Overview of cerebrovascular disease causes, types, symptoms and treatment

The brain is an extremely complex structure that provides control over many processes in the human body. For normal functioning, this body must receive a large amount of oxygen and nutrients. Brain tissues are extremely sensitive to lower levels of saturation with essential substances.

The term cerebral disease can hide hemorrhagic and ischemic types of stroke, intracranial hemorrhages of various localization, chronic disculatory brain pathology, hypertensive and atherosclerotic encephalopathy, etc. All these conditions are characterized by acute or chronic cerebrovascular accident. The international classification of diseases classifies a significant number of pathologies into the class of cerebrovascular disorders.

For many modern people, health is in 2nd or 3rd place, therefore, what cerebrovascular disease is they will know after the diagnosis is made. However, this serious disease is associated with two pathological conditions that are extremely common in modern people, including atherosclerosis and hypertension.

Thus, atherosclerotic plaques and chronically elevated blood pressure are the most common causes of cerebrovascular disease. Atherosclerosis is currently an extremely common blood vessel disease. This pathological condition develops against the background of a critical increase in blood cholesterol.

The lion’s share of cholesterol enters the human body along with food rich in animal fats. This substance is viscous and sticks to the walls of blood vessels. In addition, atherosclerotic plaques contain blood elements and some other substances. The appearance of atherosclerotic plaques in the vessels of the brain contributes to the narrowing of their lumen, as well as the development of inflammatory processes. Atherosclerotic plaques can quickly become a cause of cerebrovascular accident.

Arterial hypertension associated with hypertension over time becomes the cause of the development of foci of damage and necrosis of the walls of blood vessels located in the brain. In addition, chronically elevated blood pressure leads to stretching and increased permeability of the walls of blood vessels. The lumen of the vessels gradually narrows, as stenosis develops.

All these processes lead to the fact that brain cells begin to die, without receiving the necessary amount of oxygen. According to statistics, approximately 40% of patients suffering from cerebrovascular disease have a history of grade 3-4 hypertension. In addition, often hypertension becomes a cause of stroke.

Another common cause of cerebrovascular disease is systemic vasculitis. Diseases belonging to this group are accompanied by deformation and inflammatory processes affecting the walls of blood vessels. Damaged vessels cannot normally perform their function, which leads to insufficient oxygen supply to brain tissues and their gradual death.

Cerebrovascular disorders have a different origin.

But we can distinguish common provocative factors that can change the state of the vessels of the brain:

  1. Hormonal disruptions (including during hormonal therapy with drugs).
  2. Deviations in metabolism.
  3. Exposure to tobacco and alcohol.
  4. Hypertension.
  5. Stressful situations.
  6. Injuries to the skull and spine.
  7. Hypodynamia.
  8. Hereditary predisposition to the development of cerebrovascular disorders.

Many such factors constantly or periodically affect the human body, and with age, the effects of these influences accumulate.

Therefore, in the elderly, cerebrovascular insufficiency of the brain is more likely, although recently pathologies of this group have become more common in the young population.

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People at risk

  • those who smoke and / or drink alcohol, drug addicts;
  • non-sports office workers;
  • patients with diabetes;
  • people over 60 years old.
PathologyCauses
Cerebral arteriosclerosisIt occurs due to impaired metabolism of fats in the body. It, in turn, can be caused by diabetes mellitus, poor diet, endocrine and genetic diseases, a sedentary lifestyle.
ThrombosisIt occurs due to thrombophilia, a congenital bleeding disorder that increases the likelihood of blood clots. Also the cause may be damage to the walls of blood vessels.
Cerebral angiospasmOccurs due to chronic heart disease; endocrine diseases; stress abuse of caffeine, nicotine, energy; addiction; self-medication with drugs that increase blood pressure and tone the walls of blood vessels.
ArteritisOccurs due to infection or autoimmune reactions.

The etiology of CVB is very complex. It includes the interaction of many factors that are not always possible to establish. Hypertension, and atherosclerosis, and a violation of the rheological properties of the blood can become the cause of the blood supply disturbance.

The World Health Organization identifies more than three hundred factors predisposing to the occurrence of cerebrovascular insufficiency.
They can be divided into four large groups:

  • The main factors that are modifiable;
  1. hypertension;
  2. atherosclerosis;
  3. diabetes;
  4. smoking;
  5. obesity and others
  • Other risk factors that can be changed:
  1. alcohol consumption;
  2. mental illness;
  3. social status;
  4. taking certain medications, etc.
  • Non-modifiable risk factors:
  1. age;
  2. heredity.
  • The so-called “new” risk factors:
  1. bleeding disorders;
  2. vasculitis.

People at risk

In the vast majority of cases, atherosclerosis of the vessels – deposits of cholesterol that form plaques – leads to acute and chronic processes in the brain. These plaques carry the highest cerebrovascular risk, since they cause narrowing and blockage of the blood vessels of the brain, which in the future can provoke a violation of cerebral blood flow, cerebral ischemia with serious consequences.

Other causes of cerebrovascular disease may be:

  1. Thrombosis and embolism due to malfunctioning of the blood coagulation system.
  2. Vasculitis, or damage to the connective tissue, which most often encompasses large and small vessels.
  3. Dystonia of cerebral vessels, or a violation of the nervous regulation of vascular tone, as well as serious psychoemotional overstrain.
  4. Spasm of arteries against the background of chronic arterial hypertension.
  5. Osteochondrosis of the cervical segment of the spine, causing transient disorders of cerebral circulation.
  6. Inflammatory diseases of the cerebral vessels.

Factors that provoke the development of cerebrovascular diseases include:

  • bad habits – smoking, alcoholism;
  • diabetes;
  • obesity;
  • frequent stress and nervous overload;
  • elderly age;
  • dyslipidemia;
  • hypertension of any degree;
  • cardiac ischemia;
  • blood clotting;
  • hypodynamia;
  • burdened heredity;
  • long-term use of hormonal contraceptives;
  • gout.

The causes of cerebral pathogenesis are divided into primary and secondary.

  • developing cerebral arteriosclerosis;
  • diabetes mellitus, gout;
  • hypertension.
  • alcohol abuse;
  • smoking;
  • the predominance of fatty foods in the diet;
  • sedentary lifestyle;
  • hereditary causes;
  • inflammatory infections;
  • neck osteochondrosis;
  • diseases of the heart system;
  • overweight;
  • increased blood clotting;
  • previous injuries;
  • poisoning with various chemicals;
  • emotional stress (stress, feelings).

Factors that lead to a deterioration in the blood supply to the brain, experts conditionally divided into two groups. The most common cause of problems is atherosclerotic lesions of the body’s main blood vessels. Cholesterol plaques form on their walls, respectively, the clearance in them decreases.

The second reason for the appearance of these problems is inflammatory processes in the cerebral vessels, which are called vasculitis.

The risk group includes all those people who are prone to the development of a disease such as atherosclerosis. These are patients with diabetes, smokers, as well as those who are overweight.

Cerebrovascular disease (CVB) in the early stages of development is characterized by sleep disturbance in the patient (insomnia, sudden awakening in the middle of the night and inability to fall asleep after waking up), fast fatigue, poor working capacity, memory loss, fussiness, distraction, and impaired thinking.

The causes of the development of the disease are various factors:

  • stroke – often becomes the cause of the development of cerebrovascular disease;
  • cerebral arteriosclerosis is the most common cause of CVB;
  • chronic stress;
  • smoking;
  • alcoholism;
  • excess weight;
  • diabetes;
  • pathology of the structure of blood vessels;
  • diseases of the circulatory system;
  • hypertension;
  • swelling;
  • infectious diseases;
  • antiphospholipid syndrome;
  • injury.

Treatment of CVB depends on the cause of the violation, the severity of the disease. In some cases, surgery becomes the main treatment method.

  1. Hormonal disruptions (including during hormonal therapy with drugs).
  2. Deviations in metabolism.
  3. Exposure to tobacco and alcohol.
  4. Hypertension.
  5. Stressful situations.
  6. CHD.
  7. Injuries to the skull and spine.
  8. Hypodynamia.
  9. Hereditary predisposition to the development of cerebrovascular disorders.

What causes the problem

Cerebrovascular disease is a pathological condition characterized by organic changes in brain tissue. They arise due to problems with blood supply. Because of this, brain cells do not receive enough oxygen and other nutrients. All this becomes the reason for the appearance of such changes, as a result of which cognitive disorders appear or even such a serious complication as a stroke can develop.

The basis of the problems in most cases are diffuse or multifocal lesions of the brain. They are manifested by mental, neuropsychic or neurological disorders that characterize cerebrovascular disease. Discirculatory encephalopathy is currently absent in the international classification of diseases established as a result of 10 revisions (ICD 10), although in Russia this diagnosis is most often used to indicate chronic problems with cerebral circulation.

Inflammatory processes in the vessels are also the most common causes of the development of such a disease.

Causes

The main reasons for the development of cerebrovascular insufficiency:

  1. atherosclerosis;
  2. osteochondrosis;
  3. atherosclerotic lesion;
  4. thromboembolism, thrombosis on the background of blood coagulation dysfunction;
  5. vasculitis.

Factors

But there are other related factors:

  • diabetes;
  • obesity;
  • inflammatory process in the vessels of the brain;
  • pathology of the heart;
  • abuse of bad habits (alcohol, smoking, caffeine);
  • gout.

Aftermath

As a result, the quality of blood supply to the brain is deteriorating. Tissues and cells are worse supplied with oxygen, which means they do not get the right amount of nutrients. Such conditions will become the optimal environment for the development of pathological changes of a diffuse and focal nature.

The progression of the disease provokes complications such as fainting and tinnitus, a decrease in the quality of vision. Epileptic seizures also appear in a separate category of patients. A stroke accompanied by tissue necrosis is a predictable complication.

Cerebrovascular insufficiency diseases

Osteochondrosis as the root cause of cerebrovascular disease

Due to the long and strong influence of provoking factors, diseases develop that subsequently lead to the appearance of cerebrovascular insufficiency:

  1. Atherosclerosis. This common ailment causes adhesion of cholesterol plaques to the inner surface of the vascular walls. Subsequently, such vessels can not fully perform their functions.
  2. Vasculitis. It is accompanied by inflammatory phenomena that impede normal blood circulation.
  3. Osteochondrosis. It is accompanied by the development of vertebro-basilar insufficiency with inhibition of blood flow in the vertebral vessels.
  4. Hypertension. An increase in the arteries of pressure provokes their spasm.
  5. The formation of blood clots also leads to cerebrovascular insufficiency due to clogging of blood vessels.

It is often difficult to determine the main cause of cerebrovascular disease. So in some cases, the diagnosis remains unspecified.

People at risk

According to ICD-10, cerebrovascular disorders belong to the class of diseases of the circulatory system and go under the code I60-I69. The group includes the following diseases:

  • Subarachnoid hemorrhage.
    There is a rupture of blood vessels and blood flow into the cavity located between the soft and arachnoid meninges. Among the causes – traumatic brain injury, rupture of arterial aneurysm. It leads to disability even with timely treatment, in fifty percent of cases death occurs.
  • Intracerebral hemorrhage (hemorrhagic stroke).
    The outflow of blood into the parenchyma. The main reason is hypertension. Mortality – 40%.
  • Cerebral infarction (ischemic stroke).
    Due to a violation of the blood supply, the tissues are starving, which leads to the death of neurons. As a result, homeostasis is disturbed, water from the blood plasma seeps into the brain, which causes its edema and the displacement of individual parts inside the cranium. Mortality – 56%.
  • Diseases that do not lead to cerebral infarction, in which blockage and stenosis of the pre-cerebral arteries occurs.
    This includes embolism (blockage of blood vessels by foreign particles that penetrate into the structures of the main organ of the central nervous system with blood flow), narrowing of veins and arteries, thrombosis, complete or partial obstruction.
  • Aneurysm of the brain.
    Expansion of the lumen of blood vessels due to their thinning without rupture, except for the congenital form.
  • Hypertensive encephalopathy (hypertensive crisis).
    A violation of cerebral blood flow, accompanied by neurological symptoms. It is a complication of hypertension.
  • Moyamoy’s disease.
    Progressive pathological changes in the vessels of the brain, during which their slow narrowing occurs, up to complete occlusion (blockage).

According to ICD-10, cerebrovascular diseases also include stratification of the cerebral arteries without rupture, purulent thrombosis of the intracranial venous system, cerebral atherosclerosis. This includes vasculitis (inflammation of the central vessels), a progressive vascular leukoencephalopathy in which white matter is affected.

Diseases that damage the cerebral vessels of the brain appear in acute, chronic or transient forms. They may be mild, moderate or severe. Acute severe illnesses lead to quick death. Qualified assistance should be provided in the first five to ten minutes, and it is not always effective. Such diseases include:

  • intracerebral hemorrhage;
  • ischemic stroke;
  • stroke of unspecified origin;
  • acute hypertensive encephalopathy.

Chronic cerebrovascular insufficiency is caused by blockage of the vascular lumen. The disease is slow, the patient’s condition worsens in stages. If the patient in time draws attention to the deterioration of well-being and begins treatment, the course of the disease can be slowed down. If you do not take measures to stop this process, the disease can go into acute form. This group includes:

  • narrowing and stenosis of cerebral vessels;
  • cerebral thrombosis;
  • encephalopathy (subcortical, hypertonic, atherosclerotic, discirculatory);
  • cerebral arteritis.

Cerebrovascular diseases can be transient. In this case, cerebral functions of vascular origin are sharply disturbed, which are manifested by mixed, cerebral or focal symptoms. Transient cerebrovascular pathology is completely reversible throughout the day: after an attack, only a slight malaise can remain. Such diseases include:

  • Transient ischemic attack (microstroke).
    It develops due to a decrease in blood supply. The difference from a stroke is that the disease is not accompanied by irreversible damage to a part of the brain.
  • Hypertensive cerebral crisis.
    It is characteristic for stage 2 and 3 hypertension. A sudden increase in blood pressure occurs, accompanied by manifestations of cerebral symptoms. It happens of varying severity. The duration of malaise can last several days, with a severe course of the disease death is possible. If symptoms persist within hours, urgently see a doctor.

CVB, according to the ICD, is reflected under codes 165 – 167; 167.2; 167.3; 167.4; 167.8. Separately allocated vascular dementia F01.2; F 01.1; F 01.3. Section 169 indicates neurological syndromes that develop as a consequence of CVB.

In the neurological clinic of the Yusupov hospital they provide assistance to people with cerebrovascular diseases. In the hospital, you can undergo treatment for cerebrovascular disease, rehabilitation after illness. Doctors pay great attention to preventing the development of vascular diseases of the brain, the hospital has developed programs to restore the brain functions of the patient after a severe stroke, and dementia and chronic cerebrovascular disease are being treated.

During the consultation, the doctor will explain what a person’s cerebrovascular disease is, how the hospital provides medication for cerebrovascular disease of the brain, and surgical treatment of cerebrovascular disease. The patient’s medical history will be stored on a modern medium, at the end of treatment the patient will receive a full description of his treatment in the clinic. You can make an appointment with a doctor by calling the Yusupov hospital.

There are several approaches to the classification of cerebrovascular accidents. All cerebrovascular diseases are divided into transient, acute and chronic. Acute cerebrovascular disease options include:

  • hemorrhagic stroke;
  • ischemic disease;
  • acute hypertensive encephalopathy.

The chronic forms of impaired intracerebral circulation include:

  • vascular stenosis;
  • encephalopathy;
  • thrombosis;
  • cerebral arteritis;
  • Moyamoy disease.

Transient cerebrovascular accidents include hypertensive crisis and transient ischemic attack.

People at risk

It is enough for specialists to know the heading to which the disease is attributed in order to understand what diagnosis is made to the patient. So, in order to make it clear to everyone that the patient has chronic cerebrovascular disease, the ICD assigned pathology code I67. For the designation of acute forms, codes I60-I66 are intended. By them are meant such pathologies:

  • I60 – subarachnoid hemorrhages are combined here;
  • I61 – intracerebral hemorrhage;
  • I62 – other intracranial non-traumatic effusions;
  • I63 – cerebral infarction;
  • I64 – strokes not specified as heart attacks or hemorrhages;
  • I65-I66 – cases of blockage and stenosis of cerebral and precerebral arteries that do not lead to cerebral infarction, but in situations where a fatal outcome has occurred, they are replaced by the code I63.

Section I69 includes those consequences of cerebrovascular diseases that resulted in death.

It is necessary to register diagnosed diseases according to the rules established by the ICD 10. Cerebrovascular disease, the duration of which is no more than 30 days, can be assigned to section I60-I66. All the consequences of the disease should be indicated not just under a common code, but specifically identified.

In order to be diagnosed with cerebrovascular disease, it is necessary to consult a doctor on time. Statistics confirm that in the initial stages of the disease, units turn to doctors. Many attribute their ailments to bad weather, lack of vitamins, and overwork. As a result, patients are admitted to hospitals with strokes and ischemic attacks.

Diagnosis of the disease is as follows. First you need to pass a biochemical and general blood test. They will determine if there is a risk of developing atherosclerotic changes in the vessels. In addition to analysis, it is also good to do ultrasound diagnostics. Using duplex and triplex scanning can reliably assess the state of blood vessels.

Using such a radiopaque research method as angiography, it is possible to identify areas of narrowing and blockage of blood vessels. Using EEG, you can evaluate how the brain functions. During this procedure, changes in electrical activity are recorded.

Detonic  ECG signs of ventricular arrhythmias

The most reliable and accurate methods are CT, MRI or scintigraphy. All of these studies are high-tech. They provide additional information about the structures of the central nervous system.

Of the pathologies of the circulatory system, cerebrovascular diseases are included in the block with codes 160-169 (according to the International Classification of Diseases of the ICD). Of the acute pathologies in the classification, various forms of hemorrhagic stroke, forms of ischemic stroke, and unspecified form of stroke are noted. Chronic diseases, including cerebrovascular syndrome and included in the concept of “discirculatory encephalopathy”, are:

  • occlusion and stenosis of cerebral vessels;
  • hypertensive encephalopathy;
  • atherosclerotic encephalopathy;
  • cerebral arteritis;
  • venous sinus thrombosis without ischemic stroke;
  • Moyamoy disease.

Prevention of the development of cerebrovascular disease

The initial manifestations of cerebrovascular diseases in their chronic course may go unnoticed, as the patient perceives them as a consequence of fatigue, overwork, exhausting work. The disease clinic at this stage may include such signs:

  • insomnia or minor sleep disturbances;
  • headache;
  • fatigue growth;
  • poor tolerance of mental stress;
  • weakness;
  • decreased memory and attention;
  • learning disruption.

In the future, cerebrovascular insufficiency, if treatment has not been started, manifests itself more clearly. Headaches are observed, which a person often takes for a migraine and sometimes drinks completely inappropriate pills and drugs. Further, insomnia takes on a serious manifestation, there is high irritability, numbness of the arms and legs, dizziness, nausea, and tinnitus.

If even at this stage a person does not go to the doctor, even more serious symptoms may appear:

  • severe occipital pain;
  • depressive conditions;
  • temporary, transient visual impairment – spots, flies, loss of visual fields;
  • fainting;
  • motor disorders – paresis and paralysis;
  • serious memory impairment;
  • signs of transient vascular crises;
  • frequent dizziness with nausea and vomiting;
  • unsteadiness of gait;
  • drop attacks – weakness and falling without loss of consciousness.

Despite the fact that cerebrovascular diseases are prone to progression, in many patients the condition is stable for many years and does not change. But still, the risk of complications is very high. Among them there are transient ischemic attacks, disruption of the internal organs, various neurological complications, vascular dementia.

After a stroke, a person may fall into a coma or die in the first days or weeks.

In the future, even when the patient manages to survive, he may experience a lack of sensitivity of limbs and paralysis, cognitive impairment and impaired control of the functions of internal organs, malfunctions of vital reflexes, etc. These problems can be prevented if you seek help at an early stage, which will be the best prevention of stroke, as well as subcortical encephalopathy – a gradual loss of self-care and the development of epileptic seizures.

Cerebrovascular disease is a pathological change in the blood vessels of the brain that provokes a disturbance in the circulation of cerebral blood flow. Pathologies are preceded by atherosclerosis and hypertension, and its consequence is a stroke with a disability or death.

The etiology of the disease is expressed in the slow narrowing of the small arteries in the brain, the development of focal ischemia of the white brain substance. Symptoms of cerebrovascular disease are as follows:

  • persistent headache;
  • noises in the ears;
  • bouts of dizziness;
  • decrease in the field of view, spots in front of the eyes;
  • mental dysfunctions (impaired thinking, memory, decreased attention, insomnia, trembling fingers, slowing speech);
  • behavior change (lethargy, lethargy, causeless irritability and resentment);
  • pathological lesions of most of the brain, expressed in impaired coordination of movement, paralysis, impaired speech and memory, signs of parkinsonism, dementia.

Cerebrovascular disease is divided into acute and chronic forms.

Acute types of CVB:

  • acute hypertensive encephalopathy;
  • transistor ischemic crisis;
  • hemorrhagic or ischemic stroke.

The chronic form of cerebrovascular pathology is dyscircular encephalopathy, which is divided into the following types:

  • cerebral vascular thrombosis – vascular obstruction due to clogging of the lumen by blood clots or atherosclerotic plaques;
  • cerebral embolism – blockage of small vessels by emboli that have come off large vessels;
  • cerebral hemorrhage caused by rupture of a vessel (hemorrhagic stroke);
  • dyscircular encephalopathy with subsequent transition to the acute form of CVB.

Cerebrovascular insufficiency has various symptoms, their classification is carried out according to the time and intensity of manifestation, taking into account the stage of progression of the pathology.

The initial manifestations characteristic of stage 1 cerebrovascular disease of the brain usually appear slowly.

The main symptoms of the disorder include:

  1. Reduced performance.
  2. Difficulty concentrating.
  3. Difficulties in remembering newly learned information.
  4. Excessive fussiness.
  5. The inconstancy of emotions.
  6. Irritability.
  7. Dryness in the mouth.
  8. Sensation of hot flashes.
  9. Heart rhythm disorders.

The pathological phenomena that accompany cerebrovascular disorders are reflected in the physical and mental abilities of a person, cause difficulties in performing activities that the patient previously engaged in without much difficulty. Due to a distorted perception of events and a person’s unwillingness to accept the opinions of other people, conflicts often arise even with immediate family members who do not immediately understand the reason for such changes in character.

Chronic cerebrovascular disease (CPVC) of degree 2 is manifested by even more vivid cerebral symptoms, so at this stage it already becomes clear that the cause of changes in the human psyche is his disease.

Multiple violations of the psychoemotional sphere, depression of intelligence and motor capabilities are manifested. Problems begin with coordination and orientation, the sensitivity of different analyzers (in particular, the visual ability decreases).

Further progression of the CEH causes seizures and decreased speech quality.

Impaired intracerebral circulation may be the result of the progression of osteochondrosis of the cervical spine. With the destruction of the intervertebral disc or its displacement, narrowing of the lumen of the artery is observed. This affects cerebral circulation.

Arterial hypertension also contributes to the development of cerebrovascular pathology. High blood pressure provokes damage to blood vessels. Chronic hypertension leads to distension and increased vascular permeability. This condition creates the conditions for the formation of aneurysms and the development of hemorrhagic stroke. Almost all people with 3-4 degrees of hypertension have signs of cerebrovascular disease.

Clinical signs of the development of such a pathological condition as cerebrovascular syndrome grow slowly. The initial manifestations of cerebrovascular insufficiency are blurry in nature, therefore, often attributed by patients to overwork. The early symptoms of this disease include:

  • mood swings;
  • fatigue;
  • increased irritability;
  • headache;
  • decrease in working capacity;
  • noise in the head;
  • sleep disorders;
  • memory impairment.

As the disease worsens, clinical manifestations become more pronounced. All previously present symptoms are aggravated. A person has complaints of apathy and depression.

Transient speech and vision disorders are possible. Fainting often occurs. Memory impairments increase and intelligence decreases. In the absence of targeted treatment, this disorder can create conditions for the development of life-threatening conditions such as hemorrhagic stroke or ischemic attack.

The main symptoms that may indicate CVB are the reason for going to the doctor:

  • decreased performance amid general fatigue
  • lowered emotional background, mood swings
  • sleep and wakefulness problems, trouble falling asleep, insomnia, frequent awakenings
  • general cognitive impairment, characterized by problems with short-term memory, there is a tendency to think, the formation of mental chewing gum, getting stuck in one job and the inability to switch attention to another process; problems with oral count
  • excessive fussiness
  • headaches become persistent persistent
  • cerebral crises occur occasionally, gross violations of the functions of the brain are observed
  • the appearance of weakness in the limbs, speech disorders take rough symptoms, sensitivity decreases or changes, visual acuity decreases.

The rate of increase of symptomatic manifestations and their severity largely depends on the characteristics of the course of cerebrovascular disease. In most cases, symptoms of cerebrovascular accidents increase over time. In the early stages of the development of pathology, patients may not pay attention to their symptoms, considering them the result of a busy day. Early manifestations of cerebrovascular disease include:

  • frequent headaches;
  • decrease in working capacity;
  • sleep disorders;
  • depression;
  • memory impairment;
  • fatigue;
  • irritability.

Symptoms are becoming more intense and varied against a background of decreased brain tissue nutrition. Headaches become more frequent. Many people suffering from cerebrovascular disease may mistakenly consider existing headaches as migraines. It is not possible to stop the pain syndrome with the help of conventional medications.

In addition, as cerebrovascular accident occurs, attacks of general weakness and dizziness appear. During physical exertion it may darken in the eyes. In addition, tinnitus appears in the mornings against the backdrop of a developing CVB. In addition, due to malnutrition of brain tissue, symptoms such as irritability and other emotional disorders, persistent dry mouth, asthenia, tachycardia, etc. can be observed.

There are many more signs of cerebrovascular disease, which the patient may not immediately pay attention to. A clear symptom of impaired oxygen supply to brain tissue is a decrease in mental performance. Solving any problems in this case requires some effort. In addition, it is difficult for a person suffering from cerebrovascular disease to remember dates, compare events, etc. In addition to a decrease in intellectual abilities, phobias and unfounded fears, neuroses and psychoses appear.

The first stage

  • frequent headaches
  • dizziness,
  • drowsiness,
  • reduced performance
  • lethargy,
  • forgetfulness and distraction.

Pathology features

Cerebrovascular syndrome refers to a group of brain diseases that are caused by a violation of cerebral circulation against the background of organic or functional damage to cerebral vessels. Symptoms of pathology may not be noticeable in the early stages, but later they acquire a high severity. Against the background of vasoconstriction, which in the vast majority of cases occurs due to arterial hypertension and atherosclerosis, there is a violation of cerebral blood flow and subsequent hypoxia and ischemia of brain tissue.

Cerebrovascular syndrome causes the development of discirculatory encephalopathy – a progressive organic brain lesion. Now it is a serious medical problem. Currently, cerebrovascular diseases, which can exist in an acute, transient and chronic form, provoking a cerebrovascular accident, are a leading cause of death.

As for statistics, strokes, acute cerebrovascular disorders, account for a large proportion of cerebrovascular pathologies. Ischemic stroke accounts for up to 75% of all strokes, subarachnoid hemorrhages – 5%, the rest is hemorrhagic stroke. Chronic cerebrovascular diseases are noted in approximately 700 people for every 100 thousand people.

CPVC is a gradual disruption of the brain, in which the symptoms of damage to the brain cells are pronounced due to insufficient blood circulation in the brain. Pathologies are mainly affected by older people after 50 years.

There are 3 degrees (stages) of the clinical course of the disease:

  1. The initial stage (1 degree). Symptoms: headaches, disruption of the vestibular apparatus (unstable gait), insomnia, memory impairment, fatigue and decreased performance. There are changes in the structure of the fundus (retinal angiopathy), high blood pressure, cardiac arrhythmia.
  2. In the middle stages (grade 2) of vascular dementia, a decrease in mental and intellectual abilities, cerebral vascular sclerosis, and a change in the structure of cerebral fluid are observed.
  3. At the last stage (grade 3), CVAC patients are assigned disability due to pronounced signs of impaired mental activity.

Often the disease is accompanied by attacks of stroke, myocardial infarction and cardiac arrhythmia.

Despite the fact that in most cases the development of cerebrovascular disease is preceded by atherosclerosis, hypertension, or systemic vasculitis, there are a number of environmental and internal factors that can, under certain circumstances, cause the development of cerebrovascular disorders. Such endogenous and exogenous predisposing factors include:

  • chronic diseases of the cardiovascular system;
  • diabetes;
  • long smoking experience;
  • alcoholism;
  • obesity;
  • infectious diseases;
  • brain tumors;
  • congenital pathologies of the structure of cerebral vessels;
  • tendency to thrombosis;
  • bruises of the brain;
  • disorders of hematopoiesis;
  • sedentary lifestyle;
  • massive bleeding of any etiology;
  • antiphospholipid syndrome;
  • chronic stress;
  • osteochondrosis of the cervical spine.

This is not a complete list of pathological conditions and external factors that can have a negative effect on the vessels that feed brain tissue. Among other things, the influence of a hereditary factor on the development of a condition such as cerebrovascular disease is currently being actively studied. Many people suffering from various forms of cerebrovascular accident have close relatives who, in a certain age period, had similar symptoms.

In addition, age-related changes are considered predisposing factors that can provoke cerebrovascular diseases, including a decrease in the production of a number of important hormones and a slowdown in metabolism. In women, the development of cerebrovascular disease can be associated with menopause and those changes that are observed in this condition.

Primary

The patient rarely pays attention to the first signs of cerebrovascular disease, taking everything for ordinary malaise. You should beware and consult a doctor if the following symptoms regularly make themselves felt:

  • frequent mood swings;
  • irritability;
  • fatigue;
  • reduced performance;
  • tolerable headaches;
  • dizziness;
  • insomnia;
  • noise in the ears and head;
  • cardiopalmus;
  • dry mouth;
  • memory impairment.

If cerebrovascular disease of cerebral vessels is not treated, the condition worsens. Against the background of oxygen starvation, noise in the head, migraines increase, dizziness becomes more frequent and appears even with tilts and turns of the head.
The patient often cannot fall asleep; during the day he feels drowsiness and weakness. The following symptoms directly indicate problems with the vessels of the brain:

  • problems with the sensitivity of certain parts of the limbs;
  • transient visual impairment;
  • speech disorder;
  • short-term fainting lasting several seconds is possible;
  • deterioration of mental abilities, intelligence;
  • concentration is disturbed;
  • memory problems appear;
  • depression, apathy, neurosis, psychosis, keen attention to one’s own health.

– occlusion and stenosis of cerebral vessels;

– Ischemic or hemorrhagic stroke;

– transient ischemic attack;

– venous sinus thrombosis;

– cerebral hypertensive crisis;

If you know the international classification, it is easy to find out what doctors can mean when they say that the patient has cerebrovascular disease. The ICD 10 code for this group is I60-I69.

Even if there are developing signs, a person may not have a clue about what cerebrovascular disease is. Under this term, a whole group of diseases is combined. These ailments are insidious, they lead to violations of many vital functions provided by the brain.

Their essence is the inhibition of cell activity due to insufficient blood supply in case of damage to the vessels of the brain.

The group of cerebrovascular diseases includes several serious pathologies:

  1. Hemorrhagic stroke.
  2. Intracranial hemorrhage.
  3. Chronic discirculatory encephalopathy.
  4. Ischemic stroke.
  5. Hypertensive encephalopathy.

Neurology is engaged in the study of the characteristics of the course of CVB and the treatment of such disorders.

preventive measures

Cerebrovascular disease requires a comprehensive diagnosis to identify the root cause of the problem. Patients require examination by a neurologist. Often consultations are required with such narrowly focused specialists as a cardiologist, ophthalmologist, etc. The studies assigned to identify this disease and pathological conditions that can provoke the development of this violation include:

  • coagulogram;
  • serological tests;
  • ECG;
  • radiography;
  • angiography;
  • transcranial dopplerography;
  • electroencephalography.

Additionally, CT or MRI can be prescribed. These studies can clarify the nature of damage to brain structures.

To prevent the disease, you should follow these tips:

  • adhere to a hypocholesterol diet;
  • get rid of all bad habits;
  • control your pressure;
  • avoid any overloads;
  • reduce weight;
  • get rid of stress and their consequences;
  • after 45 years, regularly undergo preventive examinations;
  • if necessary, take antiplatelet agents and drugs to optimize cerebral blood flow for preventive purposes.

From this article you will learn: what is cerebrovascular disease (CVB for short), its causes and types. Symptoms and methods of treatment.

Date of publication of the article: 13.11.2016//

Cerebrovascular disease is a brain disease caused by a gradual progressive lesion of brain tissue against the background of chronic cerebrovascular accident. The disease is based on a pathological change in the cerebral (cerebral) vessels, which leads to insufficient blood supply to brain cells, and, as a consequence, oxygen starvation of tissues.

CVB develops in stages against the background of any vascular disease. First, due to vascular pathology, the blood circulation of the brain is disturbed, leading to oxygen starvation. Chronic lack of oxygen and nutrients leads to disruption of various brain functions. First transient, and then persistent organic changes in the brain tissue are formed. Clinically, this is manifested by cognitive personality disorders – multiple mood swings, decreased intelligence, difficulty remembering.

It is impossible to completely cure cerebrovascular disease, because it directly depends on the root cause, for example, hypertension, which also cannot be cured, but only corrected. The disease is very common. It is diagnosed in more than 50% of patients after 60–75 years. It develops gradually over the years. Its symptoms invariably affect a person’s quality of life, often presenting a serious threat due to complications, the most important of which is a stroke.

Cerebrovascular insufficiency initially occurs due to atherosclerosis and high blood pressure. Cholesterol plaques arising from atherosclerosis significantly reduce the lumen of the veins of the brain. This changes the bleeding for the worse. Such a process triggers the occurrence of ischemia and hypoxia, then irreversible changes in brain tissue follow.

Arterial hypertension causes oxygen starvation of brain cells. Frequent hypertensive crises bring a stroke closer. It is characterized by the death of nerve cells of any region of the human brain. The cause may be vascular ruptures or their thrombosis.

  • chronic diseases of the heart and blood vessels;
  • osteochondrosis of the cervical vertebrae;
  • diabetes;
  • chronic stress;
  • bad habits;
  • antiphospholipid syndrome;
  • overweight;
  • heavy bleeding of any etiology;
  • pathology in the structure of the veins of the brain (hereditary form);
  • impaired hematopoietic functions;
  • sedentary lifestyle;
  • tendency to the appearance of blood clots;
  • bruises of the brain.

These are not all the causes of the disorder. In our time, research work is ongoing that is aimed at studying the hereditary factor that causes cerebrovascular syndrome. Medical experts also draw attention to the fact that the cause of the disease can be poor metabolism and decreased secretion of very important hormones. This fact is more common in women who entered the menopause.

The disease goes through the following stages of its development:

  • the inner layer of blood vessels is damaged;
  • normal bleeding rate drops;
  • an excess of glucose or oxygen appears;
  • oxidative stress arises at the molecular level;
  • then tissue cells begin to die.

Cerebrovascular disease has increasing symptoms, which depends on the classification of each individual case.

In the initial stages, people may not even pay attention to its signs, which usually appear by the end of the working day.

  1. Irritability.
  2. Headache.
  3. Fatigue increase.
  4. Depression.
  5. Decline in performance.
  6. Sleep disturbances.
  7. Memory impairment.

With the development of CVB, the oxygen supply to the brain decreases, the symptoms increase, and become more pronounced. Many people confuse ordinary headaches and manifestations of cerebrovascular insufficiency. It is impossible to appease them with ordinary medicines. Then dizziness begins, weakness appears throughout the body and tinnitus. With physical activity, it can darken in the eyes. Tachycardia, mood swings, asthenia, dry mouth and so on may also begin.

If such symptoms are observed for several days, a person should immediately contact any medical institution where he can undergo consultation and examination of doctors.

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Comparing and evaluating all the signs, experts identify the stages of cerebrovascular insufficiency.

  • first: it is very difficult to suspect CVB (initial symptoms indicate any of the diseases or injuries);
  • second: a person has mental disorders that can become a reason to recognize a person as disabled, but he is quite capable of caring for himself;
  • third: vascular dementia develops – a pathology of cerebrovascular insufficiency. The sick person is not able to move around, navigate in space and do anything. In this case, assistance is required.

In the last stages of cerebrovascular insufficiency, hypochondria develops, speech and visual acuity are impaired. In the event that a person is not treated, the symptoms become even more serious.

  1. Decreased reflexes.
  2. Paresis and paralysis of limbs.
  3. Shaky gait.
  4. Loss of sensitivity in some parts of the body.

If a sick person who has cerebrovascular disease does not turn to doctors for help, then subsequently there is a stroke and transistor ischemic attacks.

The pathological condition of CVB is most often diagnosed by chance when a person undergoes examination for other vascular diseases, however, this can be done even in the early stages. The reason for this lies in the fact that cerebrovascular disease is quite slow. To accurately determine the presence of the disease, the patient needs to undergo not only an examination, take an anamnesis, but also undergo other instrumental and laboratory studies.

It all starts with a visit to a neurologist who checks the degree and depth of damage to brain tissue. Particular attention is also paid to concomitant diseases. In this case, the help of narrow-profile specialists is often required: otolaryngologist, cardiologist, ophthalmologist, etc.

  • lipoprotein analysis;
  • functional visualization of the brain;
  • blood pressure fixation;
  • duplex angioscanning;
  • electroencephalography;
  • X-ray
  • serological reactions to a specialist list of infectious diseases;
  • urinalysis (general);
  • prothrombin index recognition analysis;
  • blood test (biochemical and general).

MRI and ultrasound of the brain are considered the most informative and accessible ways. They are completely safe for humans, so they can be used many times as needed. Some individual cases require consultation with an endocrinologist and the use of studies to determine hormone levels. A comprehensive examination allows you to accurately determine all the features of the pathology in order to prescribe an effective treatment for cerebrovascular disease.

To eliminate cerebrovascular dangerous disorders, drug therapy is most often used. First of all, it is aimed at eliminating the main causes, restoring normal blood circulation in the brain and stopping the development of symptoms that distinguish this disease. However, this should be supported by the rejection of destructive habits, a change in lifestyle, a balanced diet and an optimal sleep and rest regime.

When prescribing the necessary medications, the specialist is guided by the characteristics of cerebrovascular manifestations and risk factors for the patient himself. All drugs are anti-sclerotic or hypoglycemic. Dosage and specific agents are selected only individually.

If there is a risk that the disease will become acute, then anticoagulants and antiplatelet agents are prescribed, which patients need to take all their lives.

These drugs prevent blood clots from forming. Also selected are those whose action is aimed at the nutritious enrichment of brain tissue with oxygen.

The effects of CVB

CVB can lead to gross violations of the brain, often with subsequent disability; in extreme, but often encountered cases – fatal.

Timely access to qualified help:

  • relieve severe consequences (for example, partial or complete loss of legal capacity)
  • will make the rehabilitation process less complicated and costly
  • improve forecast function recovery

The prognosis of cerebrovascular disease depends on the patient’s lifestyle, attitude to their own health, a responsible approach to treating the disease, and the severity of the disease. The patient should abandon bad habits, eat rationally, monitor weight, avoid stress, engage in sports, and timely treat emerging disorders in the circulatory system.

Cerebrovascular disease is dangerous for its irreversible consequences. Circulatory disorders in the brain often lead to strokes, severe impaired memory and mental activity, difficulty orienting in space, dementia, and seizures of epilepsy.

In some cases, Binswanger’s disease develops, accompanied by the development of mental retardation, complete disability and impaired speech functions (dysarthria).

Cerebrovascular disorders often lead to a change in a person’s personality and an increasing deterioration in cognitive capabilities. Due to a decrease in the supply of oxygen to brain cells, disorientation in space is possible. Phobias may occur. In addition, dementia often develops against the background of the dying of large areas of the brain. With the progression of this pathological condition, a person may lose the ability to self-service.

The prognosis depends on the individual characteristics of the course of the disease. The early start of complex treatment reduces the risk of life-threatening complications. Changing lifestyle, giving up bad habits, proper nutrition and regular exercise will improve the general condition. Ignoring the doctor’s recommendations regarding the treatment, creates the conditions for the adverse course of this disease and the development of serious complications.

symptomatology

– dizziness, noise and pain in the head;

– numbness of the limbs, impaired sensitivity in them;

– periodic visual impairment;

– short-term loss of consciousness.

In the worst cases, transient ischemic attacks and strokes occur. These conditions cause a significant violation of the blood supply to the brain, as a result of which nerve cells die.

Evidence

For such a disease, the following symptoms are characteristic:

  1. The progression of the disease. If untreated, the disease will progress, transform into new stages.
  2. The ability to classify the stages of the disease according to certain symptoms.

Forms

For cerebrovascular insufficiency, acute and chronic forms may be characteristic. At each stage, certain symptoms and signs occur. The acute stage is characterized by deterioration in the quality of memory and perception of information. In a chronic form, vasoconstriction occurs and, as a result, blood clots form. As a result of overvoltage, a rupture of the vessel can occur, it becomes the result of this phenomenon.

Treatment of cerebrovascular chronic insufficiency requires surgical intervention. Blood clots are bypassed. In some cases, a heart valve replacement is required. This minimizes the risks to the life of the patient.

Classification of cerebrovascular diseases

There is another classification of types of cerebrovascular diseases, partially overlapping with the ICD:

  1. Diseases of the brain, including ischemic damage:
  • ischemic heart attack;
  • hemorrhagic cerebral infarction;
  • ischemic encephalopathy.
  • Intracranial hemorrhage:
    • subarachnoid;
    • intracerebral;
    • mixed.
  • Hypertensive cerebrovascular disease:
    • lacunar lesions;
    • hypertension encephalopathy;
    • subcortical leukoencephalopathy.
    • diet with the exception of cholesterol-rich foods from the diet, rejection of fatty, salty, smoked foods, increased consumption of fresh fruits and vegetables, fiber-rich foods, reduction of sweet and flour foods;
    • mobile lifestyle – regular walks, sports;
    • weight control;
    • refusal of bad habits (smoking, alcohol);
    • constant monitoring of blood pressure;
    • Athletes should avoid excessive physical exertion;
    • older and older people need to undergo an annual medical examination;
    • treatment of concomitant diseases (diabetes mellitus, infections, pathologies of the heart, kidneys, liver, etc.).

    Timely detection of CVB and correctly selected therapy will prevent the development of chronic cerebrovascular insufficiency, maintain health and avoid dangerous consequences.

    In contact with

    Cerebrovascular
    disease

    group of diseases of the head
    pathological brain
    changes in cerebral vessels with
    impaired cerebral circulation.
    Most common causes
    cerebrovascular
    diseases are atherosclerosis
    narrowing hypertension
    cerebral lumen and
    decrease in cerebral blood flow.

    Often
    such diseases are associated
    sugary
    diabetes, smoking, ischemic
    heart disease. Distinguish transient
    acute and chronic progressive
    disturbances of cerebral circulation.
    Disorders of cerebral circulation
    are the second most common
    cause of death in the group of diseases
    cardiovascular system after
    coronary heart disease.

    I. Diseases of the head
    brain with ischemic damage

    1. Ischemic
    encephalopathy

    2. Ischemic
    cerebral infarction

    3. Hemorrhagic
    cerebral infarction

    III. Hypertension
    cerebrovascular disease

    1. Lacunar
    changes

    2. Subcortical
    leukoencephalopathy

    3. Hypertension
    encephalopathy

    1) headaches
    brain associated with ischemic
    damage – ischemic encephalopathy,
    ischemic and hemorrhagic heart attacks
    brain;

    2) intracranial
    hemorrhage;

    3) hypertension
    cerebrovascular disease –
    lacunar changes, subcortical
    hypertensive leukoencephalopathy
    encephalopathy.

    The clinic uses
    the term stroke (from Latin in-sultare – to jump),
    or brain stroke. A stroke may be
    represented by a variety of pathological
    processes: hemorrhagic stroke
    – hematoma, hemorrhagic impregnation,
    subarachnoid hemorrhage; –
    ischemic stroke – ischemic
    and hemorrhagic heart attack.

    disease
    brain caused by ischemic
    damage.

    Ischemic
    encephalopathy. Stenosing atherosclerosis
    cerebral arteries accompanied
    violations in maintaining constant
    blood pressure in the vessels
    brain. Chronic
    ischemia. Most sensitive to
    ischemia are neurons primarily
    pyramidal cells of the cerebral cortex
    and pear-shaped neurons (Purkinje cells)
    cerebellum, as well as neurons in the Zimmer zone
    hippocampus.

    In these cells are recorded
    developmental calcium damage
    coagulation necrosis and apoptosis.
    The mechanism may be due to production.
    these neurotransmitter cells
    (glutamate, aspartate) that can cause
    acidosis and opening of ion channels.
    Ischemia also causes gene activation
    c-fos in these cells leading to apoptosis.

    Morphologically
    characteristic ischemic changes
    neurons – coagulation and eosinophilia
    cytoplasm, pycnosis of nuclei. In place of the dead
    cells develop gliosis. Process
    affects not all cells. Upon death
    small groups of cortical pyramidal cells
    the big brain talk about laminar
    necrosis. Most common ischemic
    encephalopathy develops at the border
    front and midbrain pools
    arteries, where, due to features
    angioarchitectonics are favorable
    hypoxia conditions – weak
    vascular anastomosis.

    Heart attacks
    brain. Causes of Heart Attacks
    brain are similar to those with
    IHD, but in some cases, ischemia may
    be caused by compression of the vessel outgrowths
    dura mater during dislocation
    brain as well as a fall
    systemic blood pressure.

    Ischemic
    cerebral infarction is characterized
    development of collicative necrosis
    irregularly shaped (“softening center”).
    Macroscopically determined only
    after 6-12 hours. After 48-72 hours, it forms
    area of ​​demarcation inflammation, and
    then there is a resorption of necrotic
    masses and a cyst is formed. In rare cases
    in place of small necrosis
    a glial scar develops.

    Hemorrhagic
    cerebral infarction is more often
    result of embolism of the arteries of the head
    brain, has cortical localization.
    The hemorrhagic component develops
    due to diapedesis in the demarcation zone
    and especially pronounced with anticoagulant
    therapy.

    Intracranial
    hemorrhage.
    Subdivide
    on intracerebral (hypertensive),
    subarachnoid (aneurysmal),
    mixed (parenchymal and
    subarachnoid – arteriovenous
    vices).

    Intracerebral
    hemorrhage. Develop at break
    microaneurysms in bifurcation sites
    intracerebral arteries in patients
    hypertension (hematoma), and
    also as a result of diapedezis (petechial
    hemorrhagic hemorrhage
    impregnation). Hemorrhages are localized
    most often in the subcortical nodes of the head
    brain and cerebellum. The outcome is formed
    cyst with rusty walls due to
    hemosiderin deposits.

    Subarachnoid
    hemorrhage. Arise due to the gap
    cerebral aneurysm
    not only atherosclerotic, but also
    inflammatory, congenital and
    traumatic genesis.

    Hypertension
    cerebrovascular disease.

    Develop
    in people with hypertension.

    Lacunar
    changes. Represented by many
    small rusty cysts in the subcortical area
    cores.

    Subcortical
    leukoencephalopathy. Accompanied by
    subcortical axon loss and
    the development of demyelination with gliosis and
    arteriologinosis.

    Hypertension
    encephalopathy. Occurs in patients
    with a malignant form of hypertension
    disease and is accompanied by development
    fibrinoid necrosis of the walls of blood vessels,
    petechial hemorrhages and edema.

    Stroke

    acute cerebrovascular accident,
    characterized by sudden (during
    a few minutes, hours)
    the appearance of focal and / or
    cerebral neurological symptoms,
    which lasts more than 24 hours or
    leads to the death of the patient in more
    short period of time
    due to cerebrovascular pathology.

    К
    strokes include a heart attack
    brain hemorrhage
    to the brain and subarachnoid
    hemorrhage
    with
    etiopathogenetic and clinical
    differences.

    С
    taking into account the time of neurological regression
    deficit, highlight transient
    cerebrovascular accidents (neurological
    deficiency regresses within 24 hours,
    unlike the stroke itself) and
    minor stroke (neurological deficit
    regresses within three weeks
    after the onset of the disease).

    Vascular
    brain diseases take second place
    in the structure of mortality from
    circulatory system diseases
    after ischemic
    heart diseases

    Exist
    three main types of stroke: ischemic
    stroke, intracerebral and subarachnoid
    hemorrhage. Intracerebral and (not in
    all classifications) non-traumatic
    subshell hemorrhages include
    to hemorrhagic stroke. According to
    multicenter international research,
    correlation of ischemic and hemorrhagic
    strokes averages 4: 1-5: 1
    (80-85% and 15-20%)

    Ischemic
    stroke
    ,
    or heart attack
    the brain.
    More
    occurs in patients older than 60 years,
    having a history of heart attack
    myocardium
    rheumatic defects
    heart disturbance
    heart rate and conduction, sugar
    diabetes.
    A large role in the development of ischemic
    stroke play rheological disorders
    blood properties, pathology of the main arteries.
    The development of the disease in
    night time without loss of consciousness.

    People at risk

    In order to prevent the development of cerebrovascular pathology, it is necessary to monitor health from a young age. Hypertensive patients should constantly measure blood pressure, avoiding exceeding its parameters of 140/90 RT. Art. If this happens, measures should be taken to normalize it. Among the preventive measures, the following actions can be distinguished:

    • track weight;
    • adhere to proper nutrition, limit the use of animal fats, salt;
    • avoid stress, emotional stress, physical stress;
    • do not smoke, limit alcohol consumption, ignore drugs;
    • lead a mobile lifestyle, prefer walking, walking in nature;
    • daily exercise;
    • avoid situations that can lead to head injury;
    • normalize the mode of work and rest;
    • get enough sleep.

    Preventive measures are very simple:

    • regular examinations by specialists
    • healthy lifestyle, moderate physical activity
    • proper, healthy nutrition
    • alternating work with rest periods.

    People at risk

    Therapy

    If you have been diagnosed with cerebrovascular disease of the brain, then you can not let the problem drift. This condition requires treatment, otherwise complications can not be avoided. But it is worthwhile to understand that for proper therapy it is necessary that the patient himself wants to recover. So, an improvement in the condition is possible only if the patient changes his lifestyle, sheds excess weight, and quits smoking and alcohol.

    But, in addition to this, it is necessary to consult with your doctor and find out which therapy will be optimal. In many cases, conservative methods are used. But in some situations, it is desirable that timely surgical intervention be performed that will eliminate the areas of narrowing of the vessels that feed the central nervous system.

    Conservative treatment

    At home, it is completely impossible to cure this disease, so it is better to conduct therapy under the supervision of a doctor.
    Adequate treatment of chronic cerebrovascular disease at an early stage can help prevent a stroke. Since brain damage is secondary, first of all, it is necessary to influence the cause – hypertension, atherosclerosis, vasculitis and other diseases. Also the goals of treatment are improvement of hemodynamics in cerebral vessels, correction of the main signs of the disease, optimization of metabolism.

    If the patient has subcortical encephalopathy on the background of arterial hypertension, initial measures should be aimed at correcting the pressure. In case of cerebral infarction due to multiple embolisms and coagulopathies, treatment with antiplatelet agents (Aspirin) and anticoagulants (Warfarin) is urgently started. With atherosclerosis, statins are introduced into the course of therapy (Crestor), a diet with a decrease in the amount of fat in the diet is required.

    1. Calcium channel blockers to improve cerebral blood flow and blood composition (Corinfar, Cinnarizine).
    2. Drugs with metabolic effects to improve metabolism in tissues (Sermion, Tanakan).
    3. Nootropics for the normalization of blood vessels and blood microcirculation (Piracetam, Glycine).
    4. Antioxidants and antihypoxants to eliminate ischemia and optimize tissue metabolism (Actovegin, Cerebrolysin, Mekaprin).
    5. Vasodilators, vasoactive drugs (Pentoxifylline, Agapurin).
    6. Preparations for relieving vasospasm (Papaverine, No-spa).
    7. Diuretics for cerebral edema and the appearance of signs of heart failure (Lasix, Veroshpiron, Mannitol).
    8. Sedatives and antidepressants, tranquilizers to normalize autonomic functions and eliminate neuropsychiatric symptoms (Haloperidol, Seduxen).
    9. Preparations for the correction of metabolic disorders and for the replenishment of plasma (Glucose, Ringer’s solution).
    10. Analgesics for severe headaches (Analgin, Promedol).
    11. Drugs for cognitive impairment (Ginkgo Biloba).

    In severe cases of acute cerebrovascular accident, tracheal intubation is used, if necessary, the patient is connected to mechanical ventilation. In parallel, sanitize the airways. In the treatment of cerebrovascular diseases, the method of hyperbaric oxygenation, which helps the blood to saturate with oxygen, and then transfer it to the brain, has proven itself well.

    Severe forms of the disease may require surgery. It may include the removal of an atherosclerotic plaque, a blood clot from an affected vessel (endarterectomy), an increase in the lumen of the vessel with a stent (stenting), a catheter with a balloon (angioplasty). Arterial aneurysms, some types of intracerebral hemorrhages are also treated surgically.

    In chronic problems with blood supply to the brain, conventional medication treatments are often used. They are aimed at lowering the concentration of cholesterol in the blood, maintaining blood pressure, and improving blood supply to tissues. Taking the medications prescribed by the doctor in combination with the correction of nutrition and lifestyle as a whole allows you to maintain the brain at the required level for quite a long time.

    Antiaggregant, nootropic, vasodilator, hypotensive, hypocholesterolemic agents are prescribed for treatment. Antioxidants and multivitamin complexes are also recommended in parallel.

    Traditional surgical methods can eliminate ischemia of brain tissue. For this, only x-ray endovascular and microsurgical interventions are currently performed.

    In some cases, balloon angioplasty is recommended. This is a procedure during which a special balloon is introduced into the vessel and inflated there. This helps to expand the lumen and normalize blood flow. After such an intervention – to prevent clumping or re-narrowing of the artery – it is desirable that stenting be done. This is a procedure during which a mesh implant is placed in the lumen of the vessel, which is responsible for maintaining its walls in a straightened state.

    If cerebrovascular disease has been diagnosed, endarterectomy can also be performed. This is a microsurgical operation during which all cholesterol deposits are removed from the lumen of the vessel. After that, its integrity is restored.

    Medicines used

    Thus, we have found out why it is so important for specialists to know what code the pathology we are considering is. Cerebrovascular disease is the result of a number of diseases. Therefore, therapy should primarily be aimed at eliminating them.

    So, with multiple cardioembolism and a multi-infarction state, coagulopathy and agniopathy, it is necessary to take antiplatelet agents. The most popular among them is ordinary acetylsalicylic acid, which is prescribed in a dosage of 1 mg per kg of patient weight. It may also be recommended to take medications such as Clopidogrel or Dipyridamole in a dosage of about 150-200 mg per day. Also in such situations, anticoagulants are prescribed, for example, the drug “Warfarin”.

    Neurological abnormalities are treated using nootropic drugs, neurotransmitters and amino acids. Such drugs as Glycine, Neuromidin, Cerebrolysin, Actovegin can be prescribed. With noise in the ears and dizziness, “Betagistin” is often prescribed in a dosage of 24 mg twice a day.

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    It is important for patients suffering from pressure surges to normalize it. Among the prescribed vasoactive drugs, such medicines as Vinpocetin, Pentoxifylline are popular.

    The following drugs are also often prescribed: “Halidor”, “Omaron”, “Cholitilin”, “Donepizil”, “Piracetam”, “Perineva”.

    Treatment of cerebrovascular disease in most cases is carried out with medical methods. Therapy should primarily be aimed at eliminating the main causes of the development of the problem, restoring normal blood circulation in the vessels of the brain and stopping the symptoms. To improve hemodynamics, calcium channel blockers and phosphodiesterase enzyme inhibitors are usually prescribed. Drugs belonging to these groups are selected individually for each patient, as well as their dosage.

    These medicines can help reduce the risk of blood clots. In addition, drugs are selected individually that contribute to improving the nutrition of brain tissue with oxygen.

    The treatment regimen can be supplemented with other drugs that differ in pronounced neuroprotective effect. If there is a mention of atherosclerosis in the medical history, the use of drugs belonging to the group of statins can be shown. In addition, the use of drugs necessary to normalize blood pressure can be indicated.

    • Corinfar.
    • Cardipin.
    • Cardil.
    • Dilzem.
    • Verapamil.
    • Cinnarizine.
    • Cerebrolysin.
    • Actovegin.
    • Cerebrocurin.
    • Imidazole.
    • Ketoprofen.
    • Mecaprine.
    • Sermion.
    • Cavinton.
    • Tanakan.
    • Vinpocetine.
    • Fraxiparin.
    • Heparin.
    • Sincumar.
    • Phenylin.
    • Warfarin.
    • Chimes.
    • Acetylsalicylic acid.
    • Lipostat.
    • Tykveol.
    • Probukol.
    • Lovastatin.
    • Piracetam.
    • Glycine.
    • Omaron.
    • Phenibut
    • Pantogam.
    • Trental.
    • Pentoxifylline.
    • Agapurin.
    • Eufillin.
    • Papaverine.
    • Dibazole

    With the development of acute life-threatening conditions, surgical treatment may be required. Most often with cerebrovascular disease, angioplasty, endarterectomy or stenting of damaged arteries are performed. When performing angioplasty, a catheter with a balloon is inserted into the affected blood vessel, which, when opened, increases the lumen of the artery.

    Diagnosis of cerebrovascular insufficiency

    Cerebrovascular syndrome can only be detected by diagnosis in a medical institution. Even if there is a suspicion of such a disease, neither the patient himself nor his relatives can determine the pathology at home. Therefore, you should find a good vascular surgeon who can recognize the type of disorder and prescribe treatment.

    The diagnosis of CVB can be made after the following diagnostic measures:

    1. Blood tests (prothrombin index, biochemistry is very important), urine.
    2. Tests for infections (syphilis).
    3. EEG.
    4. ECG.
    5. Chest x-ray.
    6. Angioscanning is a very informative method for detecting cerebrovascular insufficiency.
    7. Scintigraphy.
    8. Angiography.
    9. Transcranial Doppler.
    10. MRI.

    Only the diagnostic results will tell what it really is happening to the person, what anatomical changes lead to violations.

    Problems may arise in deciphering cerebrovascular disease, but the selection of a qualified specialist will quickly determine the type of ailment and develop a treatment.

    Given that in most cases the symptoms of cerebrovascular disease increase slowly, often this pathological condition is diagnosed by chance during certain studies in case of suspected presence of other vascular diseases. An accurate diagnosis of cerebrovascular disease requires not only a medical history and examination of the patient, but also a series of laboratory and instrumental studies.

    Diagnosis begins with the fact that patients are assigned a neurological examination, which allows to determine the degree and nature of damage to brain structures. Consultation with other highly specialized specialists may also be required, including an ophthalmologist, cardiologist, otolaryngologist, etc. The most commonly used laboratory and instrumental methods for diagnosing cerebrovascular disease include:

    • general and biochemical blood tests;
    • serological reactions to certain infectious diseases;
    • analysis for the determination of prothrombin index;
    • general urine analysis;
    • radiography;
    • duplex angioscanning;
    • angiography;
    • brain scintigraphy;
    • transcranial dopplerography;
    • electroencephalography;
    • blood pressure measurement;
    • analysis to determine the fraction of lipoproteins in the blood.

    In some cases, it is advisable to consult with an endocrinologist and conduct studies on the level of hormones. In addition, if there is a history of diseases of the cardiovascular system, daily ECG monitoring may be indicated. A comprehensive examination allows you to accurately diagnose and develop the best strategy for correcting the symptomatic manifestations of CVB.

    1. Blood tests (prothrombin index, biochemistry is very important), urine.
    2. Tests for infections (syphilis).
    3. Chest x-ray.
    4. Angioscanning is a very informative method for detecting cerebrovascular insufficiency.
    5. Scintigraphy.
    6. Angiography.
    7. Transcranial Doppler.

    The first stage

    When these signs appear, few people see a doctor. But in vain! If you identify the disease at this stage – you can get rid of the symptoms without resorting to operations, as well as avoid complications.

    The second stage

    As cerebrovascular insufficiency progresses, the following occurs:

    • headaches worse;
    • tinnitus appears;
    • vision deteriorates;
    • there are fainting.

    Fainting is one of the symptoms of the second stage of cerebrovascular insufficiency.

    If the disease has passed to the second stage, consult a doctor immediately, as already at this stage dangerous complications may develop, which you will read about below.

    If you do not start treatment for the disease, disorders of the psycho-emotional sphere appear. This can be a sharp mood swings, inadequate response to stressful situations, various neuroses and psychoses, phobias, obsessive states. Often in such a situation, the patient turns only to a psychotherapist who treats mental health disorders, not knowing about the true reason for their appearance.

    Also, in the second stage, disorders of the motor apparatus begin to appear. Unsteady gait, trembling in the limbs may appear.

    If you do not conduct the correct treatment of the pathology at this stage, then the negative symptoms from the psyche intensify:

    • learning ability is reduced;
    • long-term and short-term memory worsens;
    • the emotional reaction to occurring events disappears;
    • ability to logical thinking decreases;
    • orientation in space is broken.
    • disturbances and coordination of movements also progress.

    All this leads to a complete disability of the patient.

    If the first symptoms occur, consult a cardiologist. He will prescribe the following diagnostic procedures:

    duplex scanning of vessels of the neck and head;

    MRI or CT scan of the brain.

    Diagnostic methods for cerebrovascular insufficiency

    Primary diagnosis is carried out by a neurologist, includes:

    • thorough examination of complaints, medical history and life
    • assessment and analysis of symptoms, including pre-disease
    • complete neurological examination

    According to indications, additional examination methods are prescribed:

    • laboratory research
    • ultrasound examinations, including duplex and triplex scanning of vessels with dopplerography
    • functional, incl. daily monitoring of blood pressure and ECG
    • radiological
    • MRI and CT of the brain

    According to indications, a consultation with other specialist doctors is prescribed, including a cardiologist, endocrinologist, therapist, nephrologist, psychotherapist, etc.

    For the diagnosis of pathology, you should consult a qualified angiosurgeon or neurologist. In parallel, in most cases it will be necessary to be examined and treated under the supervision of a cardiologist in order to influence the cause of the cerebrovascular disease. With the development of an acute form of cerebrovascular accident, the patient is placed in a hospital and all the necessary examinations are already carried out there.

    The main methods of instrumental diagnostics that are performed to make an accurate diagnosis:

    1. Chest x-ray.
    2. Encephalography.
    3. Vascular duplex or triplex (angioscanning of vessels) or transcranial dopplerography.
    4. Angiography.
    5. Scintigraphy or MRI with contrast.

    Modern examination methods described above, in particular MRI and scintigraphy, are highly sensitive to changes in the brain. They help detect vascular atherosclerosis and the presence of blood clots, oncopathology, aneurysms, hematomas. Duplex scanning of blood vessels reveals blood flow velocity and hemodynamic disturbances.

    A laboratory examination consists of a clinical blood test to determine the level of platelets, red blood cells, hemoglobin, hematocrit, white blood cells with a developed white blood cell formula. The analysis of the lipid spectrum, blood coagulation rate, blood glucose level is carried out.

    Diagnosis of the disease is carried out mainly with the use of instrumental methods:

    • Dopplerography of cerebral vessels using ultrasound to detect vascular anomalies;
    • electroencephalography (EEG) of the brain, allowing to study the activity of the cerebral hemispheres;
    • CT of the vessels of the brain of the spiral type;
    • MRI of the head to determine the degree of damage to blood vessels and white brain matter;
    • radiography of the head with the introduction of contrast agents.

    To confirm this diagnosis, a neurological and psychological examination of the patient is also prescribed.

    The following procedures are carried out:

    • measurement of pulsation of vessels of the limbs and head;
    • pressure at 4 points of the upper and lower extremities;
    • ECG and ultrasound of the heart;
    • auscultation of the heart and abdominal aorta for the presence of arrhythmia and noise;
    • Dopplerogram of the cervical vessels to exclude stenosis of the carotid and head arteries.

    Timely diagnosis simplifies the treatment of cerebrovascular insufficiency. After a series of diagnostic procedures, a series of tests, an assessment of the patient’s condition and his medical history, the specialist can prescribe an effective treatment regimen. Compliance with the doctor’s instructions will make it possible to prevent the progressive process and the onset of adverse effects. Also, therapy will alleviate the condition of the patient, will help maintain the ability to adequately assess what is happening.

    Therapy is carried out with the aim of:

    • stabilization of the patient;
    • slowdowns of progress;
    • prevention of ischemic diseases;
    • normalization of blood supply to areas of the brain;
    • eliminate the symptoms of underlying and concomitant diseases.

    Methods and techniques

    In the treatment of cerebrovascular insufficiency, therapeutic and surgical techniques are used. The most common methods:

    1. Conservative schemes. They suggest lowering cholesterol, normalizing blood pressure, improving blood supply to the brain, and eliminating the effects of atherosclerosis.
    2. Combined circuit. It is aimed at the simultaneous administration of drugs with vasodilating, antioxidant, antibacterial properties. As part of this technique, vitamin formulations are used.
    3. Supporting activities. These are reflex, aroma, and hirudotherapy sessions.
    4. Surgical Schemes. This is balloon angioplasty, in the framework of which the removal of narrowed sections of blood vessels is performed. This is done in order to normalize blood supply.

    The second procedure is stenting, it is needed to expand the walls of blood vessels. Endarterectomy – shunting, cleansing the ducts from cholesterol plaques.

    The second stage

    Folk methods

    It is worth noting that cerebrovascular disease is an extremely difficult condition in terms of the development mechanism, the treatment of which requires the use of potent drugs according to the scheme prescribed by the attending physician. Folk remedies can be used solely as an adjunct to medical treatment.

    There are not many folk remedies that can improve the condition of a person suffering from cerebrovascular disease. To improve cerebral circulation, the use of tinctures of peony root may be recommended. To prepare a healing tincture, you need to take about 1 dried peony root, chop it thoroughly and pour 1 cup of boiling water. The resulting mixture must be infused for 2 hours. Ready infusion should be applied to a tablespoon about 5-6 times a day.

    A good tonic and firming effect gives a citrus-honey mix. To prepare such a tasty and healing product, you need to carefully chop 1 lemon and 2 oranges in a meat grinder. It is necessary to add a little honey to the mixture so that the finished substance turns out to have a sweetish taste. Next, the mix should be left in the refrigerator for about a day, and then taken in a tablespoon 3-6 times a day.

    A positive effect on the state of brain tissue is exerted by the infusion of young needles with lemon juice. To prepare such a therapeutic agent, it is necessary to take about 100 g of young needles of any coniferous tree and pour 1 liter of boiling water. About a day later, you need to add juice from ½ part of lemon to the infusion. Use this tool 3 times a day on a tablespoon on an empty stomach. The course of treatment with this folk remedy must be continued for at least 3 months.

    In addition, a tincture of celandine has a positive effect on cerebrovascular disease. This remedy must be taken ½ teaspoon 3 times a day. The course of treatment with this tool is at least 2 weeks. Before using this or that folk remedy, you should consult a doctor. Even light herbal remedies have their contraindications, which must be taken into account.

    Even if you are not a supporter of alternative medicine, cerebrovascular disease is the problem that lends itself better to therapy with an integrated approach. Even doctors say that it will not work to normalize their condition without increasing physical activity, normalizing nutrition, quitting smoking and other bad habits.

    In addition, you can use folk recipes in parallel with the main therapy. For example, many recommend chopping 2 oranges and a lemon in a meat grinder or in a blender with the skin, but without pits. In the resulting slurry, you need to add ½ cup of honey, mix and leave for a day at room temperature. After this, the mixture must be placed in the refrigerator and take 2 tbsp. l up to 3 times a day. You can drink it with green tea.

    Nowadays, it has been proven that dosed moderate physical activity helps to cure many chronic cerebrovascular diseases. If there are no contraindications, the doctor will recommend special gymnastics (exercise therapy), which the patient should perform daily to maintain normal function of all blood vessels.

    Alternative treatment can serve as a good method for the prevention of acute complications of cerebrovascular diseases, but only in conjunction with traditional treatment. Such recipes are effective:

    1. Cut the peony root into pieces, pour a teaspoon of it with a glass of boiling water, leave for 2 hours. Strain, drink a tablespoon four times a day.
    2. Chop the flesh of the lemon. Separately, pour 2 tablespoons of pine needles 400 ml and leave for an hour. Strain the broth, pour them lemon, consume this product before meals 50 ml three times a day.
    3. Squeeze beet juice, combine with honey in equal parts. Take 3 tablespoons twice a day.
    4. Combine a glass of horseradish juice, lemon and red currant, add a glass of honey. Take the drug in a tablespoon three times a day.
    5. Eat honeysuckle berries as often as possible, which relieve spasm of blood vessels and headaches.

    Etiopathogenesis

    Ischemic
    stroke most often develops
    at narrowing or
    clogged arteries supplying the head
    brain.
    Not getting the oxygen they need and
    nutrients brain cells
    die. Ischemic stroke is subdivided
    atherothrombotic, cardioembolic,
    hemodynamic, lacunar and stroke
    by type of hemorheological microocclusion

    Atherothrombotic
    stroke
    ,
    usually occurs on
    cerebral atherosclerosis
    arteries of large or medium caliber.
    Atherosclerotic plaque narrows
    lumen of the vessel and contributes to thrombosis.
    Possible arterial arterial embolism.
    This type of stroke develops.
    stepwise, with an increase in symptoms
    for several hours or
    days, often debuts in a dream. Often
    atherothrombotic stroke is preceded by
    transient ischemic attacks.
    The size of the ischemic lesion
    vary.

    Cardioembolic
    stroke
    there
    with full or partial blockage
    embolism of a brain artery. Most often
    cardiogenic causes of stroke
    embolism with valvular heart disease,
    recurrent rheumatic and bacterial
    endocarditis, with other lesions
    hearts that are accompanied
    education in its cavities
    parietal thrombi.
    Often an embolic stroke develops
    due to paroxysm atrial
    arrhythmias. The beginning of cardioembolic
    a stroke is usually sudden in
    wakefulness of the patient. IN
    disease onset is most pronounced
    neurological deficit. More common stroke
    localized in the blood supply zone
    middle cerebral artery, the size of the lesion
    ischemic damage medium or
    large, hemorrhagic
    component. History of possible
    thromboembolism of other organs

    Hemodynamic
    stroke
    due to
    hemodynamic factors –
    decrease in arterial
    pressure (physiological,
    for example, during sleep; orthostatic
    iatrogenic arterial
    hypotension, hypovolemia)
    or falling heart rate
    (due to myocardial ischemia,
    severe bradycardia, etc.).
    The onset of hemodynamic stroke
    may be sudden or stepped
    at rest or in the active state of the patient.
    The sizes of heart attacks are different, localization
    usually in the area of ​​adjacent blood supply
    (cortical, periventricular, etc.).
    Hemodynamic strokes occur
    against the background of pathology extra- and / or
    intracranial arteries (atherosclerosis,
    septal artery stenosis, abnormalities
    vascular system of the brain)

    Lacunar
    stroke
    due to
    lesions of small perforating
    arteries. It usually occurs on the background
    high blood pressure
    gradually over several hours.
    Lacunar strokes are localized in
    subcortical structures (subcortical
    core inner
    capsule,
    the white matter of the semi-oval center,
    the base of the bridge), the size of the foci is not
    exceed 1,5 cm. Cerebral and
    no meningeal symptoms
    there is a characteristic focal symptomatology
    (purely motor or pure
    sensitive lacunar syndrome,
    atactic hemiparesis, dysarthria, or
    monoparesis)

    Stroke
    by type of hemorheological
    microocclusion
    there
    against the background of the absence of any vascular
    or hematologic disease
    established etiology. Reason
    pronounced hemorheological
    changes, violations in
    hemostatic system and fibrinolysis.
    Scanty neurological
    symptoms combined with significant
    hemorheological disorders

    Cerebrovascular disease: what is this diagnosis

    The cause of the development of cerebrovascular disease are inflammatory processes in the vessels of the brain that affect the arteries and veins. The most common cause of the disease is cerebral arteriosclerosis. Treatment of the disease begins with the elimination of risk factors:

    • diabetes;
    • cerebral atherosclerosis;
    • arterial hypertension;
    • high blood cholesterol.

    Drug therapy, diet help restore vascular elasticity, improve blood circulation in the brain, reduces the risk of developing cerebrovascular disease.

    Cerebrovascular disease: intracranial hypertension

    Cerebrovascular disease is considered a collective term, which hides various diseases that lead to impaired cerebral circulation. Such diseases can occur in both acute and chronic form, belong to the class of cerebrovascular disorders. Intracranial hypertension is characterized by abnormally high intracranial pressure.

    Intracranial hypertension leads to a violation of cerebral circulation, provokes the formation of secondary cerebral ischemia. Cerebrovascular diseases become the cause, which leads to the development of intracranial hypertension. Increased intracranial pressure can lead to coma, impaired sensation, speech impairment, and other serious disorders. Intracranial hypertension is a serious complication of brain disease.

    Cerebrovascular disease: dyscirculatory encephalopathy

    Dyscirculatory encephalopathy is characterized by diffuse or focal lesion of cerebral vessels. The disease leads to impaired memory, thinking, attention, a serious complication of the disease is the development of dementia – dementia. The course of the disease is accompanied by various symptoms:

    • impaired motor activity;
    • cerebellar dysfunction;
    • affective disorders;
    • sharp fluctuations in blood pressure;
    • dizziness;
    • violation of chewing and swallowing food, other pseudobulbar disorders;
    • at a late stage of the disease, fecal and urine incontinence are observed in patients.

    The cause of the disease is atherosclerosis of the brain vessels, hypertension, various disorders leading to damage to the vascular system, blood diseases and other causes.

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  • Tatyana Jakowenko

    Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

    For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

    He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

    Detonic