Brain microangiopathy what is the treatment

In most cases, drug therapy is performed. Surgery is indicated only for extensive brain damage.

Treatment with surgery is necessary only if the collateral vessels are unable to compensate for the lack of blood circulation. The operation is possible with the ineffectiveness of medications.

Drug therapy is focused on the fight against the underlying disease:

  • diabetes;
  • infection;
  • arterial hypertension;
  • injuries.

Dosages and the course of drug therapy are established by the attending physician individually for each patient, depending on the form of pathology and its severity.

  • In diabetes mellitus, the type of Insulin and a number of hypoglycemic agents are selected.
  • With hypertension, it is recommended to treat microangiopathy with statins, antihypertensive drugs and agents that lower serum cholesterol. High-pressure patients need a diet rich in fiber, and light exercise.
  • The cerebral form requires therapy with nootropic drugs, multivitamin complexes and nicotinic acid.

To improve the effectiveness of conservative treatment, physiotherapy, head massage and sports are prescribed.

Patients do not always understand when they are diagnosed with “microangiopathy of the brain”, what it is and whether it is possible to cure it. The doctor usually prescribes complex therapy.

First of all, the patient should take drugs that normalize blood pressure. To eliminate the lack of oxygen in the brain, use antihypoxants, such as “Emoxipine.” It is also important to adjust lipid levels by applying statins, fibrates, bile acid sequestrants. These can be the following drugs: “Atorvastatin”, “Simvastatin”, “Rosuvastatin”.

Also, if microangiopathy is diagnosed, treatment should be performed using nootropics that improve brain nutrition. These are Piracetam, Nootropil, Cerebrosiline, Encephabol. For the normalization of blood circulation, nicotinic acid preparations are used: “Pikamilon”, “Xantilone nicotinate”.

Treatment of microangiopathy of the brain is carried out comprehensively. First of all, the doctor must choose the appropriate patient drugs to normalize blood pressure. To eliminate the signs of oxygen deficiency in the brain tissues, antihypoxants, for example, Emoxipin, are taken. An important role is played by the correction of lipid levels.

Nootropics are used to improve brain nutrition: Piracetam, Cerebrolysin, Nootropil, Encephabol. With the help of nicotinic acid preparations, blood circulation is improved: Picammilon, Xanthinol nicotinate.

The prognosis of the disease worsens in the presence of hypertension in the patient, in which case the symptoms progress rather quickly. Age is also important: in older people, the disease progresses faster.

Choosing a treatment method for cerebral microangiopathy is necessary depending on:

  • From the form of the disease;
  • Its location;
  • The general tone of the patient.

Many methods are aimed at reducing complications and counteracting the symptoms of the disease. Drug treatment is prescribed to improve blood circulation and to strengthen the vascular walls.

  • Antispasmodic drugs;
  • Medications to normalize blood coagulation and to improve microcirculation in the vessels of the brain.
  • The dose and duration of angiopathy therapy is assigned individually to each patient.

Auxiliary methods of therapy:

In severe cases, surgery is performed. Basically, she should:

  • Contribute to the reconstruction of vascular walls;
  • Restore the gaps in them, which leads to improved blood circulation, and therefore, nutrition of organs and soft tissues.

The treatment of cerebral microangiopathy is complex, including dieting and prescribing to patients the main groups of drugs:

  • Antihypoxants eliminate the signs of hypoxia in the brain tissue – Emoxipin.
  • Statins and fibrates adjust the level of lipids in the blood – “Fluvastatin”, “Lovastatin”, “Fenofibrate”.
  • Nootropic drugs improve trophism of the brain – Pantogam, Nootropil, Phenibut.
  • Antihypertensive drugs are prescribed for patients with arterial hypertension – “Kapoten”, “Tenorik”.
  • Drugs that improve microcirculation – Pentoxifylline, Xanthinol.
  • Angioprotectors improve the condition of the vascular wall and reduce its pathological permeability – “Ditsinon”, “Complamin.”
  • Antioxidants – vitamin E, group B, selenium, lipoic acid.
  • Disaggregants and antiplatelet agents – Thrombo ACC, Cardiomagnyl, Trental, Curantil.
  • Coenzymes normalize all types of metabolism in diabetes mellitus – Cocarboxylase, Flavinate, Pyridoxalphosphate.

Physiotherapy usually complements drug treatment and improves blood microcirculation in the tissues. Patients undergo mud therapy, electrical stimulation, plasmophoresis, electrotherapy, heat therapy, balneotherapy, microwave resonance therapy, massage, acupuncture.

Currently, the pharmaceutical industry produces a huge number of hypoglycemic drugs, which are selected individually by each endocrinologist for each patient. If necessary, they are prescribed insulin. In parallel with the treatment of the main pathology, symptomatic and pathogenetic therapy is carried out aimed at preventing the development of complications of microangiopathy.

pharmacological groupname of drugs
antihypoxants to prevent brain cell hypoxiaEmoxipin
febrate groupFenofibrate
nootropic medications· Nootropil;
antihypertensive drugs· Tenorik;
· Kapoten
microcirculation aidsPentoxifylline
group of drugs angioprotectorsDicinon
medication antioxidant groupSelenium
Vitamin E
B vitamins
antiplatelet drug groupCardiomagnyl;
· Curantyl;
coenzymes for diabetesFlavinate

In addition to medication, physiotherapy is used:

  • Plasmapheresis method;
  • Mud treatment;
  • Stimulation by electric waves;
  • Thermal warming;
  • Balneotherapy technique;
  • Massotherapy;
  • Acupuncture to restore reflexes.

When restoring the lumen in the vessels, surgical intervention is applied using the technique of cryosurgery, or using laser coagulation.

Microangiopathy of the brain is treated comprehensively. First of all, medications are prescribed that normalize blood pressure, and also eliminate the signs of a lack of oxygen in the brain tissues. Lipids are corrected, and statins, fibrates, bile acids, etc. are prescribed. To make the brain better fed with oxygen, doctors prescribe nootropic drugs, as well as nicotinic acid.

Surgical intervention for this disease is carried out in rare cases, only when it is not possible to restore the vessels by the medication method, and the circulatory deficiency cannot be compensated by the lateral blood flow paths. Together with medication, patients are prescribed massage and a pool, this helps to improve their condition. But the foci of gliosis do not disappear, over time, their number increases.

Steps of the development of the pathological process

Microangiopathy of the brain is considered a fairly common pathology, which is characterized by impaired tone, the structure of the walls of blood vessels and capillaries directly in this organ. As a result, the patient has a disturbed metabolic process of brain tissue.

The more the disease progresses, the less elasticity of the vascular wall becomes, there is a thickening and reduction of the vascular lumen. This can lead to obstruction of small vessels for intense blood flow. As a result, brain neurons suffer from a lack of blood flow, oxygen and glucose.

After the vessels become less durable, they begin to break, which can provoke a subarachnoid hemorrhage. If blood flow is absent, then local neurons die off, foci are replaced by gliosis, and scar formation occurs.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.