of circulatory disorders needs a detailed study. Treatment for hemodynamic disorders is aimed both at eliminating the obstacles to the normal blood supply to tissues and organs, and at eliminating disorders caused by the pathological condition.

What is a circulatory disorder

This term is used to denote conditions when the cardiovascular system loses its ability to provide a full blood supply to tissues and organs.

According to the nature of the manifestations, hemodynamic disorders are classified as follows:

• initial signs of circulatory failure (characterized by the development of intermittent symptoms that can only appear in a state of increased stress);
• acute circulatory disorders (symptoms often occur suddenly, often without warning symptoms; cause a life-threatening condition);
• chronic disorders of hemodynamics (develop over a long time; have a gradually progressive character).

Causes of hemodynamic disorders

Varying degrees of narrowing of the artery leading to progressive circulatory failure

The causes of circulatory disorders of organs and tissues include both factors affecting the functioning of the heart and effects that can affect the state of blood vessels:

• Arterial hypertension (hypertension).
• High blood cholesterol and impaired triglyceride metabolism.
• Elderly age.
• Diabetes.
• Tobacco smoking.
• Overweight.
• Thrombosis.
• obliterating atherosclerosis.
• Obliterating endarteritis (this disease is more common in men and causes a change in the blood circulation of the tissues of the lower extremities).
• Phlebeurysm.

Thrombus in a vein with thrombophlebitis. The figure shows one of the mechanisms of separation of the thrombus segment, which leads to thromboembolism.

It must be borne in mind that a circulatory disorder in a particular area can lead to similar disorders in organs in systems in other areas. For example, thrombophlebitis in the lower extremities can lead to thrombosis or pulmonary embolism. Therefore, diseases that cause local circulatory disorders in one of the areas must be considered as a problem of the whole organism.

Embolus in a vessel

Clinical manifestations

Circulatory disorders, regardless of the area of ​​localization, are usually divided into acute and chronic.

• Acute circulatory disorder is characterized by a sudden disruption of the organ and is accompanied by severe pain. In the case of localization of the pathological process in the tissues of vital organs, life-threatening conditions develop that require emergency care. This condition can develop as a result of an embolism or persistent spasm of the artery.
• Chronic hemodynamic disorders develop over a long period of time, leading to a gradual extinction of the functional activity of the affected organ. Such pathologies cause atherosclerotic damage to the vascular bed or a gradual decrease in the elasticity of the vascular wall.

The mechanism of formation of an ischemic focus in the brain in arterial thromboembolism

Manifestations of hemodynamic disorders depending on the nature and location of the lesion:

Area of ​​violation	Manifestations of acute hemodynamic disturbance	Symptoms of chronic circulatory failure
Brain	Disorders of consciousness, up to its loss. General cerebral symptoms: headache, dizziness, stupor. Focal neurological symptoms, the specificity of which depends on the localization of the pathological focus. Speech disorders	Episodic headaches. Dizziness, balance disorders. Noise in the head, in the ears. Gradually progressive memory impairment. Episodes of weakness in specific muscle groups
Spinal cord	Paresthesias and paresis in the extremities controlled by the affected segment of the spinal cord. With the defeat of the cervicothoracic region - respiratory disorders caused by paresis of the respiratory muscles. In the case of spinal stroke at the lumbar level - dysfunction of the pelvic organs and blood supply to the lower extremities	Episodic, slowly progressive disturbances of sensitivity, the localization of which is determined by the level of the lesion. Gradually developing and progressive peripheral paresis. Dysfunction of the pelvic organs
cardiac muscle	This condition is called myocardial infarction. The clinical picture is characterized by a sharp decline in the functional activity of the heart muscle, which is manifested by a generalized hemodynamic disorder.	Attacks of soreness and burning in the retrosternal space, at the beginning of the disease provoked by the load, and in advanced stages - arising at rest. Dyspnea. Widespread edema resulting from progressive cardiac weakness
upper limbs	Sharp soreness. Rapidly developing swelling. Violation of motor function - limitation of mobility due to pain and muscle weakness. Dysesthesia. In the absence of timely medical care - the development of gangrene	Paresthesia, dysesthesia. Signs of tissue hypotrophy
lower limbs	Pronounced pain syndrome. Swelling of soft tissues. Muscle weakness. Decreased sensitivity. Intermittent lameness. In the absence of timely assistance - tissue necrosis, gangrene	Sensitivity disorders. Gradually increasing muscle weakness. Signs of impaired tissue trophism

For the treatment of impaired blood circulation, doctors prescribe angioprotectors. They improve metabolic processes in the vascular wall and normalize capillary permeability. Among angioprotectors, the most effective are Curantil, Trental, Pentoxifylline.

Reopoliglyukin is a low molecular weight dextran preparation that attracts additional blood volume from the intercellular space into the bloodstream and improves blood fluidity.

Vasoprostan is a drug from the prostaglandin E1 group. It improves blood flow, elasticity of erythrocytes, microcirculation, and also activates the anticoagulant system of the blood.

Calcium channel blockers are designed to improve cerebral circulation and have a cerebroprotective effect. These include Kordaflex, Cinnarizin, Arifon.

Myotropic antispasmodics dilate blood vessels, increase cerebral blood flow and are highly effective in spasms of cerebral vessels. The drugs of this group are "Cavinton", "No-shpa", "Eufillin".

Folk remedies to improve blood circulation

Folk treatments for poor circulation include occasional ginger drinks. To prepare them, pour boiling water over a teaspoon of ginger, a teaspoon of honey and a pinch of black pepper. Ginger drink warms and stimulates blood flow, especially in the legs. Black and red pepper, mustard and horseradish are good for blood. These spices prevent blood clotting and help fight cold feet syndrome. Garlic in its natural form or in also improves blood circulation.

Hawthorn saturates the blood with vitamins and strengthens the immune system. Hawthorn tincture is recommended to be taken 2 times a day for 20 minutes. before meals. Hawthorn treatment is supplemented with a complex composition of ginger and cinnamon, which enriches the blood with nutrients. Watermelon - good for blood. It contains lycopene, which improves blood quality. The ginseng plant accelerates blood flow in the legs and improves the tone of blood vessels and the body as a whole.

Calendula or red pepper ointment is used to treat poor circulation in the legs. It is applied to the legs in the absence of damage to the skin.

Water procedures to improve blood circulation

A hot foot bath is an effective remedy that has been tested for centuries. This procedure improves blood circulation and reduces high blood pressure. You can increase the effectiveness of foot baths by adding a little powder of mustard, oregano or rosemary to the water. Another option for a similar procedure to strengthen blood vessels is a bath with black ground pepper and crushed ginger.

A hot compress has the same healing effect as foot baths. A compress soaked in hot water is applied to the feet, left for 3 minutes, and then ice is applied. This alternation is repeated several times. You can also take alternate hot and cold showers. This method will improve blood circulation not only in the legs, but throughout the body.

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

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 do even a few minutes. It is a known fact that oxygen reserves are not created in the brain, and there are no substances capable of nourishing it in anaerobic (in the absence of oxygen) conditions. That is, the nerve cells of the brain constantly need oxygen, glucose and "cleaning" (cleansing from the waste products of cells).

Excursion to physiology

The uninterrupted supply of substances necessary for the nerve cells of the brain, and the purification of waste products is carried out by the cerebral circulation 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 peculiar, perfect structure that ideally regulates blood flow, ensuring its stability. They are designed in such a way that with an increased flow of blood into large vessels, a strong pulse of blood coming from the heart is weakened due to the numerous bends (siphons) of the vessels along the vascular bed, which contribute to the pressure drop and smooth out the pulsating blood flow. Due to complex regulatory mechanisms, with an increase in total arterial pressure, the pressure in the brain remains stable for a long time. Regulatory systems make it possible to redistribute blood flow from brain regions with less stress to areas with enhanced brain activity.

The brain has an autonomous system of regulation, 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. At 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 (pathways), which is due to the greater activity of the cells. Thus, during intense mental work, the local blood flow in the cerebral cortex can increase by 2-3 times compared to the state of rest.

The brain has the richest capillary network. Nerve cells are not only intertwined, but also pierced by capillaries. The vessels of the brain are interconnected by collaterals (“bridges”). Arterial collateral circulation of the brain, which is 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 a high intensity of blood flow in the vessels of the brain, the blood pressure in them is maintained at a relatively constant level. A complex chain of regulatory mechanisms protects the brain from falling blood pressure and hypoxia (decrease in oxygen). On the way of blood flow to the brain, there are many sensitive cells (pressoreceptors, chemoreceptors) that can respond to blood pressure and regulate the heart rhythm and vascular tone.

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

Thus, the cerebral circulation is provided with complex regulatory mechanisms that allow maintaining the constancy of the intake of the substances it needs.

With excessive blood supply to the brain, its excessive hydration (accumulation of fluid) can occur, followed by the development of edema and damage to vital centers that are incompatible with life. The reason for the redundancy of blood supply can be, for example, an increase in systemic arterial pressure up to 160-170 mm Hg. Art. and higher.

In the problem of impaired blood supply to the brain, much attention is paid to the arteries. But no less important is the venous circulation. Through the veins, waste substances (slags) are removed with the blood - that is, the brain is cleansed. Thanks to these vessels, a 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, contributes to the occurrence of phlebitis and thrombophlebitis.

There is another feature of the veins of the brain that must be taken into account. The wall of a venous vessel in the brain does not have a valve apparatus, unlike, for example, the veins of the extremities (valves help withstand stress by moving the blood up and preventing it from moving in the opposite direction). Therefore, venous blood in the vessels of the brain is freely passed in both directions, depending on the pressure that has arisen. This creates the danger of a rapid spread of infection from the sinuses and eye sockets, which is facilitated by the atomic features of the structure of the nose and its paranasal sinuses, which are in close proximity to the brain. When coughing, venous pressure increases, it becomes possible to reverse venous flow, stagnation, hypoxia of the brain. There are cases of loss of consciousness during a coughing fit in the presence of a chronic respiratory disease and in young children, when they "come in" in a cough with an illness and in crying with a cry to cough.

It becomes clear why long-term respiratory disorders, 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 focus of infection, contribute to its penetration into the brain.

Observe the manifestations of congestion in the brain (dilated, blood-filled vessels of the fundus), for example, an oculist can. But this is also visible to the naked eye: red, swollen eyes after sleep (due to alcohol intake the day 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 causes of deterioration in cerebral circulation can be associated with impaired blood flow to the brain and outflow of blood from the brain.

What happens when blood pressure rises?

At first, vascular tone is slowly disturbed. Over time, while maintaining high blood pressure (BP), small cerebral hemorrhages and strokes can occur.

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

How does this happen? A specific protein (a hyaline-like substance resembling cartilage in its structure) is deposited on the walls of blood vessels, which leads to the development of hyalinosis. 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 edema and hematomas lead to the following hemorrhages (hemorrhagic stroke).

Atherosclerosis that accompanies hypertension, or existing 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 is thick and viscous).

Acute circulatory disorders are strokes (hemorrhagic and ischemic). But it all starts with transient disorders of cerebral circulation 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 focus with impaired blood supply is formed in the brain, the patient may become numb half of the body (on the side opposite to the site of 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, an epileptic seizure may occur.

In case of circulatory disorders, depending on the location of the lesion, the legs and arms may weaken, the head may feel dizzy, it can be difficult for the patient to swallow and pronounce sounds, photopsia occurs (appearance of luminous points in the eyes, sparks, etc.) or diplopia (doubling of visible objects) . A person loses orientation, he has memory lapses.

Signs of cerebrovascular accident on the background of hypertension are manifested in the following: the head and eyeballs begin to hurt, the person experiences drowsiness, he has stuffy ears (as in an airplane during takeoff or landing) and bouts of nausea. The face turns red, sweating increases.

Unlike strokes, all these symptoms, which are called "transient attacks", disappear within a day.

Chronic cerebrovascular accident (CIC), in contrast to acute forms, develops gradually. There are three stages of the disease:

1. In the first stage, the symptoms are vague. They are more like chronic fatigue syndrome. A person quickly gets tired, becomes quick-tempered and absent-minded, forgets some insignificant moments. His sleep is disturbed, his mood often changes, his head hurts and is dizzy.
2. In the second stage, chronic cerebrovascular accident is accompanied by a significant deterioration in memory, minor impairments in motor functions develop, causing unsteady gait. There is constant noise in the head. A person does not perceive information well, with difficulty concentrating his attention on it. Becomes irritable and insecure, loses intelligence, reacts inadequately to criticism, often becomes depressed. He gradually degrades as a person and poorly adapts socially. He is constantly dizzy and has a headache. He always wants to sleep. Performance has been significantly reduced.
3. In the third stage, all symptoms intensify. The degradation of the personality turns into dementia, memory suffers. Leaving the house alone, such a person will never find his way back. Motor functions are impaired, which manifests itself in hand tremor, stiffness of movements. Speech impairment, uncoordinated movements are noticeable.

Consequences of cerebrovascular accidents

Disability is a sad result of acute and in many cases chronic disorders of cerebral circulation.

Acute cerebrovascular accident has serious consequences. In most cases, a person who has had a stroke becomes completely helpless. He cannot eat, perform hygiene procedures, dress himself, etc. on his own. Such people have a completely impaired ability to think. They lose track of time and do not orient themselves in space at all.

Some people still have the ability to move. But many people after a violation of cerebral circulation forever remain bedridden. Many of them keep a clear mind, understand what is happening around them, but are devoid of speech and cannot express their desires and feelings in words.

How to prevent cerebrovascular accidents

There is an opportunity to protect yourself from this serious disease, no matter what category it belongs to. Only many people neglect it.

This is an attentive attitude to your health and all the changes that occur 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 work of the systems responsible for this organ.

Elevated temperature is an indication of a malfunction in the body. But many go to work with a temperature of 37 ° C, considering it normal (explaining this by the fact that the tests did not reveal anything).

Is there transient numbness in the extremities? Most people rub them without asking the question: why is this happening?

It is not normal to live on constant medical treatment for chronic diseases of the nose and respiratory tract, not to associate them with existing internal disorders and not think about the consequences (because there is no time, because the ENT doctor will perform the procedure and for some time it will become easier).

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

After all, all these are satellites of the first minor changes in the system of cerebral blood flow.

Often, an acute cerebrovascular accident is preceded by a transient one. But since its symptoms disappear within a day, not every person is in a hurry to see a doctor in order to be examined and receive the necessary medical treatment.

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

And here again the instructions of the great Avicenna are recalled: "Set up food, sleep, wakefulness ... and the disease will recede."

Blood circulation in the body is a continuous process. It is necessary to provide the organs and systems of the body with oxygen and nutrients. Also, with the help of the blood flow, substances formed as a result of the metabolic processes of cellular life are also excreted.

Poor circulation in the extremities is diagnosed when the vessels are not able to provide proper nutrition to the tissues. This can be understood if characteristic symptoms appear: tingling in the fingers, numbness, trophic changes in the skin.

Circulatory disorders are divided into acute and chronic, slowly increasing. If you start treatment on time, noticing the first signs of pathological changes in blood vessels, the function of blood supply can be normalized.

Symptoms of peripheral circulatory disorders

Signs of poor circulation in the arms and legs are indicated by the following factors:

• a feeling of freezing of the limbs not only in the cold season, but also in the heat;
• crawling feeling;
• periodically there is a tingling sensation in the fingers;
• there are numbness of the limbs;
• their hair begins to fall out;
• the color of the skin of the extremities becomes pale to blue;
• nails exfoliate, often break;
• erectile function disappears;
• small wounds on the skin of the extremities heal for a long time, begin to fester, ulcers form.

Even with the constant application of the cream, the skin is overdried, it is impossible to solve the problem with cosmetics.

Poor circulation in the limbs is caused by the following reasons:

1. Damage to blood vessels due to trauma
2. Violation of the general diet.
3. Smoking.
4. Chronic diseases that disrupt the endocrine system, such as diabetes.
5. Hypertonic disease.
6. Violation of the biochemical composition of the blood, especially cholesterol levels.

When the initial symptoms of poor circulation of peripheral organs appear, treatment should be started, otherwise the condition can cause unpleasant consequences.

Slowed blood circulation increases the risk of trophic ulcers, can provoke the onset of a gangrenous condition. Ulcers are especially common in people with diabetes. Tight underwear, uncomfortable shoes - and attrition turns into a purulent-inflammatory process.

The most dangerous consequences are the occurrence of critical ischemia of the lower extremities. A symptom of the disease is swelling of the fingers, which is difficult to eliminate.

Poor circulation in the hands indicates that the blood supply to the cardiovascular system is impaired. Numbness of the hands often appears against the background of pain in the chest, tingling of the heart, during shortness of breath.

Violation of blood supply is diagnosed on the basis of the clinical picture and special diagnostics.

The following research methods help to identify the problem:

• Ultrasound of veins and arteries;
• ultrasound;
• CT scan;
• magnetic resonance imaging;
• contrast phlebography;
• scintigraphy.

The necessary examination methods are chosen by the doctor based on the clinic and the patient's capabilities. If the patient has a pacemaker sewn in, wave examinations are not performed.

Treatment of peripheral circulatory disorders

What to do if there are symptoms of poor circulation in the lower extremities? Most likely, this begins varicose veins and you should contact a phlebologist.

In order to stop the development of the disease, the following drugs are prescribed:

1. Venotonic drugs used orally and externally. They strengthen the venous walls, increase their tone.
2. Heparin-containing preparations can also be local and administered for internal use. With their help, the composition of the blood and its coagulability change.
3. Venolife proved to be effective - a remedy that combines the properties of heparin-containing and venotonic drugs. In addition, it contains vitamin B5. Venoline helps to treat numbness, remove swelling and relieve external manifestations of circulatory disorders - dry skin and discoloration. This quality of the drug is very much appreciated by women.

Massage effects and physiotherapy are connected to the treatment of varicose veins: magnetotherapy, pneumocompression. Helps reduce pain special compression underwear

What should I do if my hands are constantly swollen and sore? The best way to combat numbness in the hands is an underwater massage.

Traditional medicine in the treatment of peripheral blood supply

To combat the violation of peripheral blood supply in the piggy bank of traditional medicine, there are many recipes.

The following procedure effectively helps to restore blood supply in the arms and legs:

1. mix equal amounts of sugar and sunflower oil;
2. prepare a container with hot water, 250 ml - 2 tablespoons of table salt;
3. Anoint the skin with a mixture of oil and sugar, dip the limb in saline solution - its initial temperature should be about 38ºС;
4. keep the limb in water for 30-45 minutes.

This medicine will help restore blood supply to the legs and arms. A quarter-liter jar is filled with crushed garlic, poured with water and placed in a dark, cool place for 2 weeks. The composition must be stirred a couple of times a day. When the remedy is infused, it is filtered and put in the refrigerator. Take 5 drops 3 times a day, diluted in a tablespoon of water. The course of treatment is 10-14 days.

Another bath is herbal. It is made up of equal parts of chamomile, nettle, oregano, lemon balm. 2 cups of herbal raw materials are poured with 3 liters of boiling water, they are waiting for it to cool down to 38ºС, and placed in a hand or foot bath.

Prevention of circulatory disorders

To improve the condition of the peripheral vessels of the extremities, they require dosed physical activity. For the legs, this is walking at a moderate pace, for the hands - gymnastics. If you have to constantly print, or do the same work, you need to take a break every 45 minutes.