Treatment of chronic cerebral ischemia

The main reason for the development of chronic cerebral ischemia in humans is cerebral arteriosclerosis. With this disease, fat deposits increase on the inner vascular walls. Cholesterol gradually narrows the gaps, disrupting the blood supply. When there is a complete blockage of the arteries, a thrombus occurs, which also leads to the development of ischemia. Factors provoking the disease:

  • carbon monoxide poisoning;
  • anemia;
  • bradycardia;
  • tachycardia;
  • acute heart failure.

Atherosclerosis can provoke a dangerous condition of the patient – an ischemic attack of the brain. It does not affect brain cells, but is a harbinger of a stroke. A transistor ischemic attack of the brain develops rapidly, but lasts from 2 to 30 minutes. Symptoms of the disease are different, depending on which part of the brain is affected:

  • If the carotid artery is blocked, then muscle weakness, blindness, and a violation of sensitivity appear.
  • With blockage of the vessels of the vertebral region, a split in the eyes appears, impaired movement.

The first symptom of a chronic disease is fatigue, so coronary artery disease of the brain can be detected even at an early stage with timely contact to the doctor. If this is not done, then over time the disease progresses rapidly, expanding the range of influence. The range of symptoms that indicate a worsening situation:

  • general weakness;
  • speech impairment;
  • decreased sensitivity;
  • pressure drops;
  • fainting;
  • vomiting, nausea;
  • focal headaches;
  • memory impairment.

Most often, cerebral ischemia develops against a background of blockage and other pathologies of arteries that carry nutrients. In this case, the brain tissue ceases to be saturated with the required amount of oxygen, which leads to the destruction of neurons and their connections, which determine the normal functionality of this organ.

The list of diseases that can provoke the development of cerebral ischemia is quite extensive, therefore, to systematize the data, 2 main causes of insufficient blood supply can be distinguished:

  1. Acquired, resulting from the development of diseases of the circulatory system.
  2. Congenital, caused by genetic disorders. Most often, such factors are found among newborns and children of the first year of life.

In an adult, a lack of blood supply to brain tissue can be caused by the following acquired ailments:

  • Atherosclerosis. With this disease, cholesterol plaques and other harmful substances are deposited on the walls of blood vessels, while narrowing the duct and making them sensitive to various injuries.
  • Hypertension is a frequent companion of atherosclerosis, due to which a spasm of the muscle tissue of blood vessels occurs, leading to a deterioration in the outflow of venous blood. Together, these two diseases can provoke chronic ischemic cerebrovascular disease, narrowing their lumen over time. Such a case is often accompanied by gentle symptoms, while acute manifestations begin to occur in a severely neglected case.
  • Type 2 diabetes mellitus, characterized by high blood insulin.
  • Amyloidosis. This is a typical disease of the elderly, in which protein metabolism is disturbed. As a result, specific protein polysaccharide deposits — amyloids — that interfere with normal blood circulation, form on the walls of blood vessels.
  • Diseases that provoke pathological thickening of the blood with the formation of blood clots, as well as violating its oxygen consumption. In combination with atherosclerosis, such changes can provoke the development of acute ischemia, which in most cases leads to death.

Among children, the most common diagnosis is cerebral ischemia of the newborn, which can be acquired during labor, or congenital, provoked by various pathologies in the development of the circulatory system of the baby. This disease is extremely dangerous for the life of the child and in most cases leads to severe neurological abnormalities.

Like any other brain disease caused by insufficient blood supply to this organ, the first manifestations of ischemia depend on the degree of hypoxia. In this case, the patient first of all feels the fast fatigability of the body, it becomes quite problematic for him to concentrate on one subject or an event from his life, and his intellectual abilities are further reduced.

The main symptoms of coronary heart disease:

  • frequent dizziness, fainting;
  • decreased perception of the surrounding world by the organs of touch;
  • sleep disturbance;
  • blood pressure instability;
  • the appearance of frequent headaches;
  • disorders of perception of information;
  • emotional instability.

ishemij lechenie - Treatment of chronic cerebral ischemia

It is noteworthy that coronary artery disease of the brain of the right or left hemisphere has corresponding symptoms, which manifest themselves to varying degrees and depend on the location of the affected area, therefore, treatment of the left hemisphere usually bears fruit faster in people of any age.

The success of the treatment of cerebral ischemia depends on a large number of factors, including the accuracy of the diagnosis, the speed of medical assistance and the susceptibility of the body to the therapy received. Therefore, it is extremely important to prevent the occurrence of consequences such as ischemic stroke, which in most cases leads to negative consequences.

The treatment of cerebral ischemia is often complicated by the appearance of other concomitant diseases, therefore, in the treatment of the disease itself and its manifestations, a set of measures is usually used to improve cerebral circulation and eliminate the negative consequences.

The brain is reliably protected by the bones of the cranial box, and any surgical intervention in its structures can have an extremely negative effect on the overall health of the patient, therefore, in the treatment of chronic forms of ischemia, it is preferable to use conservative medical methods of treatment.

The decision on how to treat and what medications and procedures should be used is made by the patient’s doctor based on the cause of the disease that caused similar changes in brain structures.

So, if ischemia was caused by thrombophilia, then prophylactic drugs are used that prevent blood clotting and blood clots (anticoagulants), for example, Aspirin and other medicines made on its basis (Aspirin-cardio).

To dissolve an already formed thrombus, special medications are used – thrombolytics (Tenecteplaza, Retaplaza). However, their use is strictly limited due to the fact that such drugs have a large number of side effects, it is used only with a confirmed diagnosis. Due to the directed action of thrombolytics, their use allows to reduce the percentage of deaths among patients with acute course of the disease, while taking the drug should be performed no later than 3 hours after the first signs of ischemia.

Also used are vasodilator drugs, which over time restore blood flow to the affected brain structures, thereby improving intracellular metabolism (Nimodipine).

To improve brain activity and accelerate the restoration of damaged structures, special drugs are used – nootropics, which contribute to the speedy restoration of higher psychiatric functions of the brain (for example, “Piracetam”).

The use of an operative solution, such as a disease such as ischemia, is extremely limited, therefore, surgical operations are used only in emergency cases, when conventional drug therapy does not give the desired result. In this case, the operation should be aimed at restoring the patency of the vessel that feeds the affected area of ​​the brain.

The use of non-traditional methods of treatment can be considered by a specialist from the point of view of auxiliary rehabilitation therapy of cerebral ischemia, while all manipulations must be strictly coordinated with the attending physician.

To remove puffiness, the following diuretic plants are allowed: lingonberry, watermelon, mountain ash. To remove cholesterol and toxins from the body, cereals, for example, corn or oats, can perfectly fit. The following medicinal plants are also able to stop the development of atherosclerosis:

ishemij lechenie prichina - Treatment of chronic cerebral ischemia

Cerebral vascular obstruction

Chronic cerebral ischemia is a condition in which brain cells are kept in conditions of oxygen “hunger” for a long time due to insufficient blood supply, while metabolic processes are disturbed in neurons and brain tissue is damaged. Blood vessels supplying the brain can become narrowed or clogged by blood clots, emboli, atherosclerotic plaques, which is why brain cells do not receive oxygen and nutrients.

This condition occurs with atherosclerosis, arterial hypertension, diabetes mellitus, vascular anomalies, heart failure. Risk factors for developing chronic cerebral ischemia are old age, smoking, alcohol consumption, hereditary predisposition, and obesity.

ishemij lechenie zabivchiv - Treatment of chronic cerebral ischemia

Slight deterioration in memory and attention, heaviness in the head

Grade 1 (initial manifestations): a patient suffering from chronic cerebral ischemia at the initial manifestation stage is concerned about mild deterioration of memory and attention, headache, heaviness in the head, general weakness, increased fatigue, sleep disturbance, emotional instability, mood swings, dizziness.

ishemij lechenie recept - Treatment of chronic cerebral ischemia

Prescribing treatment by a doctor

  • The main causes of chronic cerebral ischemia include arterial hypertension and atherosclerosis. Often there is chronic cerebral ischemia caused by a combination of two conditions. In addition, among other causes of this disease, there will be symptoms of cardiovascular diseases, which are expressed in violation of the heart rhythm (for example, in arrhythmia), which, in turn, leads to a decrease in the systemic type of hemodynamics.
  • Doctors give great importance to the study and anomalies of blood vessels, both the brain and vessels of the cervical spine. Such anomalies, as well as those associated with the aorta or vessels of the shoulder girdle, often do not manifest themselves for a long time, up to the moment of development of atherosclerotic and hypertonic processes.
  • In recent years, neurologists have identified a number of other reasons that contribute to the development of chronic cerebral ischemia, including venous pathology of an intracranial and extracranial nature. It is possible that the onset of chronic ischemia is affected by compression of arterial and venous vessels. Doctors take into account both the spondylogenic effect and the possible compression of the vessels with muscles, aneurysm or a tumor. Another possible cause of this pathology is developing cerebral amyloidosis.

Disease complications

If a person takes care of himself and notices all changes in his state of health, then it will not be difficult for him to notice the following symptoms of the development of cerebral ischemia in himself or his relatives:

  • Cognitive impairment. At the initial stage of cerebral ischemia, disturbances in perception and memory become especially pronounced, memory lapses are increasingly appearing. At the same time, insignificant changes in this area remain invisible to the patient himself, however, with time worsening, they are able to change the quality of his life and influence relations with other people.
  • Decrease in intellectual abilities. The previous mental work becomes overwhelming, apathy appears, caused by rapid fatigue and unwillingness to think.
  • Irritability, anxiety and inability to control one’s psycho-emotional state, frequent mood swings. In this case, tantrums are replaced by a severe headache, which eventually turns into a migraine.
  • Various sleep disorders. The sick person may well confuse day with night, insomnia develops, while night rest does not fully restore strength.

Chronic ischemic brain disease can provoke frequent dizziness, followed by nausea and vomiting. Also, the sensitivity of the body is disturbed, fainting becomes frequent, indicating a further exacerbation of the disease.

An attack of acute form of cerebral ischemia is characterized mainly by hypothermia, impaired hearing and vision, a fainting state and subsequent stroke, which in most cases leads to loss of motor function, impaired speech and thinking. With the defeat of important brain centers, deep disability and inability to self-care often occur. This condition is extremely dangerous for human life and requires immediate medical attention.

A large number of factors affect the severity of the consequences of cerebral ischemia: the degree of damage to the brain structures, the duration of the pathological process, as well as diseases that could develop due to a lack of blood circulation. Most often, the following complications result from ischemia:

  • in older people – ischemic stroke or softening of brain tissue;
  • vascular sclerosis and encephalopathy;
  • motor dysfunction;
  • paresthesia and other disorders of tactile sensations;
  • loss of speech ability;
  • epileptic seizures;
  • thrombosis with inflammation of the walls of blood vessels.

The most serious complication of ischemic disease is a brain stroke, in which the tissues located in the lesion are softened. This irreversible process leads to the destruction of neurons and their connections, due to which part of the brain dies. At the moment, there is really no correct treatment that prevented him and would contribute to the regeneration of lost structures.

As a result of brain encephalopathy, the systematic death of nerve cells and degeneration of their connections occurs. The consequences of this complication are extremely fatal for a person, as as a result of this ailment the individual loses control over his body and becomes incapable.

Hypoxic-ischemic brain damage in some cases is accompanied by various disorders of sensitivity. Like any other manifestation of dysfunction of the cerebral cortex, they are mirrored: for example, when the left hemisphere is damaged, a person loses the ability to clearly pronounce, but is fully aware of his position.

If the pathological process began to progress in a newborn or a child of the first year of life, then in most cases this leads to a lag not only in mental, but also in physical development. Therefore, in order to avoid such consequences, a pregnant woman should be sensitive to her state of health and follow all doctor’s prescriptions.

The main consequences of chronic cerebral ischemia will be oxygen starvation and metabolic disturbances in the tissues of this organ, while the disease will manifest stealthily and slowly.

Brain ischemia is a chronic severe illness. It is caused by a violation of the supply of oxygen to the body. All human systems suffer from this. But the brain reacts first.

The mechanism of the disease is very simple. Vessels that transport blood are susceptible to the accumulation of cholesterol accumulations. No wonder nutritionists so advocate the limited use of products containing it. Of course, normal blood flow through “clogged” vessels is completely impossible. There is chronic atherosclerosis. It is characterized by blockage of blood vessels.

The main function of the vessels – transport – has been lost. Through blood vessels clogged with cholesterol plaques, blood cannot enrich the body with oxygen in sufficient quantities. Such starvation is the most severe stress for all human tissues. It should be noted that it is the brain that is the largest consumer of oxygen. That is why this fasting is fatal for him. At the same time, the consequences that cerebral ischemia provokes can be fatal. After all, these cells are not restored.

In medicine, there are two categories of ailment:

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

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

  1. Brain ischemia of the 1st degree. In general, the patient is quite normal. Sometimes there is a slight malaise, chills, dizziness. After physical work, pain in the hands appears. In some cases, a change in gait is noticed. A person, as it were, “pokes fun”, takes smaller steps. People around you may notice a change in temperament and the nature of the patient. As a rule, cerebral ischemia of the 1st degree causes the patient an inexplicable feeling of anxiety, constant irritability, sometimes even depression. If you observe a person more carefully, you can reveal distraction. It is very difficult for the patient to concentrate, concentrate. Slow thinking is also characteristic.
  2. Cerebral ischemia of the 2nd degree. This stage is characterized by an increase in symptoms. A person feels the progression of headaches, nausea. Behavioral disorders are more pronounced and are already quite noticeable. There is a loss of worldly and professional skills. The ability to plan action is increasingly difficult. At the same time, critical self-esteem of behavior is reduced.
  3. Cerebral ischemia of the 3rd degree. Absolute inaction regarding treatment leads to this stage. An acute lesion of almost all neurological functions is detected. The patient manifests Parkinson’s syndrome, impaired motor functions of all limbs, urinary incontinence. Decreased ability to control legs and loss of balance make walking difficult. In some cases, movement is completely impossible. Such a patient loses orientation in space. Sometimes he cannot adequately understand whether he is standing, lying or sitting. Speech is severely disturbed, memory is lost, and thinking is absent. Mental disorders reach their climax, sometimes you can observe the complete disintegration of the personality.
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Stages

There are three stages of this disease:

  1. Initial stage . At this stage, subjective disorders predominate, in the form of headaches, dizziness, lethargy, weakness, and insomnia. These disorders are followed by objective disorders: impaired coordination, memory. At this stage, neurological disorders are not observed. In this regard, with surgical treatment, it is possible to eliminate some symptoms, or even the disease itself.
  2. Stage of subcompensation. Symptoms progression, especially from the neurological side. Loss of control over their actions, reeling when walking, walking on tiptoe or on toes. Violation of the oculomotor muscles, coordination of movements.
    Slow motion is observed, the patient becomes apathetic. At this stage, it is possible to cure only some neurological disorders.
  3. Stage of decompensation. There is a violation of the normal functioning of some organs. The patient does not have the ability to move independently, he loses consciousness. Involuntary urine is observed, behavior becomes inadequate.
    There are violations of the regulation of movement, as well as muscle tone, psychotic disorders. Basically, patients with the third stage of cerebral ischemia are disabled. They may have micro strokes.

Each stage of ischemia leads to a violation of the usual quality of life.

We offer you to read a similar article about cerebral ischemia in a newborn.

In neurology, there are three stages of discirculatory encephalopathy.

At the first stage, a combination of classical complaints with a diffuse type of neurological symptomatology is observed, which manifests itself as anisoreflexia and a non-coarse type of reflexes. It is also possible that the gait may change (walking can become slow, the patient often moves in small steps). The first stage is characterized by a decrease in coordination stability and uncertainty when performing movements.

Very often, doctors note emotional disturbances in the form of irritability and anxiety in patients, and depression is not rare. At this stage, slight cognitive abnormalities of the neurodynamic type arise, which implies the depletion of the nervous system, decreased attention, and inertia of the intellect.

It is characterized by aggravated neurological symptoms, which are characterized by the formation of an implicit syndrome, nevertheless one that subsequently dominates. In addition, various extrapyramidal disorders can be detected, as well as ataxia, pseudobulbar syndrome and even CN dysfunction. Interestingly, over time, complaints become less pronounced, they are no longer so acutely perceived by the patient himself.

In addition, at the second stage, the patient’s ability to control his own actions worsens, and there are also difficulties in planning cases that a person wants to take at the next time. Although there is a violation in the performance of actions, however, the ability to compensate remains for a long time. In addition, there are signs of reduced social adaptation.

She is distinguished by a vivid manifestation of neurological syndromes. In this case, a violation occurs when walking and the ability to keep balance (the patient can often fall). Urinary incontinence is observed, and Parkinson’s syndrome is also characteristic. Due to the absence or decrease in a sober understanding of what is happening with the patient, the volume of complaints decreases.

Personality disorders can manifest themselves as a retarded reaction, an explosive state, apathetic-abulic symptom and psychological abnormalities. In addition to neurodynamic (or dysregulatory) malfunctions in the cognitive sphere, the manifestation of operational disorders such as speech and memory impairment, decreased ability to think, and so on is possible.

1 ishemiya golovnogo mozga - Treatment of chronic cerebral ischemia

All of these symptoms can later go into dementia. The latter leads to the inability to quickly adapt to the new situation, to a drop in performance in the personal, social and professional fields of life. Very often, doctors indicate a person’s disability. At some point, the patient ceases to serve himself.

Brain ischemia, like other pathological processes that are caused by insufficient blood supply to this organ, has its own code according to ICD-10 (international classification of diseases of the Tenth revision). In this list, all variants of brain disorders are divided into parts, the main characteristic of which is the degree of vascular pathology.

So, the changes caused by chronic cerebral ischemia are numbered 167, and this includes several diseases that cause a gradual decrease in cerebral blood supply.

A stroke caused by an ischemic stroke, like other acute manifestations of ischemia, is not included in this list – a separate serial number 163 (cerebral infarction) or 164 (stroke not specified as hemorrhage or heart attack) is allocated for it.

Depending on the severity of the disorders that were caused by the pathological process, 3 stages of cerebral ischemia are distinguished, each of which has characteristic symptoms and features.

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The first stage

It is characterized by weak manifestations of cerebrovascular accident – the patient may complain of frequent localized pains, rapid fatigue, which does not depend on the length of rest time, as well as insomnia, decreased brain activity, which manifests itself in a deterioration in the quality of memorization and concentration, emotional instability.

Due to the fact that these symptoms of ischemia are temporary in nature and do not appear at the same time, most often the sick person simply overlooks them or does not attach much importance.

f985cf6191cf6291dabaf758d0db2d71 - Treatment of chronic cerebral ischemia

According to observations from medical practice, at this stage of the disease, ischemia of the brain responds well to treatment, the result of which will be a complete recovery of the person.

The second stage

Further destruction of the brain structures occurs with the corresponding symptoms, while depending on the location of the affected area of ​​the brain, certain violations in the functioning of the organs will be noticeable. It is mainly manifested by the following neurological symptoms:

  • frequent dizziness, fainting;
  • memory impairment (short-term loss or amnesia) and other cognitive disorders;
  • excessive irritability and instability of the psycho-emotional state;
  • decreased intelligence, the appearance of signs of personality degradation;
  • limb tremor and other impaired motor function leading to disability.

The effectiveness of the therapy depends on the severity of the damage caused by insufficient blood supply, while the improvement of metabolic processes only partially returns lost abilities and slows down the progression of the disease.

The third stage

Organic damage to brain tissue provokes the appearance of severe neurological abnormalities, while the patient is often unconscious and can no longer control his body.

The situation as a whole is complicated by the fact that at this stage of the disease, the patient cannot accurately formulate and voice words that worry him, dementia sets in and complete personality degradation. In this case, the patient is provided with adequate medical assistance in this situation, which consists in supporting the patient’s life support.

Ischemic attack

Often, against the background of an acute transient ischemic disturbance of cerebral circulation, a transient ischemic attack of the brain (TIA) develops, which, like any such violation, has the corresponding symptoms.

So, let’s figure out what is an ischemic attack of the brain and what are its possible manifestations.

Mostly, this condition is characterized by various neurological disorders (paresis and sensitivity disorders), which were caused by pathological processes taking place in any part of the central or dorsal part of the central nervous system. In this case, TIA, unlike a stroke, is not accompanied by a heart attack (irreversible softening) of the brain structures.

Another distinguishing feature of this condition is the short duration of the attack, which usually does not exceed 1 hour. If the symptoms of the disorder appear for a longer time (but not exceeding 24 hours), then in most clinical cases, examination of the brain reveals tissue infarcts.

Most often, transient ischemic attack affects people with atherosclerosis of the main cerebral and vertebral arteries. Due to the fact that such conditions are often left without due attention from the patient (attacks can occur several times throughout a person’s life), it is very difficult for specialists to make a prognosis of such a course of the disease. However, it was found that in 50% of cases of TIA within 5 years the patient develops a stroke with its corresponding complications.

In most cases, acute cerebral ischemia is focal in nature and most often leads to ischemic stroke. One of the causes of such conditions is the susceptibility of cerebral vessels to atherosclerosis, which in combination with persistent hypertension causes an acute course of the disease.

As a result of atherosclerosis of the cerebral arteries, a gradual narrowing of the lumen of the vessel occurs due to cholesterol deposits on its walls. In this case, muscle fibers become fragile and susceptible to damage and the influence of high blood pressure inside the vessel.

Under the influence of these unfavorable factors, one of the artery walls ruptures most often with subsequent bleeding and the formation of a blood clot at the rupture site. Further, due to the cessation of blood supply to the corresponding site, there is a destruction and necrosis of its structures (ischemic stroke or cerebral infarction).

Diagnosis of chronic cerebral ischemia

The patient examination scheme solves several problems at once: localization, type and volume of the lesion, the probable cause of the pathology and associated diseases. The doctor after interviewing the patient and identifying factors that could provoke the disease, sends him for diagnosis. Chronic cerebral ischemia is detected by MRI, in which the problem area is visualized, and a duplex scan showing the location of the affected vessels.

In this case, the brain suffers due to a lack of glucose and oxygen. As a result, brain functions are impaired. A person becomes forgetful, depressed, frequent mood changes are noticed.

Thanks to the international classification of diseases, doctors are much easier to navigate in a huge variety of diseases of human organs. The ICD code is 10 from 163.0 to 169.0.

An important role in the diagnosis is played by a correctly collected patient history. In the history it is important to find out: whether myocardial infarction, coronary heart disease, angina pectoris, hypertension, atherosclerosis, diabetes mellitus. It is necessary to conduct a subjective and objective examination, to listen to all complaints of the patient.

Be sure to study the neuropsychological and neurological symptoms.

A number of instrumental studies are carried out:

  • Doppler ultrasound;
  • Magnetic resonance imaging;
  • Electrocardiogram;
  • CT scan;
  • Electroencephalography;
  • Echocardiography;
  • Holter monitoring.

And also apply laboratory research methods:

  • General blood analysis;
  • Blood chemistry;
  • Blood coagulation;
  • Blood for sugar;
  • Lipid fractions.

Doctors suggest that left hemisphere and right hemisphere ischemia are distinguished by the accompanying symptoms. If the foci of chronic cerebral ischemia are located on the side of the left hemisphere, then treatment will occur faster and more efficiently.

The root causes include:

  1. Incomplete cerebral blood supply, resulting in oxygen starvation. In the absence of oxygen for a long time, cells cannot function as before. If this condition lasts a very long time, a heart attack is possible;
  2. Arterial hypertension;
  3. Atherosclerosis;
  4. Thrombosis;
  5. Damage to the vascular wall;
  6. Spinal diseases such as osteochondrosis, disc herniation.

For auxiliary reasons include:

  • Ischemic kidney disease;
  • Diseases of the heart and its vessels;
  • Overweight;
  • Bad habits;
  • Decompression sickness;
  • Diabetes;
  • Blood diseases such as anemia or erythrocytosis. Find the ICD code 10 for mixed anemia.
  • Tumor due to compression of the artery;
  • Loss of blood in large quantities;
  • Elderly age;
  • Venous pathology;
  • Carbon monoxide intoxication, etc.

The etiology of the disease is quite large, but the main factor is circulatory disorders for various reasons.

If the disease arose as a result of the fusion of arterial hypertension and atherosclerosis, then the diagnosis is as follows: chronic cerebral ischemia of mixed genesis.

Unfortunately, it is very difficult to identify an ailment at the initial stage. Cerebral ischemia of the brain may not cause the patient any complaints. It should be understood that blood vessels do not have nerve endings, so the development within their disease proceeds quite imperceptibly. Unpleasant sensations arise only when unpleasant consequences, as a rule, have already arrived.

For diagnosis, the attending physician carefully examines the symptoms based on the patient’s complaints. Carefully checks for past illnesses to determine if a person is at risk. In addition, chronic cerebral ischemia is diagnosed using a variety of examination methods:

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

The last method of examination is quite unique and important research. Dopplerography consists in measuring the speed of blood movement. Thus, it becomes possible to localize cholesterol plaques in the deceleration sites.

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

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

The main factors provoking the disease:

  • multiple pregnancies;
  • late toxicity, which occurs in severe form and is accompanied by an increase in pressure and the presence of protein in the urine;
  • detachment of the placenta;
  • diseases and bad habits of the mother;
  • the birth of an infant earlier or later;
  • disruptions in the uteroplacental circulation, which provokes the necrosis of the brain areas of the baby;
  • heart defects in a child.

In medicine, there are three degrees of severity:

  • Easy stage of ischemia. In a baby, you can observe a pronounced inhibited state. Or, conversely, a strong excitement that lasts up to five to seven days.
  • Moderate degree of ischemia. This form is usually accompanied by convulsions in newborns. Such symptoms can be observed in a child for a sufficiently long period.
  • Severe degree of ischemia. These babies are immediately placed in the intensive care unit.

No matter how terrible the diagnosis of “cerebral ischemia” sounds, the treatment carried out by modern medicine makes it possible to achieve significant success. The main directions are the restoration of blood circulation in the brain and the creation of conditions for the full functioning of unaffected areas.

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

In medicine in recent years, the occurrence of chronic cerebral ischemia is usually considered in two ways: by the nature and nature of the damage and by habitual localization. In the case of bilateral diffuse damage to the brain, more precisely, its white matter, they speak of a leukoencephalopathic type of encephalopathy.

Most often, the lacunar variant is caused by a process such as the occlusion of small vessels. A significant role in the pathogenesis of diffuse lesion is attributed to a decrease in systemic hemodynamics or, as it is also called, arterial hypotension. The cause of the decrease in blood pressure will be incorrectly performed antihypertensive therapy, as well as a decrease in cardiac output. A significant role is given to severe coughing, orthostatic hypotension, which often happens in the case of vegetative-vascular dystonia.

As you know, the main pathogenetic link of this disease is the depletion of the compensation mechanism, as well as a decrease in the energy work of the brain, which leads to a clear development of functional disorders and such irreversible morphological processes as slowing down blood flow, lowering blood glucose, lowering oxygen levels, and the occurrence of capillary stasis, the appearance of slowed cerebral blood flow, thrombosis, the ability to depolarize cell membranes.

  • polymorphic movement disorders;
  • decreased memory and mental abilities;
  • changes in the emotional background of the patient.

A feature of chronic cerebral ischemia is its progressive course. In addition, the disease is characterized by the presence of stages and syndromes. Doctors note the so-called inverse relationship between the complaints present (especially those related to concentration of attention and ability to remember) and the degree of manifestations of this ailment.

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The main clinical manifestation of discirculatory encephalopathy today is considered cognitive impairment, which can be detected even in the first stage. Their character, as a rule, is progressive, which is noticeable already in the third stage of the disease. In parallel with emotional disorders (such as emotional lability, inertia and all kinds of loss of interest), a variety of motor disorders can occur, including the inability to control and perform both simple reflex and complex automated movements).

Pathology is not an indication for urgent hospitalization of the patient. Inpatient treatment is necessary when the process of the disease is complicated by the development of a stroke condition or severe pathology. If a cognitive type of disorder is found, if the patient is deprived of his usual environment, the condition may worsen.

Treatment of chronic ischemia is usually carried out by a neurologist on an outpatient basis. In the case of the development of the disease before the 3rd stage, doctors appoint patronage.

Diagnosis of the pathology is often complicated by blurry and lethargic symptoms, because of this, the first signs of cerebral ischemia can be confused with the manifestations of other ailments included in the list of medical international classification of diseases of this organ:

  • progressive supranuclear palsy;
  • cortico-basal degeneration;
  • atrophy of the brain;
  • Parkinson’s disease;
  • the development of malignant and benign tumors in the structures of the brain;
  • Alzheimer’s disease;
  • hydrocephalus;
  • idiopathic senile dysbasia, which is expressed by obvious impaired gait;
  • loss of coordination of movements (ataxia).

Specialists know many manifestations of cerebral ischemia, therefore the attending physician (most often a neurologist), in order to avoid the consequences caused by a medical error, should use a comprehensive approach to the examination of the body.

ishemij lechenie neustoichivaj chotba 2 - Treatment of chronic cerebral ischemia

Shakiness and instability while walking

  • treatment of a disease that contributes to the occurrence of ischemia,
  • correction of risk factors,
  • elimination or weakening of the symptoms of the disease,
  • prevention of disease progression.

ishemij lechenie pitanie - Treatment of chronic cerebral ischemia

Treatment of ailment

Unfortunately, quite effective methods of combating the disease have not been found. If the patient is diagnosed with chronic cerebral ischemia, treatment should be carried out only by a competent neurologist.

ishemij lechenie vred privichki - Treatment of chronic cerebral ischemia

As a rule, the fight against an ailment includes such measures:

  1. Normalization of blood pressure, preventive methods to avoid stroke, ischemic attacks. For these purposes, a variety of blood-thinning and vasodilating drugs are used. Pentoxifylline, Warfarin, etc. are referred to such medicines.
  2. Restore blood circulation in the vessels, improve metabolism. Omaron is considered quite effective. It includes piracetam. Namely, this substance has a beneficial effect on cells, restoring them and significantly improving oxygen saturation. Encephabol, which is widely used in the treatment of children with a similar ailment, has also proven itself well.
  3. Recovery of physiological and behavioral functions. For such purposes, massage, magneto-and electrophoresis, exercise therapy, restorative therapy are prescribed.

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

If the patient has revealed quite advanced cerebral ischemia of the brain, the treatment consists in surgical intervention. The main goal is the operative removal of sclerotic plaques. Brain surgery is the most complex type of surgery. They require the highest skill from the doctor. Moreover, quite often they are fraught with serious, sometimes completely unpredictable, grave consequences.

That is why surgery is a last resort. They resort to it only in cases where conservative treatment has not yielded positive results.

Folk remedies for cerebral vessels

ishemij lechenie narodn med - Treatment of chronic cerebral ischemia

There are patients who prefer treatment with folk remedies. For this purpose, they are used inside tinctures or decoctions of thyme, medicinal sweet clover, cucumber grass flowers, goat seed seeds. Treatment is carried out in courses of 2-3 weeks. Many people believe that since folk remedies do not contain “chemistry”, they are safe to use. It’s a delusion! All medicinal herbs have contraindications for use, as well as side effects with an overdose.

4700898 1ishemiya golovnogo mozga prichinyi zabolevaniya - Treatment of chronic cerebral ischemia

The disease is due to the fact that it progresses slowly, gradually increasing with a variety of symptoms. You can stop the development of chronic brain ischemia using folk recipes:

  1. Garlic-lemon mixture. Grind a few cloves of garlic (2-3) into gruel, pour unrefined vegetable oil (100 g), put in the cold for a day. Take 1 tsp. adding lemon juice (1 tsp) three times a day. Continue treatment for 1 to 3 months without interruption.
  2. Herbal infusion. Mix in the same amount of grass – mint, motherwort, thyme. Pour the mixture (3 tbsp.) With boiling water (450 ml). Insist until cool, strain, drink half a glass after meals 2 times/day. The course is at least 1 month.

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

  • decoctions of oak bark;
  • freshly squeezed carrot juice;
  • decoctions of mint;
  • Adonis;
  • compresses from a variety of herbs.

preventive measures

As previously mentioned, there are no ways to completely recover from an ailment that occurs in a severe form. In this regard, the prevention of the disease becomes a rather important factor.

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

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

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

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

Of great importance is the so-called secondary prevention. It implies the timely treatment of heart disease, hypertension.

Laboratory research

The main goal of laboratory research is to identify the causes that contributed to the development of chronic cerebral ischemia with its possible mechanisms of a pathogenetic nature. Doctors also strongly recommend a complete blood count, a blood sugar test, and lipid profiles.

In order to determine the degree of damage to the vessels of the brain, as well as its substance, to detect any other background diseases, doctors recommend undergoing instrumental studies such as:

  • ECG;
  • echocardiography;
  • ophthalmoscopy;
  • USDG (first of all, this study is performed for the main arteries of the head);
  • spondylography of the cervical spine;
  • triplex (or duplex) scanning of vessels of intracranial and extracranial types;
  • angiography of blood vessels (in order to detect vascular abnormality).

All patient complaints usually inherent in the chronic type of cerebral ischemia can also be detected in various somatic pathologies and in some cases with oncology. Symptoms inherent in chronic cerebral ischemia can also be signs of various mental disorders and endogenous disorders.

The diseases with which chronic cerebral ischemia should be differentiated are:

  • supranuclear palsy of a progressive type;
  • Parkinson’s disease;
  • cortico-basal degeneration;
  • Alzheimer’s disease;
  • multisystem atrophy.

Very often, differential diagnosis of this disease with malignant and benign brain tumors, idiopathic dysplasia, normotensive hydrocephalus and ataxia is required.

Proper nutrition

The most important weapon against the formation of cholesterol plaques is the prevention of a harmful component in the body. In this regard, it is very important to establish proper nutrition. A lot of diets have been developed. Some of them are aimed at lowering cholesterol and blood sugar. A professional nutritionist can help sort out this diversity. There are even special anti-cholesterol diets. We will not analyze specific options.

The main thing is to understand the essence:

  • The proportion of fat should not exceed one third of the total diet.
  • Carbohydrates in the body are replenished only due to fruits and vegetables. From baking, sugar, confectionery must be completely abandoned.
  • Animal fats should be minimized. Pork should be excluded from its menu, preferring lean meats such as turkey, chicken.
  • The amount of salt consumed should be reduced. You need to add very little to the food, it is better to remove the salt shaker altogether from the table.
  • You should significantly reduce the amount of food consumed at a time, while increasing the number of meals. Nutritionists recommend eating five or six times a day.
  • It is very important to strictly control the use of cholesterol. To do this, you need to know its content in the products. So, for example, in the liver (100 g) there are 438 mg of cholesterol, and in sour cream, skim milk and kefir – only 2 mg.

Conclusion

In any case, it must be said that vascular pathologies do not arise just like that. Often their cause is the patient himself. Of course, heredity and individual characteristics should not be ruled out, but maintaining a healthy and healthy lifestyle has always led to a more favorable old age and the absence of incurable diseases.

The main thing that needs to be clarified is that acute cerebrovascular accidents can be cured only with high-quality and timely therapy. It is necessary to use preventive methods to prevent its complications using folk and traditional methods.

A person who spends a lot of time in the fresh air, eating properly, has excellent health. Indeed, during a walk, he breathes in fresh air containing oxygen. This component is simply necessary for the proper operation of all internal systems. Having established “anticholesterol” nutrition, such a patient will protect his blood vessels from clogging. So, nothing puts free circulation.

Otherwise, cerebral ischemia may develop. This disease belongs to the group of ailments that are easier to avoid than try to treat subsequently. Do not neglect simple methods of prevention, actively move. Do not forget that you should protect your health when it is not yet lost.

Antihypertensive therapy

Antihypertensive therapy is aimed at maintaining normal blood pressure and stabilizing the state of chronic ischemia. If doctors prescribe antihypertensive drugs, the patient should be careful and monitor the jumps in their blood pressure. As you know, in the case of developing chronic ischemia, the mechanism of autoregulation of cerebral blood flow begins to work intermittently.

If we talk directly about the antihypertensive drugs prescribed by doctors, then the first thing is about the medicines of two groups:

  • angiotensin converting enzyme inhibitors;
  • angiotensin II receptor antagonists.

The drugs of both the first and second groups are capable of exerting two effects simultaneously: in addition to angiohypertensive, they are also angioprotective, which means protecting the affected organs, which usually include the kidneys, heart and brain. The effect of antihypertensive drugs usually increases significantly if they are combined with antihypertensive drugs such as hydrochlorothiazide and indapamide.

3638412 2narusheniya pamyati i kognitivnoy funktsii golovnogo mozga chastyie priznaki distsirkulyatornoy entsefalopatii - Treatment of chronic cerebral ischemia

Hypolipidemic therapy is prescribed for patients with atherosclerotic lesions of the cerebral vessels. Along with dyslipidemia, lipid-lowering drugs such as statins, atorvastatin and simvastatin are prescribed. In addition to exerting their main action, such substances significantly improve endothelial function, while reducing blood viscosity, and contributing to the antioxidant effect.

Antiplatelet therapy helps to activate the platelet-vascular link of hemostasis, therefore, it implies that the patient takes special antiplatelet drugs (for example, acetylsalicylic acid). If necessary, treatment with the use of antiplatelet agents such as dipyridamole and clopidogrel can be prescribed.

Combined drugs

In addition to the main therapy described above, depending on the mechanism that caused the disease, individual treatment is prescribed, which is designed to normalize the rheological properties of the blood and establish venous blood flow, normalizing microcirculation. Typically, such drugs have neurotrophic and angioprotective properties. For example, a doctor may prescribe one of the following combinations:

  1. cinnarizine (not more than 75 mg) together with piracetam (1-1,2 g per day);
  2. piracetam (not more than 1,2 g) with vinpocetine (15 mg per day);
  3. nicergoline (not more than 30 mg per day) and pentoxifylline (approximately 300 mg per day).

Typically, such combinations of drugs are prescribed no more than twice a year, each course lasts about 2 months.

Surgery

medikamentoznoe lechenie - Treatment of chronic cerebral ischemia

Medication for cerebral ischemia

Medicines used in chronic cerebral ischemia contribute to the normalization of blood flow in the brain, the enrichment of brain cells with oxygen and nutrients, as well as improve the rheological properties of blood. Antioxidants are used: mildronate, mexidol, tocopherol. Drugs that improve cerebral circulation: Cavinton, Trental.

Mandatory prescription of drugs that promote blood thinning and prevent blood clots: acetylsalicylic acid, aspicard, clopidogrel, dipyridamole, warfarin under the control of INR. If the patient suffers from depressive disorders, antidepressants, anti-anxiety drugs: grandaxin, rexetin can be prescribed.

The choice of drugs is determined by the stage of the disease, taking into account the age of the patient, concomitant diseases, individual tolerance. In some cases, surgical treatment of chronic cerebral ischemia is performed. If it is caused by an abnormality of blood vessels, thrombosis of large vessels or vessels of the carotid arteries. Thrombectomy, stenting, endarterectomy can be performed.

2812061 3atorvastatin preparat dlya snijeniya urovnya holesterina - Treatment of chronic cerebral ischemia

In the case of developing occlusive stenotic damage to the great arteries located in the brain, surgical treatment will be indicated. Reconstructive surgery is performed on the carotid artery by stenting or carotid endarterectomy.

Prevention of ischemia

Chronic cerebral ischemia is very common. Only systemic treatment of this disease can provide the necessary assistance for brain disorders. Proper treatment will help prevent cerebral infarction. Basically, the prognosis is favorable for those patients who are constantly under the control of their neurologist.

A poor prognosis is detected in connection with a late call to the doctor.

Prevention should be from an early age.

  1. limit yourself from stressful situations;
  2. follow a diet, as obesity refers to the causes of the disease;
  3. lead a healthy lifestyle;
  4. give up bad habits, such as smoking and alcohol;
  5. move more, inactivity also leads to the development of this disease.
  • Be sure to urgently treat diabetes, arterial hypertension, atherosclerosis.
  • If the occurrence of the disease could not be avoided, you should immediately stop smoking, reduce physical activity, you can not be in the sun for a long time, drink less alcohol, adhere to a certain diet.
  • A lot depends on nutrition. With improper nutrition, salts and cholesterol are deposited in the body. As a result of this, plaques appear that clog the blood vessels, and he cannot fight this obstacle. As a result, oxygen ceases to flow into all organs, and they begin to “suffocate”. A person must free the walls to give oxygen to the organs by contacting a neurologist.

You need to start to sound the alarm when:

  1. Unpleasant phenomena constantly appear in the region of the heart;
  2. There is an increase in breathing or shortness of breath even with slight physical exertion;
  3. Suddenly weakness and fatigue appear.

Conducting preventive measures helps prevent the transition of the disease to a more severe form. The prevention of cerebral ischemia itself is as follows.

First of all, patients with ischemia should pay attention to their diet, since too fatty and salty foods contribute to the accumulation of cholesterol and the formation of cholesterol plaques on the walls of organs. You should also establish a drinking regime (it is recommended to consume at least 2,5 liters of various fluids during the day). This approach usually helps to reduce puffiness and remove excess mineral compounds.

In the future, after the main treatment for cerebral ischemia, the patient is instructed to carefully monitor his health and not start treatment for concomitant diseases, while mental stress, walking in the fresh air, maintaining the recommended diet, as well as giving up bad habits, will significantly reduce rehabilitation time.

With timely diagnosis and correctly prescribed treatment, it is most often possible to stop the progressive course of chronic cerebral ischemia. If the disease is severe enough, being simultaneously weighed down by pathologies (for example, diabetes mellitus or hypertension), a marked decrease in habitual working capacity can be noted, and sometimes even until the patient is completely disabled.

Among the preventive measures that can prevent this disease, the following are distinguished:

  • prevention of obesity in general, and in particular, obesity of cerebral vessels;
  • active lifestyle;
  • quitting alcohol and smoking;
  • avoidance of stressful situations.

An important preventive measure will be the prevention of hypertension and diabetes. Not everyone knows that atherosclerosis can also contribute to the development of chronic cerebral ischemia, so it is necessary to deal with it in the early stages.

As soon as a person has discovered the first symptoms of chronic cerebral ischemia, you should immediately reduce the amount of alcohol consumed (or better to completely abandon it), reduce physical activity and avoid direct sunlight.

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.

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