Anatomically, a special vascular “formation” is responsible for the blood supply to the brain – the circle of vilisis, from which all areas of the brain receive blood.
Clinically, the brain receives blood through two main vessels – the carotid and vertebral arteries. The carotid artery, for the most part, nourishes the tissue of the hemispheres and cortex with blood. The vertebral artery basin (vertebro-basilar) carries blood mainly to the base of the brain and some components of its trunk (in particular, to the cerebellum).
Due to this separation, a transient ischemic attack can develop in any of these pools, leading to the development of a clinic typical of each type of attack.
Symptoms of the disease depend on in which area of the brain the damaged vessels are located. There are two vascular pools:
- Carotid, where the carotid arteries are located. They affect the blood supply to the hemispheres of the brain, which are responsible for sensitivity, motor activity and higher nervous activity.
- Vertebral-basilar, contain vertebral and basilar arteries supplying the brain stem. This part of the brain is responsible for vital functions: vision, blood circulation, memory, respiration.
The term “ischemic attack” is the modern name for transient disorders of cerebral circulation in accordance with the International Statistical Classification ICD-10. The paroxysmal manifestations or “attacks” that a person experiences are temporary (transient) in nature, often go away on their own.
Without fail, against the background of another ischemic attack, there is a decrease in blood supply to a certain part of the brain. The critical period of neurological symptoms is 24 hours. If cerebral insufficiency lasts longer, then the condition is regarded as a stroke.
Therefore, doctors consider varieties of transient ischemic attacks (TIA) as a very likely harbinger of acute ischemic stroke. The people got the name micro-stroke. It is practically important to start enhanced therapy during this period. Rational treatment avoids severe consequences.
In an ischemic attack, arteries that carry oxygen and nutrients to different parts of the brain undergo a short-term spasm. This is caused by a disturbed vascular reaction, a malfunction of the “controlling” function of the cortical nuclei.
Perhaps their negative role is played by:
- vascular inferiority due to genetic predisposition;
- impaired coagulating properties of blood (hyperprothrombinemia increases thrombus formation);
- autoallergy process – the formation of antibody complexes on the inner walls of blood vessels;
- inflammatory reactions with vasculitis.
Even a short-term breakdown in the supply of brain cells (neurons) disrupts the process of energy production inside, causes oxygen deficiency (hypoxia), and stops all types of metabolism.
Clinical symptoms depend on the extent of the lesion and its location. From the manifestations of a stroke, they differ in returning to a normal state within a day.
The main reason why all the clinical manifestations of a transient ischemic attack develop is the mismatch between the oxygen needs of the neurons and the ability of the vessels of the brain to deliver oxygen-rich blood to the cells that need it.
At the same time, there is no clear boundary in the clinic between ischemic stroke and transient ischemic attack – the mechanism of their development is similar, the main manifestations are similar. The main difference between a transient ischemic attack and a stroke is the duration of the disorder – the diagnosis of TIA can be made only if the duration of the circulatory disturbance does not exceed 24 hours, if the symptoms persist longer, the diagnosis will sound like a stroke.
Such factors as: can play a role in the development of transient ischemic attack:
- Change in the rheological properties of blood towards hypercoagulation.
- Some congenital malformations of the structure of the vascular walls.
- Inflammation of the vascular walls in vasculitis.
- Immunocomplex processes can also contribute – antigen-antibody complexes formed in the blood can also interfere with normal blood circulation not only in the cerebral artery basin, but also in vessels of other organs.
Due to the high demand of neurons in oxygen and nutrients, even a short-term violation of their entry to brain cells leads to pronounced clinical manifestations. If blood circulation quickly resumes, then the symptoms disappear without a trace, as cell function is restored.
In the case of a long termination of oxygen delivery, cell death occurs, and a stroke develops.
Since the duration of TIA in most cases is quite short, treatment often begins after the focal symptoms disappear, and consists primarily in preventing repeated episodes.
Depending on the factors that contributed to the occurrence of TIA, the following drugs may be included in the treatment:
- Anticoagulants and antiplatelet agents. The effect of drugs of these groups is primarily aimed at reducing blood coagulation, which avoids thrombosis.
- Neuroprotectors and nootropic drugs. These drugs improve brain cell nutrition and increase hypoxia resistance of nerve tissue.
- With atherosclerosis, lipid-lowering drugs are prescribed. These are drugs that in one way or another lower the level of cholesterol and low density lipoproteins in the blood, which prevents the progression of atherosclerosis.
- Antioxidants. These funds are designed to reduce damage to nerve tissue from substances formed during hypoxia.
- Antihypertensive drugs. Means of different pharmacological groups are used, but when using them, it should be remembered that too sharp and significant reduction in blood pressure in some cases with TIA and strokes can harm the patient.
In some cases (mainly with significant damage to the arteries by atherosclerosis), surgical treatment may be necessary.
Transient ischemic attack, or TIA, manifests itself in different ways, it all depends on the location of the lesion and the degree of damage to the vessels. Such an attack does not harm the nerve fibers, and the damage that occurs is very small and minor.
- With ischemia, the vessel may lose its patency for a short time. The cause is a spasm or blood clot. The response of the body to such a malfunction is vasodilation, an increase in blood flow to the cerebral cortex. This leads to a decrease in the supply of oxygen to cells. When blood flow is restored, ischemic attacks cease.
- With a stroke, there is an acute violation of cerebral circulation with a serious damage to the nervous system. It leads to irreversible consequences: arteries are affected, brain tissue changes, blood supply is disturbed. Therefore, when there is an acute transient ischemic attack, first aid should be provided to the victim and medical specialists should be called. An attack of this kind can lead to relapse and complications.
Local circulatory decline, causing temporary dysfunction, has four stages of development.
- the first stage is autoregulation, when blood vessels expand due to a decrease in blood flow to the brain;
- the second stage is oligemia, when the autoregulatory mechanism fails, the pressure gradually decreases, but the cells do not yet lack oxygen;
- the third stage is called ischemic penumbra, when perfusion pressure rapidly decreases, oxygen supply decreases, signs of hypoxia with impaired nerve cells begin to appear. This transient ischemic attack is reversible;
- the fourth stage is irreversible, when the state of oxygen starvation of the brain is aggravated. At this stage, a stroke develops.
The first three stages relate to TIA, they have no consequences and are short-lived.
- International >
- The main clinical manifestations of cerebrovascular accident, or symptoms of TIA
- Establishing diagnosis
- Causes and factors contributing to temporary ischemia
- What drugs are most effective in the treatment of TIA?
- Symptoms of TIA
- Prevention of the occurrence and relapse of TIA
- Signs of aortic cerebral attack
- First aid
- Attack severity criteria
- Factors directly increasing the likelihood of TIA
- Difference from stroke
- 4 How to help a person with transient ischemic attack?
- 2 Why does a transient ischemic attack occur?
- Transient ischemic attack – home treatment
- First aid
- Folk methods
- Preventive measures
- Complications and consequences
Due to the inconsistent nature of complaints, not all patients turn to the clinic. Therefore, it is impossible to provide reliable data on the frequency and prevalence of this pathology of the brain. The fact of the presence of previous transient cerebral ischemia within five years before a stroke was established in 30-50% of patients.
In ICD-10, a subgroup of transient cerebral ischemic attacks and related syndromes with the code G45 is allocated.
Their variants reflect the most frequent localization of the occurrence of a short-term mechanical obstruction in the arteries that feed the brain:
- G45.0 – level of vertebrobasilar arterial system;
- G45.1 – violation of the blood supply to the hemisphere of the brain due to temporary closure of the carotid artery;
- G45.2 – the multiple nature of vascular lesions on both sides;
- G45.3 – the symptom of transient blindness prevails in the clinic;
- G45.4 – leading manifestation – temporary amnesia (memory loss);
- G45.8 – transient ischemic attack associated with other causes;
- G45.9 – the code is diagnosed if there are signs of TIA, but the reasons are not specified.
According to the severity of the disease, the following degrees are distinguished:
- Mild – symptoms appear for about ten minutes, and then everything recovers. With this course, patients do not attach importance to the disease and do not consult a doctor, but after some time the attacks are repeated.
- Medium – signs can be observed up to several hours, but no consequences occur.
- Severe – symptoms remain during the day.
At the location of the thrombus, in connection with the international classification, transient ischemic attack has one of the following options for the course of the disease:
- carotid artery syndrome;
- global short-term amnesia;
- unspecified forms;
- multiple bilateral symptoms of cerebral arteries;
- arterial vertebrobasilar system syndrome;
- transient blindness.
The main clinical manifestations of cerebrovascular accident, or symptoms of TIA
Symptoms of transient ischemic attack
Most often, the development of TIA is observed in the carotid artery basin. As a result, the symptoms can be completely different (depending on the area that the affected vessel innervates).
Most often, a transient ischemic attack in the coronary pool manifests itself in the form of transient speech disorders (when it develops in the supply area of the left carotid artery, which feeds blood to the core of Broca’s cortex), numbness of the limb or part of the face. For a short period of time, motor activity in the arm and leg of one side of the body may be impaired (most often it persists in the future, and the process becomes a stroke).
A transient ischemic attack in WBB has slightly different symptoms. Symptoms such as dizziness and shakiness when walking come first. Patients are concerned about general weakness throughout the body. The attack may be accompanied by a slight feeling of trembling in the limbs. An objective examination can determine the presence of symptoms such as nystagmus, ataxia and intention (symptoms of ischemia in the basilar circle of blood circulation). A feeling of numbness develops quite rarely.
A daily walk reduces the risk of stroke
There are no specific methods for the prevention of ischemic attacks. All efforts should be aimed at restoring the permeability of the cerebral vessels, improving blood circulation in the internal organs, as well as nerve tissue and timely treatment of concomitant diseases that can trigger the development of a stroke.
Particular attention should be paid to the competent and timely treatment of arterial hypertension and diabetes. It is with a combination of these diseases that the risk that a transient ischemic attack develops is highest.
If TIA has already developed, then after providing medical assistance to the patient (about 10 days in a hospital), the patient is advised to be referred to the office for paroxysmal conditions and for predicting strokes, where he will be given instructions and instructions on how to prevent the development of stroke and transient attacks.
In general, compliance with the basic principles of a healthy lifestyle and timely treatment of other diseases will prevent the development of ischemic attacks and prevent more formidable complications from developing.
To prevent the development of transient ischemic attacks, the recommendations of specialists should be followed:
- take the prescribed drugs in accordance with the prescription;
- control blood pressure;
- monitor blood cholesterol;
- give up bad habits: alcohol and nicotine addiction;
- regularly drink medications that prevent blood clots;
- be checked systematically by your doctor.
So that a transient ischemic attack does not have consequences, an active and healthy lifestyle should be maintained:
- on time and often eat;
- eliminate or reduce the consumption of fatty, smoked and salty foods;
- go in for sports: swimming, medical gymnastics;
- spend more time outdoors.
If you adhere to all of the above, then the prognosis for a full recovery will be positive.
- Disturbed motor ability in the extremities. Often this happens on one side: the left arm and leg, or in only one limb. In some cases, paralysis in the whole body is possible.
- There is no sensitivity in half of the body (left or right), or in both at the same time.
- Paralysis of half of the face. With a smile, an asymmetric uplift of the upper lip is observed.
- Speech is upset: there is a fuzziness of the spoken words, there is no ability to understand what has been heard, and your own speech may be incoherent and incomprehensible in meaning, an inability to pronounce the words appears, or there is a complete lack of speech.
- Visual impairment: both or one eyeball stop moving, partial or complete blindness occurs.
- Intellectual abilities disappear: the patient cannot say where he is, to determine the time.
- Failure in higher nervous activity is manifested by the inability to write and read.
In this case, signs of transient ischemic attack are manifested:
- gait instability – rocking from side to side;
- constant dizziness – it seems that all objects are spinning;
- headaches in the occipital part;
- sweeping and inaccurate movements;
- trembling in the limbs;
- limited movement of the eyeballs of one or both eyes;
- loss of sensation in one half of the body or throughout the body;
- delayed and irregular breathing;
- impaired ability to move limbs;
- unexpected loss of consciousness.
To prevent the occurrence of the disease, it is necessary:
- Increase physical activity. Moderate physical activity normalizes blood circulation, strengthens the immune system and stabilizes the respiratory system, reduces the risk of TIA. Preference is given to walking, swimming, therapeutic exercises, cycling and yoga.
- Follow a diet. In the diet should be limited to fatty, salty, smoked, spicy, canned food. Give preference to cereals, vegetables and fruits. With high coagulability and a high concentration of sugar in the blood, ask a dietitian for help to draw up a special nutrition program.
- Timely treatment of chronic diseases. With an exacerbation of any disease, timely support of the body with medicines prescribed by a doctor is required.
- Monitor blood pressure. If necessary, correct with medication.
- Refuse bad habits: smoking and alcohol.
- Elimination of risk factors. Systematically monitor cholesterol and blood coagulation. If necessary, urgently correct them.
Do not ignore the abnormal condition that occurred with TIA, over time it will worsen. This disease warns a person of an increased risk of stroke. Having listened to such a signal, the patient must prevent a subsequent deterioration in health and return to normal life.
Signs are most often manifested by focal nerve signs. Cerebral symptoms such as headache, vertigo, nausea with vomiting, impaired consciousness are much less common.
The symptoms of a stroke and TIA in the first hours cannot be distinguished, therefore, for any signs of impaired cerebral blood flow, you need to seek medical help
Symptoms of TIA depend on the location of atherosclerotic plaques – in the carotid or vertebro-basilar vascular bed.
This type of TIA is most common and accounts for up to 70% of transient ischemic attacks.
- bouts of systemic dizziness;
- vegetative-vascular disorders;
- noise and ringing in the head and in the ears;
- bursting headache in the back of the head;
- attacks of protracted hiccups;
- pallor of the skin;
- increased sweating;
- visual disturbances – points, zigzags in front of the eyes, loss of visual fields, double vision, fog in front of the eyes;
- signs of bulbar syndrome (violation of swallowing, pronunciation of words, loss of voice);
- violation of statics and coordination of movements;
- drop attacks – attacks of sharp fall without loss of consciousness.
It is manifested mainly by focal neurological symptoms, most often these are sensitive disorders. Sometimes the symptoms are so miserable that the patient does not even realize that something is wrong with his body.
- numbness of some parts of the body, most often from one limb, but can also occur according to the type of hemianesthesia (damage to the arms and legs on one half of the body);
- the development of motor disorders in the form of monoparesis or hemiparesis (damage to one limb or arm and leg on one half of the body);
- if the lesion is localized in the left hemisphere, then speech problems develop – aphasia, cortical dysarthria;
- bouts of seizures;
- blindness in one eye.
The duration and reversibility of the symptoms of TIA is different, from a few seconds to 24 hours. But, nevertheless, an accurate diagnosis can only be made after some time. The fact is that with TIA, according to additional research methods (MRI and CT), no pathological lesions are found. If this happens, then we should talk about a stroke even in the case when all the signs disappeared during the first day after the start. In medicine, there is a special term for this type of circulatory disturbance in the brain tissue – “small stroke”.
The prognosis for a transient ischemic attack is favorable, but each such episode is an increase in the risk of developing ischemic stroke, therefore, all measures must be taken to prevent and prevent vascular catastrophe in the brain.
The main preventive measures:
- correction of risk factors for TIA;
- healthy lifestyle;
- proper nutrition;
- normalization of body weight;
- elimination of bad habits;
- treatment of concomitant diseases – hypertension, diabetes mellitus, arrhythmias, atherosclerosis, etc .;
- sufficient motor activity;
- taking blood-thinning drugs for people at risk;
- surgical correction of narrowing of arteries.
About the most important thing. Ischemic attack – a harbinger of stroke
In concluding, it must be remembered that although a transient ischemic attack does not pose a direct threat to a person’s life, it is a warning to the body that an irreparable could happen in the near future. Therefore, in no case should one ignore this condition, but it is necessary to take all measures to prevent a catastrophe.
Posted by deneb on Thu, 10/06/2016 – 19:36
Nowadays, various disorders of cerebral circulation are a fairly common pathology, which also begins to appear in younger patients.
A transient ischemic attack, which is also sometimes called a microstroke, although in itself in most cases does not pose a significant threat with timely hospitalization, it is worth considering that TIA is an alarming bell from the body in a significant number of patients who underwent a transient ischemic attack during the following five years develops a full stroke.
The prevalence of the disease is due to a number of factors, primarily the significant spread among the population of arterial hypertension, atherosclerosis and other diseases of the cardiovascular system.
First of all, the diagnosis of TIA is to identify cerebral and focal symptoms, as well as their subsequent regression after some time. As already mentioned, if the developed symptoms do not disappear during the day, then you can safely suspect the development of a stroke.
Differential diagnosis can be performed between a stroke and TIA on the first day of the development of the disease using computed tomography. With the development of a stroke in the image, it is possible to recognize the presence of an ischemic zone (penumbra) in the nervous tissue. If there is a transient ischemic attack, then there may not be any changes in the image.
Lumbar puncture, which is used to differentiate ischemic disorders and hemorrhages during an ischemic attack, will not provide reliable data necessary for making a diagnosis. A sufficiently informative study is BCA ultrasound, which allows to determine the presence of stenosis in the brachiocephalic arteries.
If there are signs of focal lesion and cerebral symptoms, treatment should be started immediately.
Causes and factors contributing to temporary ischemia
For the development of the disease, there are many different prerequisites that have a negative effect on the state of the vessels of the brain and blood coagulation. The following factors are considered to be the main factors contributing to the development of transient ischemic attack:
- Osteochondrosis of the cervical spine.
- High blood pressure.
- Thromboembolism that develops as a result of heart diseases: arrhythmias, myocardial infarction, malformations of valves, endocarditis, chronic heart failure.
- Progressive atherosclerotic vascular changes. As a result, cholesterol plaques are formed, which are distributed with blood through the vessels and can block them, slowing down the blood flow.
- Failures in the metabolic processes.
- Atrial fibrillation.
- Abnormal tortuosity of cerebral vessels.
- Autoimmune and inflammatory diseases of the blood vessels.
- Antiphospholipid syndrome.
- Angiopathy, which is manifested by dystonia, temporary reversible spasms and paresis of blood vessels.
- Bleeding and coagulopathy (bleeding disorder). These phenomena also lead to blood clots and blockage of blood vessels.
Risk factors and causes of transient ischemic attack include the following:
- artificial heart valves;
- alcoholism: poisoning of the body or its systematic use, even in small doses;
- tobacco abuse;
- low physical activity.
The more people have provocative factors, the higher the risk of TIA. In children with severe heart ailments and endocrine diseases, symptoms of transient ischemic attack appear.
Basically, the disease is diagnosed in people of an older age category, this is due to the natural aging of the body. What causes TIA in children and adolescents? Among the important factors in the development of the disease is:
- atherosclerosis of the arteries of the neck and head;
- various deviations of the vascular bed;
- the formation of blood clots in the cavities of the heart and valves, associated with a violation of blood coagulation, uncoordinated contraction of the heart muscle and infections.
To determine the exact cause of the transient ischemic attack in children, a complete examination is necessary. First of all, parents should show their child a neurologist who:
- conduct a conversation and find out all the details of the occurrence of the disease, tolerance of physical exertion, learns a family history;
- to determine the patency of the vessels of the brain will appoint a study using CT or MRI;
- EEG (electroencephalogram) will help to eliminate epilepsy.
The next doctor is a pediatrician. Most likely, a comprehensive analysis of blood coagulation indicators will be required, with which it is possible to exclude or confirm congenital diseases associated with it. The process of blood clots also develops as a result of teenage use of contraceptives, frequent visits to the solarium, the use of dietary supplements, drugs or alcohol. The next important reason is a tumor, which may result in thrombosis. For its detection, CT and MRI data are used.
It is necessary to conduct a blood test for the amino acid homocysteine. In people with a deficiency of vitamin B6 and B12, its level rises, and this contributes to the development of atherosclerosis and provokes thrombosis.
The hereditary predisposition of the child to high blood cholesterol also contributes to early atherosclerosis. To confirm this, a blood test for lipoprotein A.
It remains to visit a cardiologist who listens to heart sounds and tones. To determine the pathologies, an electrocardiogram, an ultrasound of the heart and blood vessels of the neck are necessary. Your doctor will look for birth defects that can cause abnormal blood flow and blood clots.
Examinations will take a lot of time, but they are necessary to identify the reasons in order to receive timely treatment of a transient ischemic attack and to prevent the further development of the disease.
With the rapid course of TIA, the symptoms of the disease will most likely disappear before the arrival of an ambulance or visiting a doctor, therefore, when conducting a diagnosis of transient ischemic attack, the following examinations are required:
- To analyze the patient’s complaints and to collect a medical history: find out how much time has passed after the first symptoms, whether vision, gait, sensitivity were impaired, whether heart or vascular diseases were diagnosed before.
- Conduct a visual examination of the patient for the presence of loss of vision, sensitivity, movement of limbs.
- Blood test for the level of coagulability.
- Urine analysis to check liver and kidney function.
- CT scan – to determine vascular obstruction.
- ECG – detects signs of heart rhythm failure.
- Ultrasound of the heart – performed to detect blood clots.
- Ultrasound of vessels located at the level of the neck and feeding the brain.
- TCD – the blood flow of the arteries located in the skull is assessed.
- MRI – the patency of the arteries inside the skull is visible.
- If necessary, consult a therapist.
Based on the collected history, analysis results and data obtained during the examination, the patient is given an accurate diagnosis, and the doctor prescribes the appropriate course of treatment.
TIA is not an independent disease; its appearance is associated with pathologies of the cardiovascular system, problems of blood coagulation, trauma of blood vessels and large blood loss.
The causes of thromboembolism are most often associated with:
- atrial fibrillation;
- sick sinus syndrome;
- mitral stenosis;
- atrial fibrillation;
- dilated cardiomyopathy;
- infectious endocarditis;
- myxoma of the atrium;
- acute heart attack;
- thrombosis of the left atrium.
TIA can be observed in patients with:
- unclosed oval valve;
- artificial heart valve;
- mitral valve calcification;
- heart disease;
- СЃРµСЂРґРµС ‡ РЅРѕР№ РЅРµРґРѕСЃС, Р ° С, РѕС ‡ РЅРѕСЃС, СЊСЋ;
- abnormalities in the vertebral and carotid arteries.
A special risk group associated with the occurrence of transient ischemic attack should be highlighted. Patients with:
- high cholesterol;
- high blood pressure.
There is a high probability of an ischemic attack in people who abuse alcohol, a nicotine product, and those who lead a sedentary lifestyle.
The more factors provoking an ailment present in a person, the higher the risk of developing the condition in question. In a patient suffering from diabetes mellitus, abusing alcohol or having a nicotine addiction, the risk of TIA increases three times.
Causes of brain TIA coincide with the main triggering factors of ischemic stroke:
- men over the age of 50 are most susceptible to attacks;
- atherosclerotic changes in blood vessels;
- systemic vascular diseases of an inflammatory and autoimmune nature (lupus erythematosus, vasculitis);
- overweight (obesity) and endocrine pathology;
- change in the bone processes of the spine in the cervical spine;
- heart disease, arrhythmias;
- nicotine poisoning during smoking;
- the effect of alcohol.
All these factors violate the correct response of the vessels of the brain in response to an increase in the need for nutrients, mental work, physical activity. Instead of increased blood supply, a spasm occurs, which leads to a more or less pronounced imbalance between the “request” of neurons and provision.
In the presence of severe cardiac and endocrine diseases, transient ischemia is possible in childhood and adolescence.
Clinical studies have confirmed a decrease in the incidence of ischemic stroke in the group of patients taking treatment by 30–45%. This is with reliable data on the detection of a stroke:
- in the coming years, ¼ of patients with ischemic attacks;
- during the first week – in 43% of cases.
Therefore, the requirements of doctors to go to the hospital, even if the symptoms have disappeared, clearly and provides the patient with the prevention of serious disorders.
The left column of the table contains links to the authors of the studies, the reliability is not in doubt and is confirmed by the number of participants
It is not necessary to rely only on medicines without observing personal protection rules. The consequences depend more on a person’s lifestyle than on drugs. Recommended:
- exclude smoking and alcohol;
- adhere to an anti-atherosclerotic diet for the rest of your life (sharply limit animal fats, high-calorie foods, switch to vegetable oils, fish, dairy products with reduced fat content, be sure to eat vegetables and fruits at any time of the year);
- physical activity is limited only in heavy sports; hiking, swimming, fitness, cycling are shown;
- blood pressure control will help prevent TIA in a timely manner and get rid of brain problems.
Transient ischemic attacks should be treated as a warning “bell” about the increased risk of stroke. By listening to the “signals” of your body, you can avoid severe pathology, prolong an active life and not be a burden to relatives and friends.
The likelihood of developing a transient ischemic attack is significantly affected by both existing diseases (mainly the cardiovascular system) and lifestyle features.
Among the diseases that increase the chance of a transient ischemic attack can be identified:
- Atherosclerotic lesion of cerebral vessels. With atherosclerosis, the lumen of the blood vessel narrows, (depending on the severity of the pathological process) and even in the case of a slight spasm of the vessels, their patency is significantly impaired, which leads to a violation of the blood supply to the brain tissue.
- Hypertonic disease. With a prolonged course, the walls of the vessels lose their elasticity, which in combination with atherosclerosis (the occurrence of which arterial hypertension contributes to) significantly increases the chance of a transient ischemic attack.
- Pathological processes of the heart that increase the likelihood of thrombosis. This can be atrial fibrillation, myocardial infarction, bacterial endocarditis and various cardiomyopathies.
- Nicotine addiction.
- Type diabetes, as well as smoking.
What drugs are most effective in the treatment of TIA?
As with ischemic stroke, TIA treatment has two main goals:
The earlier appropriate neuroprotective therapy is prescribed, the higher the likelihood of eliminating the symptoms of ischemia and preventing the development of a stroke. As neuroprotective agents, such drugs as choline alfacecerate, ceraxon, actovegin are used. Quite good results are shown by this therapy in the treatment of ischemic attacks in the coronary artery basin.
Improving brain metabolism.
A transient ischemic attack, during its development, disrupts the normal consumption of glucose by the nerve cells, as a result of which destruction of the nerve cell membranes by glucose oxidation products develops. In order to make such a lesion as safe as possible, various solutions are used (in particular, crystalloids are prescribed – Acesol, Ringer, Trisol). These drugs do not allow ischemia to develop in the brain tissue and contribute to the leaching of glucose oxidation products from it.
Symptoms of TIA
- Violations in the vertebro-basilar basin (VBB) cause gait unsteadiness, instability, dizziness, dysarthria (blurred speech), vision problems, sensory anomalies.
- Changes in the carotid pool lead to a sharp deterioration in vision, temporary blindness of one of the organs, impaired mobility in the limbs, and rarely cramps. These signs are short-lived.
- TIA in the retina, when the pathology affects the artery of the organs of vision, which leads to transient blindness. Patients complain about the occurrence of an obstacle in the form of a “curtain”.
- Transient global amnesia (TGA) causes a short-term loss of short-term memory (this does not affect memories of the past). Provoking factors are pain and nervous strain. Occasional memory loss can last up to 30 minutes, after which everything is restored. Symptoms: confusion, repetition of asked questions, poor orientation in space.
A TIA attack lasts no more than 15–20 minutes, after which all neurological manifestations disappear. It is because of such a short-term malaise that people do not pay attention to him and do not visit the clinic. This disorder can happen once in a lifetime or recur regularly (up to three times a day). There are as many TIA manifestations as there are functions in the brain. Temporary deviations can be observed in speech, memory, behavior.
Symptoms of TIA are determined by the localization of the lesion. In diagnosis, they indicate a dysfunctional area of the blood supply to the brain. In neurology, there are:
- cerebral symptoms – dizziness, headache, nausea, weakness, short-term loss of consciousness;
- local manifestations are more specific, typical for certain areas of the lesion.
For any dizziness, staggering when walking, you need to find out the reason
It is by focal manifestations that one form of TIA can be distinguished from another.
Vertebrobasilar attacks are the most frequent manifestation of temporary ischemia (up to 70% of all cases). They have very diverse clinical symptoms. Occur when turning the head or spontaneously.
Syndrome of “cervical” migraine – is associated with damage to the vertebral arteries during deforming spondylosis and osteochondrosis of the cervical vertebrae. It appears:
- sharp pains in the neck and neck with irradiation on the surface of the head in the form of a “helmet” to the eyebrows;
- dizziness and fainting;
Vestibular disorders – a feeling of “rotation of objects”, loss of balance, nystagmus of the eyeballs.
Atonic and adynamic changes – transient weakness, loss of muscle tone.
Convulsive syndrome – cramps in the arms and legs without loss of consciousness are characteristic, extension and extension of the extremities occur.
Vascular visual disturbances – the patient describes a sudden visual impairment, spots and dots in front of the eyes, optical shapes, and a change in color perception.
Transient speech disorders.
Paroxysmal contractions of the diaphragm – cause coughing attacks, hypertension, palpitations, lacrimation and salivation, narrowing of the pupils.
When studying patency of the carotid arteries, pathology can be detected
Carotid transient ischemic attacks are associated with impaired blood circulation at the level of the carotid arteries. Characteristic symptoms:
- short-term disturbance of consciousness or orientation;
- temporary acute weakness and impaired sensation in the arms and legs (muscle hypotension and paresthesia);
- slight speech disturbances are possible.
The following manifestations are characteristic for transient ischemia in the vertebro-basilar basin:
- Severe dizziness. accompanied by double vision, nystagmus, sometimes vomiting, which does not bring relief. Systemic dizziness can be considered a manifestation of TIA only if there is no
- The loss of half the field of view of each eye, photopsies (flashes of light, bright spots floating in front of the eyes).
- The appearance of alternating syndromes (alternating syndromes, also known as cross paralysis, is a combination of impaired functioning of the cranial nerves on the same side as the affected area, with disorders of motor and sensory functions on the opposite side of the body from the affected area of the brain).
- Temporary loss of orientation in space, as well as temporary loss of memory.
- The so-called drop attack is the patient’s fall, which is not accompanied by loss of consciousness.
The following symptoms are characteristic of TIA in the blood supply zone of the carotid arteries:
- Mono, or hemiparesis
- The decrease in sensitivity, which is most often observed either on one limb or on the fingers of one limb.
- Speech disorders, most often in the form of motor aphasia, are conditions when, due to damage to brain regions involved in the formation of sounds, legible speech becomes impossible.
The presence of one of the alternating syndromes is optic-pyramidal, in which visual disturbances are observed on the side affected by the pathological process, and hemiplegia (or hemiparesis) of central origin on the opposite.
The main criterion for the severity of TIA is its duration:
- For mild TIA, the duration of clinical manifestations is not more than 10 minutes.
- Duration of more than 10 minutes (up to a day) with the absence of organic symptoms after the disappearance of manifestations is considered to be moderate.
- The presence of organic symptoms after the disappearance of symptoms, together with a duration of several hours to a day, allows us to consider such an attack of severe TIA.
Prevention of the occurrence and relapse of TIA
- The abuse of tobacco and alcohol.
- Hypodynamia and overweight.
All these factors, one way or another, affect the ability of the vascular wall to change the lumen, which ultimately leads to the fact that at the time when the brain needs energy and oxygen as much as possible, the vessels cannot provide this need. Ischemia occurs.
- Timely treat diseases of the heart and blood vessels, primarily hypertension and atherosclerosis.
- Patients taking hormonal contraceptives are recommended to abandon this method of contraception. However, on the contrary, it is not recommended for women in the menopausal period to refuse to take estrogen-containing medicines.
- For the correction of the rheological properties of blood, it is considered justified long-term use of antiplatelet agents.
- Promising is also considered the dosed exposure of the patient to air with a low oxygen content. Such techniques can prepare the brain for a possible lack of oxygen during an attack, and, as a result, reduce the severity of the possible consequences of hypoxia.
In most cases, a transient ischemic attack has a mild course and does not leave behind any neurological disorders.
However, this condition requires a serious attitude and adequate treatment, since statistics indicate a rather high probability of developing a stroke within five years after the first TIA.
With this disease, you should not self-medicate, but you should undergo a full examination and be treated according to the results, because there are a lot of reasons predisposing to the development of TIA.
When detecting increased blood coagulability, anticoagulants and antiplatelet agents are prescribed. With elevated cholesterol, statins are prescribed. To improve blood circulation in the vessels of the brain, nootropic drugs are used in treatment, as well as intravenous drip infusion therapy.
A sharp decrease in blood pressure is unacceptable with its initially high numbers, as this can aggravate the signs of ischemic attack of the brain and cause a deterioration in well-being. If the patient revealed a pathological tortuosity of the neck vessels during the examination, which affects the blood supply to the brain, consultation with an angiosurgeon is necessary to resolve the issue of surgical treatment.
Prevention of ischemic circulatory disorders of the brain is to eliminate risk factors – the reasons why an ischemic attack can recur and lead to a stroke.
A complete rejection of nicotine and alcohol, a diet with a restriction of animal fats, fatty, fried, spicy, salty, smoked foods are necessary.
The diet should be enriched with plant foods, seafood, fiber. It is necessary to control the level of cholesterol, blood coagulation, blood glucose, body weight. Adequate physical activity must be ensured, a sedentary lifestyle is unacceptable.
Signs of aortic cerebral attack
A transient ischemic attack is a short-term but acute disorder that directly affects cerebral circulation.
This condition is characterized by certain signs that are associated with the appearance of neurological symptoms that can stop a maximum after a day. This clinical manifestation is dependent on the vascular pool, which has become a focus of reduced blood flow.
At home, it is very difficult to establish an accurate diagnosis, this requires a long diagnosis. The doctor needs an anamnesis and a complete neurological examination.
When a transient ischemic attack is detected, it must immediately be stopped.
As a rule, a person who has suffered from an ischemic attack must pass a number of tests without fail, undergo ultrasound examination. The most effective and accurate results will be those obtained after CT or MRI of the brain.
In order for the ischemic attack of the vessels of the brain to pass as completely as possible, one will have to follow certain treatment principles that are aimed at restoring the neurometabolic function of the body.
Various therapies can be supplemented by operations that subsequently ensure that repeated attacks, as well as stroke, are not possible.
Due to the fact that the base of a clinic such as TIA is nothing more than a neurological manifestation that has a temporary effect, most often a neurologist is not able to examine the patient in a timely manner. The fact is that before the consultation, the main symptomatology can simply disappear.
As practice shows, only a retrospective survey of the patient can help establish the correct diagnosis to the attending physician. In fact, an acute ischemic brain attack has a huge number of different manifestations. In practice, victims complain not only of cerebral symptoms, but also of focal.
A complete and fairly accurate picture of the clinic will depend on the location of the disorders that occurred in a particular individual in cerebral blood flow.
Usually, people notice instability during movement, severe dizziness, and the inability to clearly explain their condition (speech impairment). In addition, some have diplopia, visual impairment.
The general picture is supplemented by various suddenly arising motor or sensory abnormalities.
If there is a transient ischemic attack, the causes may lie in the carotid basin. Most often, the resulting condition affects sudden visual impairment. Some patients often complain even of total blindness that covers one eye. At the same time, problems with motor activity are noted, the patient’s sensitivity to the extremities increases, reaching seizures.
Transient blindness is not a rare symptom of TIA. It occurs in the area in which blood flows to the retina, at the locations of the ciliary and orbital arteries.
If we talk about the complete blindness of one eye, then it is usually short-term, arises due to the appearance of a “shutter”. In the future, the symptom may disappear completely, and there may also be a loss of vision of a certain area of the visual field.
Such a manifestation cannot be predicted, it can occur repeatedly. However, some patients complain of blindness, which periodically appears in one or the other part of the visual zone.
Transient blindness “covers” the patient at the same time as hemiparesis, problems with the limbs. Such symptoms, as a rule, indicate a violation that occurred in the carotid pool.
A transient transient ischemic attack can trigger global amnesia, as a result of which the patient will suddenly lose his memory. You can understand the patient’s condition by confusion, the constant repetition of the same, the occurrence of disorientation in their own housing or on the street.
The development of amnesia provokes pain or severe psychological and emotional overstrain, it most often lasts from half an hour to 2 to 3 hours. In all cases arising from the outcome of this symptomatology, memory returns to 100% of patients.
Paroxysms of memory loss can be repeated once for 5 to 7 years.
Symptoms and consequences of a transient ischemic attack are the same in many patients, which is why a physician almost always makes a complete diagnosis of the body.
To prescribe a certain type of therapy, you need to know the patient’s history, take into account family and genealogical predispositions of relatives and friends. After this, a neurological examination is carried out, various tests are performed (biochemical blood test).
Patients undergo a coagulogram and an ECG. Almost everyone is prescribed computed tomography or MRI.
To exclude other pathologies, patients are often referred for CT. A similar study aims to find out about the presence or absence of problems such as subdural hematoma or AVM. Computed tomography allows the early stages to reveal the development of ischemic stroke.
It is important to understand that in the event of problems in the carotid pool, diagnosis identifies problems in no more than 20% of cases.
As a rule, the most correct and complete visualization of foci can only be detected with MRI, and it is possible to specify ischemic zones more often after attacks that reoccur.
Positron emission tomography helps to find the answer as to what stage the patient is currently in ischemia, in addition, it helps to identify signs that contribute to the ability to restore blood flow.
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If a transient ischemic attack occurs, first aid should be provided only by medical specialists. At home, it will simply be impossible to alleviate the patient’s condition.
If, by a fluke, people were nearby, their main task is to immediately contact an ambulance.
The fact is that in the event of an emergency every minute can play a role, while the paramedic arriving on time through timely and competent actions will exclude the development of dangerous and unavoidable consequences.
The only thing you can help at home before the ambulance arrives is to put the victim on the bed, while raising his head slightly. It is quite important to ensure sound and moral peace without injuring or overloading the patient’s psyche.
Even a slight stress can worsen well-being. It is extremely important to worry about sanitary conditions, which would not require the patient to independently visit the toilet.
Irreversible consequences can be excluded by the most correct and simple actions, which in any case will affect the further outcome and development of the disease.
The therapy to which all victims of transient ischemic attacks are subjected is aimed solely at stopping the ischemic process.
The task of the attending physician in this situation is to normalize the blood supply as quickly as possible, as well as the metabolism of the site damaged by the disorder. In such a situation, it is preferable to choose hospitalization than treatment at home.
The first type of treatment for the patient gives many times more guarantees for a speedy recovery.
As a rule, in this case, treatment with anticoagulants is rarely chosen. More often, the patient undergoes antiplatelet therapy.
With this method of treatment, the main emphasis is on the use of “Acetylsalicylic acid” and “Dipyridamole.”
If embolic origin occurs, indirect anticoagulants are indicated to the patient. Most often, “Acenocumarol” and “Fenindion” are prescribed. If, in addition to everything else, it is necessary to achieve an improvement in blood rheology, a 10% glucose solution is needed.
To restore normal blood pressure in case of hypertension, antihypertensive drugs are used.
The indicated method of therapy in a transient ischemic attack, as a rule, does not exclude medications intended to improve cerebral blood flow, such as “Nicergoline”.
In addition to restoring all the damaged areas, the therapy of transient ischemic attack must necessarily do everything possible so that the incorrect metabolic phenomena that occur do not destroy the neurons.
There is neurometabolic therapy for this. Through another component that is part of the general therapy, you can get rid of additional negative symptoms, such as vomiting or headache.
The last effect on the patient’s body, who suffered from a transient ischemic attack, can be called physiotherapy, the patient will benefit from electric sleep, circular douche, therapeutic baths.
As a rule, the prevention of transient ischemic attack can be carried out only with the aim of eliminating the risk of its re-manifestation, and also because of the need to reduce the risks that affect the development of stroke.
As with any serious illness, it is important not to consume alcohol, not to smoke, to monitor blood pressure readings, and to eat a diet in food (exclusion of fatty foods). However, it is necessary to carry out therapy aimed at treating heart disease.
In addition, the patient is recommended to consume antiplatelet agents or lipid-lowering drugs.
A serious background to medicines can be preventive operations, which will exclude the pathology of cerebral vessels.
A transient ischemic attack is often the result of atherosclerosis, which is subject to cerebral intracerebral vessels.
The development of transient impaired blood flow to the brain is a dangerous harbinger. If it has at least once proved itself, it is possible that such attacks can be repeated, therefore, all measures must be taken to prevent them.
As for the possible outcomes, it is difficult to predict the condition of the patient. It is not known whether there will be more repeated ischemic attacks and how they will manifest themselves. Subject to all the doctor’s prescriptions, as well as lifestyle changes, the prognosis for TIA is quite favorable, and the risk of a second attack is minimal.
If you do not carry out preventive treatment and abuse your health, a transient disorder can lead to the development of a more severe pathology – cerebral infarction, which is much more difficult to cope with.
The most unfavorable prognosis is in those patients who suffer from malignant arterial hypertension and who have had a history of TIA episodes with a tendency to shorten the period of remission.
Attack severity criteria
There are three degrees of severity of TIA, it is they that indicate a positive or negative dynamics of the disease:
- mild – lasts about 10 minutes, focal symptoms that disappear without consequences;
- medium degree – lasts from 10 minutes or more, the attack proceeds without consequences for the patient’s health;
- severe – transient cerebral ischemic attack is delayed, and neurological signs are exacerbated.
According to ICD-10, a transient ischemic attack has a standard classification:
- TIA in VBB (vertebro-basilar basin);
- TIA in the carotid pool;
- TIA multiple or bilateral;
- transient blindness syndrome;
- TGA (transient global amnesia);
- unspecified TIA.
The variety and severity of local decrease in blood circulation in the head can be established only by a qualified medical professional.
Depending on the dynamics of the disease, 3 degrees of severity of transient ischemic attack are distinguished:
- Easy – focal neurological signs are present up to 10 minutes, pass on their own, no consequence remains.
- Moderate severity – signs last from 10 minutes to several hours, pass on their own or under the influence of therapy without consequences.
- Severe – neurological symptoms are present from several hours to 1 day, pass under the influence of specific therapy, but after an acute period, there are consequences in the form of minor neurological symptoms, which do not affect the quality of life, but are detected upon examination by a neurologist.
Depending on the frequency of attacks, they distinguish:
- rare TIA – no more than 1-2 times a year;
- with an average frequency of 3-6 times a year;
- frequent – 1 time for a month or more often.
The basis of the criteria for the severity of ischemic attacks is the necessary time for the full restoration of body functions. It is customary to distinguish between:
- mild – if the duration of the attack is up to ten minutes;
- moderate – duration from 10 minutes to several hours, in the absence of any residual effects after the attack;
- severe – the attack lasts from several hours to a day, mild organic symptoms are possible and subsequently.
Microembolas and atheromatous masses that form in the carotid and vertebral arteries (they are the result of the collapse of atherosclerotic plaques) with blood flow can move into vessels of smaller caliber, where they cause blockage of the arteries. Most often, the terminal cortical branches of arterial vessels suffer.
Atherosclerosis affects all blood vessels in the body, including the cerebral arteries, which leads to TIA or ischemic stroke.
These platelet and atheromatous masses are very soft in structure and therefore rapidly dissolve. After this, the spasm of the artery is eliminated and the blood flow in this area of the brain is normalized. All symptoms go away. Also, these microemboli can be of cardiogenic origin or be the result of problems in the blood coagulation system.
This process itself lasts only a few seconds or minutes, but pathological symptoms sometimes last up to 24 hours. This is due to edema of the vascular wall due to its irritation, which disappears several hours after the acute period.
But, unfortunately, the development of the disease is not always so favorable. If the dissolution of blood clots and vasospasm is not eliminated independently for 4-7 minutes, but in the neurons that are in hypoxia, irreversible changes occur and they die. A stroke develops. But, fortunately, such strokes have a relatively favorable prognosis, as they are never extensive.
Diagnosis of ischemic transient attack presents some difficulties. First, people do not always pay attention to the symptoms of the disorder, considering them to be a normal condition. Secondly, the differential diagnosis between ischemic stroke and TIA in the first hours presents very great difficulties, since the symptoms are very similar, and there may still be no changes on the tomography, as a rule, they are clearly visible only after 2-3 days from development pathology.
Dynamics of changes in MRI with ischemic stroke. In the case of TIA, no violations are found
For diagnosis, apply:
- a detailed objective examination of the patient, collecting complaints and studying the medical history, determining risk factors for the development of TIA;
- a full range of laboratory tests of blood and urine, which must necessarily include a lipid profile, a study of blood coagulation, a biochemical blood test;
- ECG and ultrasound of the heart to detect cardiopathology;
- Ultrasound of the vessels of the head and neck;
- magnetic resonance or computed tomography of the brain;
- blood pressure monitoring;
- other methods necessary for making a basic diagnosis.
If you follow the recommendations of the World Health Organization, then all patients with suspected TIA should be taken to a regional vascular center. The speed of the survey (within 24 hours) will significantly increase the chances of knowing the picture of general changes.
The list of procedures includes:
- MRI using diffusion-weighted images and gradient T2-weighted images;
- A CT scan is performed if it is not possible to do an MRI;
- ultrasound of the vessels of the head and neck, if there is a suspicion of a stroke;
- clinical examination of physiological parameters with blood tests;
- conducting an ECG.
Additional treatments include:
- blood coagulation test;
- biochemical blood tests.
Diagnostic criteria for transient ischemic attack are focused on the ABCD2 scale, which is widely used in Western Europe and the USA. Using it, you can predict the risk of stroke in patients who have had TIA.
Evaluation school is as follows:
- A – blood pressure indicators;
- In – age of the patient (more than 60 years);
- C – symptoms of the disease (general list of ailments);
- D – the duration of symptoms and diabetes in history.
This approach allows you to objectively evaluate both mild and more severe manifestations of ischemia.
A complete examination of the patient will allow differentiation of TIA from other diseases.
- Neurological disorders: migraines, focal cramps, brain tumor, subdural hematoma, hemorrhage, multiple sclerosis, myasthenia gravis, paralysis and narcolepsy.
- Somatic and mental disorders: hypoglycemia, Meniere’s disease, vestibular neuritis, syncope, orthostatic hypotension, hysteria, psychosomatic abnormalities.
There is a spectrum of significant signs, with the help of which it is more likely to talk about the correct differentiation of acute VBD from other diseases. These include:
- rotational dizziness;
- the degree of sensation of shakiness or stability in an upright position;
- problems with balance;
- the presence of cystic-gliotic changes in the head;
- the presence of atherosclerosis of the brachiocephalic arteries with stenosis exceeding 50%.
For TIA, the presence of several signs is characteristic, so the patient’s condition requires a qualitative analysis.
Diagnosis during an attack is complicated by its transience. But the causes of ischemic attack remain, therefore, it is necessary to determine them with the greatest accuracy. The following must be considered:
- similar symptoms occur with organic brain pathology (tumors, migraines, meningitis), therefore, all available diagnostic methods should be used;
- the patient has an increased risk of stroke;
- specialized hospitals of a neurological profile possess the most complete technical base; it is better to go through the examination in a hospital setting.
The survey plan should include:
- peripheral blood test;
- biochemical tests indicating the functioning of the liver and kidneys, the presence of tissue necrosis;
- lipid profile with the determination of the ratio of high and low density lipoproteins, triglycerides;
- detailed coagulogram to study coagulation processes;
- urine analysis to confirm liver and kidney function, to identify elements of inflammation, impaired permeability of the vascular wall;
- Dopplerography of the arteries of the neck and brain will allow you to determine the change in blood flow velocity, the initial stage of atherosclerosis, narrowed areas, volume formations from brain tissue and vascular origin (tumors, aneurysms);
- angiography of the vascular system of the cerebral arteries is used to identify the degree of circulatory disturbance, thrombosis, the development of the network of auxiliary vessels;
- an electroencephalogram allows you to distinguish the signs of vascular pathology from other organic brain lesions;
- an electrocardiogram helps to detect arrhythmias, myocardial diseases and impaired contractility of the heart.
Magnetic resonance imaging (MRI) and computed tomography are performed to exclude the connection of symptoms with tumors, the presence of a subshell hematoma
As a “mirror” of cerebral vessels, an ophthalmoscopic fundus picture is used, which is performed by an eye doctor.
For the correct diagnosis and treatment, the participation of several specialists is necessary, including a therapist, a neurologist, an ophthalmologist, and a cardiologist.
The main objective of therapeutic measures is the prevention of stroke. Therefore, it is required to start therapy in the early stages, without waiting for severe ischemic attacks and their recurrence.
Hospitalization is necessary for frequent attacks that violate the ability to work. If the examination is carried out and ischemic attacks are rare, treatment can be carried out at home under the supervision of the attending physician of the clinic.
- for blood thinning, such popular drugs as Aspirin, ThromboAss, Cardiomagnyl are recommended, if due to concomitant diseases of the stomach they are poorly tolerated, Ticlopedin is prescribed;
- in stationary conditions, Reopoliglukin is administered dropwise;
- statin drugs are widely used to lower blood cholesterol and delay the development of atherosclerosis, these include Atorvastatin, Simvastatin, Pravastatin;
- coronarolytics are used to relieve vascular spasm: Papaverine, nicotinic acid, Nikoverin;
- to drugs that restore the microcirculation of cerebral vessels include Cavinton, Vinpocetine;
- the preservation of neurons and their provision of additional energy for restoration are performed by nootropics (Piracetam, Nootropil, Cerebrolysin).
The drug coming from Germany requires caution in the use of patients with diseases of the kidneys, liver, diabetes
Recently, there has been a discussion about the appropriateness of using statins, since the craze and hopes turned into complications in the form of a disturbed psyche. Women are especially prone to them. Therefore, the appointment is considered justified if a two-month strict diet did not lead to normalization of cholesterol levels in the blood. And with a normal lipoprotein content, there is no need to use them.
It is necessary to control the level of blood pressure and take drugs for hypertension, according to indications – diuretics. Patients with diabetes mellitus cannot get rid of transient attacks without maintaining normal blood glucose levels using sugar-lowering drugs.
If the initial phenomena of thrombosis are detected under stationary conditions, fibrinolytic therapy is carried out in an attempt to dissolve and remove thrombosis.
Another article: Consequences of a second stroke
- in the presence of a connection of ischemic attacks with cervical osteochondrosis, electrophoresis is prescribed with drugs that relieve muscle spasm, careful massage of the collar zone, Darsonval currents on the head;
- oxygen, coniferous, radon baths have a good relaxing effect, it is better to conduct them in courses in sanatorium conditions;
- physiotherapy exercises helps to restore impaired blood circulation, develop a network of auxiliary vessels.
Factors directly increasing the likelihood of TIA
A transient ischemic attack is one of the types of transient disturbance of the blood circulation of the brain, in which a small branch, through which a certain part of the brain is fed, temporarily stops passing blood. In this case, irreversible consequences (that is, necrotic changes) in the “subordinate” area should not have time to arise (then this will be called a stroke).
After a microstroke, in most cases a person develops a stroke: 1/5 of those who survived the attack – during the first month after it, almost 45% – during the first year. There is an opinion of scientists that ischemic attacks are a kind of training before a stroke – they make it possible to form additional vascular branches. Strokes transferred without preliminary TIA were characterized by a more severe course.
Difference from stroke
The main and only difference between TIA and stroke is that during an attack, a section of a heart attack does not have time to form in the brain; only microscopic damage to the brain tissue appears, which in itself does not affect the functioning of a person.
In an ischemic attack for a short time, the vessel that feeds some part of the brain turns out to be impassable (a spasm occurs in it or it is temporarily blocked by a thrombus or embolus). The body includes its own compensatory mechanisms: it tries to expand blood vessels, increases blood flow to the brain. Then, when the pressure in the vessels of the brain is already at its lower boundary, the blood flow in the brain begins to decrease, which leads to a decrease in the level of oxygen exchange, and neurons begin to receive energy due to anaerobic glycolysis.
4 How to help a person with transient ischemic attack?
The main functional centers of the brain
A person has the ability to feel, think, move, experience emotions, see, hear thanks to the work of the brain. The brain consists of two hemispheres, a trunk and a cerebellum. All vital centers (respiratory, vasomotor and others) are concentrated in the brain stem. The cerebellum is responsible for balance, muscle tone and coordination.
The cerebral cortex is a collection of billions of nerve cells in which the analysis and synthesis of all the signals entering the brain, the processing of information, the organization of the activity of all organs and systems. The frontal lobe of the cortex is responsible for motor behavior, the organization of voluntary movements, logic, and speech. Centers of vision are located in the occipital zone, visual images are recognized and analyzed here.
Cessation or reduction of blood flow in the vessels of the brain
But, situations arise when the blood flow in the vessels of the brain can decrease or even stop completely. Neurons begin to experience oxygen “hunger”, brain cells are still alive, but cannot fully function, for this reason ischemia develops. This phenomenon in neurology is called “transient ischemic attack.”
If you suspect that a person has symptoms of transient cerebral ischemia, you must immediately call an ambulance. Clearly and clearly inform the ambulance dispatcher about your suspicions and what symptoms you are observing. Before the ambulance arrives, provide the patient with a horizontal position, create an influx of fresh air.
If the patient has vomiting, turn his head on his side and hold it in such a position with vomiting, so that he does not choke on the vomit. Measure your blood pressure and pulse, record data and show your doctor an ambulance. Please specify if the patient is conscious of what he was sick with and what medications he was taking, what reasons could cause a deterioration in well-being, also tell this information to the doctor.
You should not give the patient either drink or food, since he has a likelihood of dysfunction of swallowing, which may cause suffocation. Remember that the effectiveness of further treatment depends on how quickly and clearly you provide first aid, the patient’s life.
2 Why does a transient ischemic attack occur?
What are the causes of cessation of blood flow in the cerebral vessels? Their spasm or blockage (partial or complete). A transient ischemic attack often develops due to vascular atherosclerosis. Atherosclerosis is the most common cause of cerebrovascular accident. Atherosclerosis is the deposition in the vessels of plaques of “bad” cholesterol, triglycerides. These plaques, growing, are able to clog the vessel, then thrombosis occurs, or even can come off with the development of embolism.
In addition to atherosclerosis, the following causes of transient ischemia are distinguished:
- arterial hypertension
- vascular wall inflammation (endarteritis)
- heart disease (arrhythmias, coronary heart disease, cardiomyopathy)
- endocrine diseases
- pathological tortuosity of blood vessels
- osteochondrosis of the cervical spine.
Transient ischemic attack and stroke (comparison)
In these diseases, due to the formation of a blood clot or narrowing of the vessel, cerebral ischemia may develop due to starvation of neurons in conditions of oxygen deficiency. If in the next 5-10 minutes the blood flow in the vessel is restored, then the brain cells will not have time to die, and their structure and functions will be restored, if not restored, the consequences are irreversible: the cells die.
A transient ischemic attack turns into an ischemic stroke, the neurological symptoms of which are constant. It follows that a transient ischemic attack is a temporary violation of cerebral circulation, which has two outcomes: recovery (restoration of neurons and the complete disappearance of neurological symptoms) or transition to ischemic stroke (death of neurons and aggravation of neurological symptoms).
Symptoms of cerebral ischemia are more characteristic for people who are overweight, smokers, alcohol abusers, leading a sedentary lifestyle. These are the so-called risk factors, which, together with provoking diseases, cause ischemic circulatory disorders in the brain.
Transient ischemic attack – home treatment
Symptoms of pathology depend on the localization of abnormal processes. This condition occurs suddenly and can lead to dangerous consequences.
Many people are interested in the treatment of transient ischemic attack at home.
A progressive form of the atherosclerotic process. In this case, vasoconstriction, cholesterol deposits and atheromatous plaques are observed. As a result, pathological elements can enter the small vessels, which leads to thrombosis. This causes ischemia and the formation of microscopic necrotic foci in the tissues.
- Thromboembolism. Various pathologies of the heart lead to their appearance – valvular defects, arrhythmia, heart attack, etc.
- Arterial hypotension, which occurs suddenly. She can accompany Takayasu’s disease.
- Buerger’s disease. This term refers to obliterating endarteritis.
- Cervical osteochondrosis. This disease is accompanied by compression and angiospasm, which provokes vertebrobasilar insufficiency.
- Coagulopathy, blood loss, angiopathy. In this case, microembolas move with blood flow and can stop in small vessels. As a result, ischemia develops.
In addition, diseases such as diabetes mellitus, arterial hypertension, cholesterolemia can become provocative factors. Often the cause is bad habits, lack of movement, the presence of excess weight.
This pathology can have different symptoms, which depend on the area of localization of the damage.
violation of coordination of movements;
- paresis that affects certain muscles or part of the body;
- speech impairment;
- decreased visual acuity, darkening in the eyes;
- loss of sensitivity of the skin, half of the body or limbs;
- slurred speech and difficulty in choosing words;
- difficulty in recognizing body parts;
- strange movements.
If transient ischemia manifests itself in the vertebral-basilar basin, a different clinical picture is observed.
This pathology is accompanied by such symptoms:
- headaches that are mainly localized in the neck;
- memory impairment;
- problems with coordination of movements;
- sharp deterioration in hearing, vision, speech;
- paresis and loss of sensation – most often some part of the face goes numb.
- loss of sensation in the limbs or other parts of the body;
- impaired gait or coordination of movements;
- paralysis of the trunk, limb or nerve;
- loss of skin sensitivity;
- speech impairment;
- double vision in the eyes;
- loss of hearing and vision – it can be full or partial.
It is impossible to cope with a microstroke at home. Therefore, when its symptoms appear, you need to immediately call an ambulance. In this state, time plays a big role. Due to timely action, dangerous consequences can be prevented.
First aid to the patient should be provided immediately. For this person should be put to bed and raise his head slightly. Equally important is ensuring complete peace – sound and moral.
Any tension can lead to poor health. Be sure to create the right sanitary conditions so that a person does not have to get up to the toilet.
- With the strict implementation of these recommendations, it will be possible to avoid complications that may affect further life after a transient ischemic attack.
Therapy of cerebral circulation should be carried out in a special neurological department. It should be aimed at eliminating seizures and preventing stroke.
Treatment consists in restoring blood circulation and eliminating the consequences of pathology.
To cope with the disease, antihypertensive drugs are selected. Drugs are also needed to improve the blood coagulation system.
To do this, use the following tools:
- Antihypertensive drugs – contribute to the normalization of pressure. These include such drugs as Labetalol, Clonidine.
- Medicines to restore blood circulation and normalize metabolic processes in the brain. This category includes substances such as Vinpocetine and Cavinton.
- Drugs to improve the elasticity of red blood cells and reduce blood viscosity. These include Reosorbilact, Trental.
- Statins – used to normalize blood cholesterol. Such funds can be used if the diet does not help to reduce this indicator.
- Means for maintaining the tone of the cerebral vessels. This group includes Venorutin, Troxevasin.
A week after the attack, procedures are prescribed to restore the patient’s condition. Rehabilitation after a transient ischemic attack includes special massages and therapeutic exercises. Also, the patient may need to consult a psychologist and speech therapist.
- biologically active additives;
- fish fat;
- the use of iodized products – in particular, seaweed;
- medicinal sweet clover;
- alcohol tincture of nutmeg.
Use of alternative methods of treatment is permissible only after consulting a doctor and conducting adequate drug therapy.
If, with the appearance of the first symptoms of a transient ischemic attack, it was possible to provide the patient with qualified help, the reverse development of the abnormal process is possible. In such a situation, the patient may return to his usual lifestyle.
In some cases, pathology can lead to ischemic stroke. In such a situation, the forecast worsens significantly. Sometimes even death occurs.
The risk group includes people who suffer from diabetes, hypertension or atherosclerosis. The same applies to patients with bad habits.
- take medicines for hypertension;
- take drugs that help cope with the formation of cholesterol plaques;
- Control sugar levels for those with diabetes
- take aspirin to prevent blood stasis;
- perform surgical intervention for blockage of the carotid arteries.
Transient ischemic attack is a serious pathology that can cause dangerous consequences.
In order to prevent the development of complications, you should consult a doctor in time, who will select effective medicines. As an addition to standard therapy, alternative recipes can be used.
Complications and consequences
With a quick response to symptoms and timely treatment, a person returns to normal life after a short period of time. The consequence of a transient ischemic attack, not treated in a timely manner, is an ischemic stroke, which develops in half of all people who have had the disease. As a result, persistent neurological defects are formed:
- paralysis – impaired limb movement;
- memory loss, loss of cognitive abilities;
- depression, distraction, irritability;
- slurred speech.
In some cases, the prognosis is disappointing, leading to disability, and sometimes death.
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The complex effect of plant components of the drug Detonic on the walls of blood vessels and the autonomic nervous system contribute to a rapid decrease in blood pressure. In addition, this drug prevents the development of atherosclerosis, thanks to the unique components that are involved in the synthesis of lecithin, an amino acid that regulates cholesterol metabolism and prevents the formation of atherosclerotic plaques.
Detonic not addictive and withdrawal syndrome, since all components of the product are natural.
Detailed information about Detonic is located on the manufacturer’s page.