Discirculatory encephalopathy of the 2nd degree of complex origin

Without proper treatment and follow-up of patients, disease progression and the following complications are possible:

  • Cerebral hemorrhage and stroke;
  • Cerebral edema;
  • Heart attack;
  • Dementia.
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Disability

To date, disability is assigned in the case when the patient becomes unable to perform work duties due to the diagnosis “discirculatory encephalopathy”.

The possibility of disability in a DEP of 1 degree is low.

In case of DEP of the 2nd degree of the disease, patients are awarded the 3rd disability group, if they are able to partially fulfill labor obligations.

The second group is awarded at both 2 and 3 degrees of DEP – in this option, patients have periodic memory lapses. They cannot perform professional duties in any volume.

The first group of disability can only be assigned in case of a degree 3 DEP, which indicates the great danger of this form.

The above items are reflected in the Federal Law of the Russian Federation “On Social Protection of Persons with Disabilities”. The assignment of a certain group is carried out after passing a medical examination.

How many live

How long can I live with a problem? The diagnosis of DEP is far from a sentence for patients. Competent treatment initiated in a timely manner can slow the progression of the pathology of cerebral impairment for decades.

If you ignore the symptoms of the disease, the transition to the next stage occurs approximately after 18-24 months.

Discirculatory encephalopathy is divided into 4 degrees, each of them corresponds to certain signs:

    Stage I – characterized by small organic abnormalities of the brain. Most often found in children or young people. It can be confused with signs of other diseases and complications.
    The first degree of discirculatory encephalopathy is characterized by the following symptoms:
  • Fast fatiguability;
  • Irritability;
  • Bad mood;
  • Headache;
  • Memory impairment;
  • Noises in the head;
  • Dizziness;
  • Anxious sleep
  • Migraine;
  • Memory impairment
    The causes of DEP 1 degree are:
  • Inferior sleep;
  • Improper nutrition;
  • Minimal physical activity;
  • Bad ecology.
  • Stage II is a neurological disease that is very common among the elderly. The disease progresses rather slowly, but if you ignore its development, it can lead to a stroke and disability, but still, the patient will be able to take care of himself.
    The main difference between DEP 2 degrees from 1 are well-defined symptoms.
    The second stage of discirculatory encephalopathy is clearly expressed by such signs:
    • Distraction;
    • Bad memory, down to failures in it;
    • Inability to control their actions;
    • Frequent irritability;
    • The state of depression and antipathy to everything;
    • Lethargy;
    • Decreased activity;
    • Loss of interest in life;
    • Emotional and mental problems;
    • Sclerosis;
    • Inattention.

    When the disease is already actively progressing, and the patient deliberately delays the trip to the doctor, or does not take the recommended drugs, you need to know how this can turn out:

    1. For starters, this is the degradation of a person as a person, because the functioning of the brain is deteriorating.
    2. Quite often, people become disabled with a grade 2 DEP due to possible complications.
    3. Death can also occur.

    With timely treatment of stage 2 DEP, it can slow down or stop its development. Cases of regression of signs of the disease are possible. If DEP responds well to therapy, this is a sign that the patient will be able to live a full life for a long time.

    An adverse sign is the presence of demyelinating and neurodegenerative diseases in addition to DEP. They exacerbate the course of DEP, reduce the effectiveness of treatment.

    The appearance of ischemic attacks, hypertensive crises, decompensation of diabetes mellitus are also unfavorable prognostic signs promising the rapid development of the disease.

    • Stage I – characterized by small organic abnormalities of the brain. Most often found in children or young people. It can be confused with signs of other diseases and complications.
      The first degree of discirculatory encephalopathy is characterized by the following symptoms:
  • Stage II is a neurological disease that is very common among the elderly. The disease progresses rather slowly, but if you ignore its development, it can lead to a stroke and disability, but still, the patient will be able to take care of himself.
    The main difference between DEP 2 degrees from 1 are well-defined symptoms.
    The second stage of discirculatory encephalopathy is clearly expressed by such signs:
    • Distraction;
    • Bad memory, down to failures in it;
    • Inability to control their actions;
    • Frequent irritability;
    • The state of depression and antipathy to everything;
    • Lethargy;
    • Decreased activity;
    • Loss of interest in life;
    • Emotional and mental problems;
    • Sclerosis;
    • Inattention.
    1. For starters, this is the degradation of a person as a person, because the functioning of the brain is deteriorating.
    2. Quite often, people become disabled with a grade 2 DEP due to possible complications.
    3. Death can also occur.

    You need to know that people who suffer from this disease live long enough, but in the case of constant control over this disease.

  • If you discover the disease in time at the initial stage, you can recover from the disease or suspend it for a long time.
  • The prognosis in the early stages is favorable, but in the more advanced stages, the prognosis for DEP is not very good. Since the patient cannot fully recover and the ego, social skills to serve himself completely disappear.
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    As mentioned above, with a grade 2 DEP, disability of groups 2 or 3 is possible. But this is not a sentence, since there is an opportunity to stop the progression of the disease and establish normal life activities.

    Doctors say that a degree 2 DEP can be slowed down for 5 years or even decades.

    But it is worth remembering that if you ignore the symptoms or delay the trip to the doctor, you can cause serious complications or transfer your disease to the last, 3 stage.

    Among the most serious consequences are:

    • strokes
    • cerebral edema;
    • blockage of blood vessels of the brain and related diseases.

    Two main classifications are applied: by degree and by the main reason, if it is clarified.

    The first degree is minor changes in behavior: aggressiveness, forgetfulness, mood changes, “leaps of thoughts” – inconsistent thinking.

    The second degree is more pronounced changes in behavior. To the above, sharp fluctuations in mood, sleep disturbance, bad dreams, decreased intelligence, and sometimes minor hallucinations will be added. In addition to mental disorders, problems of movements also appear: tremor, ataxia (impaired coordination), unsteady gait.

    The third degree is the most severe manifestations. A significant decrease in intelligence, the inability to perform basic personal care activities.

    Forms (due to occurrence):

    • atherosclerotic;
    • arterial hypertensive;
    • phlebotic (vein pathology);
    • combined (several factors).

    If possible, identify the root cause, the doctor indicates it in the diagnosis and selects the appropriate treatment. So, with atherosclerosis, lipid-lowering drugs are prescribed, with hypertension, they lower blood pressure. Usually these two forms complement each other.

    With proper treatment of all concomitant diseases, the prognosis is favorable. People can live with degree 2 discirculatory encephalopathy for decades. Possible complications are acute cerebrovascular accidents (strokes and transient ischemic attacks).

    Disability risk

    Gradually developing mental and neurological disorders lead to the fact that with the developed third degree, patients completely lose their ability to think coherently, lose interest not only in their previous hobbies, but also in their relatives and themselves.

    Due to severe mental disorders, patients are not able to perform domestic activities and lose their ability to self-service.

    A shaky gait often leads to the fact that patients fall when walking, which, given the old age, is fraught with long-term healing injuries. Other neurological disorders – loss of control of the pelvic organs – make the patient unable to keep himself clean without outside help.

    Such changes do not develop immediately even with a galloping form, but the progression of the disease in most cases leads to just such consequences.

    DEP treatment should always be comprehensive.

    • Affect the cause of the violation;
    • Reduce the influence of harmful factors on the vessels of the brain;
    • Ensure the highest possible blood flow, as far as the primary disease allows;
    • Relieve symptoms by allowing the patient to feel like a full-fledged person.

    An obligatory component of the treatment of DEP should be a regimen of the day that is convenient for the patient, but strictly observed. It is also important that the patient is constantly engaged in some kind of mental activity, but always one that he can do.

    Insufficient mental load does not have a therapeutic effect, but too complex – undermines the patient’s confidence in their abilities, and instead of a therapeutic effect renders the opposite.

    First of all, drugs are used that affect the underlying disease that caused DEP.

    In addition to them, drugs are prescribed that improve hemodynamics in the vessels of the brain, these are:

    1. calcium channel blockers;
    2. phosphodiesterase inhibitors;
    3. antiplatelet agents that prevent red blood cells from sticking and clogging blood vessels.

    In addition, drugs will be prescribed that increase the ability of neurons to absorb nutrients and function.

    This is first of all:

    1. nootropics;
    2. derivatives of GABA (amino acid, which acts as a neurotransmitter);
    3. some drugs that stabilize the membranes of neurons that do not allow the development of foci of leukoaraiosis.

    Additionally, general strengthening drugs are prescribed. and vitamin complexes. If the disease is caused by a violation of the structure of blood vessels, then the most effective treatment is surgical.

    The diet for DEP includes the same limitations that the disease that caused encephalopathy imposes.

    1. It is recommended to consume more marine fish and seafood rich in phosphorus.
    2. Do not deny yourself sweets, as far as the diet prescribed to combat the underlying disease allows.
    3. Coffee, strong tea and energy are not recommended, alcohol is strictly contraindicated.
    4. It is necessary to refuse smoking.

    In the second stage of the disease, many people may already be given disabilities.

    Vascular diseases, especially in situations when they affect the brain, are dangerous with complications, up to dementia and stroke. It is important to track the onset of the first alarming symptoms in time and begin qualified treatment at an early stage under the supervision of a doctor.

    Definition of DEP – what is it? This diagnosis of discirculatory encephalopathy (DEP) is made when multiple changes in brain tissue are detected due to chronic cerebrovascular accident.

    Researchers have found out what conditions affect the development of discirculatory encephalopathy.

    There are several categories:

    • Causes associated with genetic disorders that cause circulatory disorders in the brain.
    • Causes after birth. They are associated with violations of the integrity of brain tissue due to trauma or diseases of the nervous system.

    It is proved that atherosclerotic, inflammatory changes in the vessels, infringement of the vessels by the vertebrae in case of osteochondrosis of the upper spine are primarily accelerators in the onset of a grade 1 DEP.

    Indirectly negatively affects smoking, alcoholism, overeating, a sedentary lifestyle – all this leads to an increase in bad cholesterol, blockage of blood vessels and thrombosis, including in the brain.

    In diabetes mellitus, changes also occur in the vessels of the whole organism – therefore, this syndrome is also attributed to predisposing factors for the development of DEP.

    Discirculatory encephalopathy alone is not a reason for attributing disability. At the same time, it usually proceeds with other diseases in which they can assign disability, or be complicated by such diseases.

    Features DEP 2 degrees

    • Most often, second-degree discirculatory encephalopathy affects people who are from 35 to 60 years old, but who are not yet retired.
    • Especially this disease develops in a population whose work is closely related to active brain activity.
    • Very often people who suffer from alcohol dependence, diabetes mellitus, as well as diseases of the neurological system are prone to this disease.
    • Namely, degree 2 dyscirculatory encephalopathy is a fairly common disease of mixed origin, which occurs in 75% of all cases of the disease.
    • DEP of the 2nd degree of complex genesis is a form of the disease that has several causes. Often it occurs when the oxygen content in the atmosphere decreases.

    It is characterized by symptoms such as:

    • Headache;
    • Dizziness;
    • Memory loss;
    • Increase in pressure.

    DEP 2 degrees – classification

    DEP of the 2nd degree is classified into such species that have their own clinical picture and specifics of passage:

      Hypertensive type of circulatory encephalopathy, often appears in young people, the disease is quick and quite acute. This species is characterized by frequent bouts of hypertensive crisis.
      The main symptoms are:
    • Violation of neuropsychological processes;
    • Inhibited reaction;
    • Frequent mood changes.
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  • A very common type of discirculatory encephalopathy is atherosclerotic discirculatory encephalopathy. The cause of this type of disease is cerebral arteriosclerosis. Further development of the disease leads to problems with blood flow, as well as impaired brain function.
    There are many factors for the appearance of the disease, they are divided into groups:
    1. The first group is associated with deviations that occurred even at birth. Most often disturb the blood supply to the brain;
    2. The second group is associated with previous neurological diseases, as well as head injuries.
  • Venous DEP of the 2nd degree develops in connection with impaired outflow of venous blood. This leads to an accumulation of blood in the veins.

    The main syndromes of DEP of the 2nd degree are noted:

    • Cephalgic syndrome. Often expressed in headaches, vomiting, and tinnitus. This type includes all the unpleasant sensations that are associated with the head;
    • Astheno-neurotic syndrome is characterized by frequent mood swings, dizziness, constant pain in the head. With this type of disease, a person becomes very crying, apathetic to everything, and also have a bad mood;
    • Vestibular coordinating disorders include frequent dizziness, problems with coordination, instability when walking;
    • Dissominal syndrome is characterized by impaired full sleep;
    • Cognitive syndrome includes significant impaired memory, as well as distraction and concentration.
    • Hypertensive type of circulatory encephalopathy, often appears in young people, the disease is quick and quite acute. This species is characterized by frequent bouts of hypertensive crisis.
      The main symptoms are:
  • A very common type of discirculatory encephalopathy is atherosclerotic discirculatory encephalopathy. The cause of this type of disease is cerebral arteriosclerosis. Further development of the disease leads to problems with blood flow, as well as impaired brain function.
    There are many factors for the appearance of the disease, they are divided into groups:
    1. The first group is associated with deviations that occurred even at birth. Most often disturb the blood supply to the brain;
    2. The second group is associated with previous neurological diseases, as well as head injuries.

    Recommendations for the disease, diet, what can not be done?

    For the prevention of discirculatory encephalopathy, you need to do physical exercises, gymnastics, lead an active lifestyle, and also adhere to a diet. Most doctors decided that a low-calorie diet affects the patient’s condition and well-being quite well.

    The term “discirculatory” in Latin means “associated with a violation of blood circulation.” Small arteries of the brain are involved in the development of the disease – the vessels through which blood flows to the brain.

    “Encephalopathy” in Latin translates as “brain disease”. Violation of blood flow leads to poor nutrition of neurons. By receiving less oxygen and nutrients, cells begin to work less efficiently.

    There are many reasons for the development of pathology of small arteries:

    • arterial hypertension (hypertension), which lasts a long time;
    • atherosclerosis common and vessels of the head;
    • violation of the outflow of venous blood from the brain;
    • systemic vasculitis (common inflammatory diseases of the blood vessels);
    • systemic connective tissue diseases (e.g., systemic lupus erythematosus);
    • diabetes mellitus and other endocrine disorders;
    • smoking;
    • heredity and other reasons.

    The same reasons are risk factors for the development of DEP or its deterioration. The main risks are smoking, alcohol, overweight, and an inactive lifestyle. They can be fought and eliminated, preventing the occurrence of encephalopathy.

    The main reason with an incompletely clarified influence is age. DEP is a disease that almost always affects the elderly.

    As a result of a decrease in blood supply to the brain for the above reasons, hypoxia occurs – a chronic lack of oxygen in the brain cells. In conditions of oxygen starvation, especially sensitive nerve cells of the brain die, and in their place there remain foci of rarefaction – voids in essence, they are called silent heart attacks.

    First of all, white matter cells and subcortical cells die. Connections between different parts of the brain are broken and gradually disappear, which is why disorders of thinking, memory, and emotional stability begin. Then the structures responsible for the coordination of movements change.

    Thus, vascular insufficiency is the cause of the death of brain cells and the destruction of neural connections.

    As a result, a persistent neurological disorder develops – discirculatory encephalopathy.

    Symptoms of discirculatory encephalopathy

    Grade 1 circulatory encephalopathy is a disease associated with poor functioning of the blood circulation of the brain, which in turn can lead to .

    It is sometimes very difficult to identify the symptoms of a grade 2 DEP, as they may also be characteristic of other diseases associated with impaired blood circulation or the brain.

    The main features include:

    • memory problems;
    • nausea;
    • vomiting;
    • dizziness;
    • loss of consciousness;
    • sclerosis;
    • loss of coordination;
    • decreased concentration, problems with thinking;
    • nervousness;
    • mental or emotional disabilities;
    • varicose veins in the fundus.

    The main syndromes of DEP of 2 degrees are distinguished:

    1. Cephalgic syndrome, which manifests itself in headaches, vomiting, and tinnitus.
    2. Dissominal syndrome includes various kinds of problems associated with sleep disturbance.
    3. Vistibularly-coordinating syndrome, it, in turn, concerns problems that are associated with the position of the body in space, when walking, dizziness and with coordination in general.
    4. Cognitive syndrome, which includes problems with memory, thinking, concentration and much more.

    It is worth mentioning that these symptoms of degree 2 dyscirculatory encephalopathy appear late in the evening, due to the moral and physical stresses that the body was exposed to during the day.

    The treatment of grade 2 DEP appears to be much more complicated than degree 1, but when compared with stage 3 dyscirculatory encephalopathy, it is still possible.

    It is most difficult to cure a degree 3 DEP and the treatment in this case is very complex and ineffective.

    In this disease, a large number of drugs are prescribed that help lower blood pressure, strengthen and protect blood vessels, improve blood flow to the brain, and resume memory and thinking.

    The treatment of this disease is primarily medical, but it can be accompanied by other methods.

    So the main methods of treatment of discirculatory encephalopathy of the 2nd degree are:

    • dieting;
    • rejection of bad habits;
    • physiotherapy;
    • therapeutic exercises;
    • acupuncture;
    • therapeutic massages;
    • pressure reduction;
    • improvement of normal blood circulation;
    • reflexology.

    The manifestations of discirculatory encephalopathy of the 2nd degree are nonspecific. There are no particular manifestations that are found only in DEP.

    Symptoms develop gradually. One of the problems of diagnosis is the weak severity of symptoms at the beginning and, usually, slow worsening. Often, relatives of patients explain unusual strange behavior by the elderly. It turns out that the disease, if diagnosed, is in the later stages, where treatment will not improve the condition.

    Symptoms of discirculatory encephalopathy of 2 degrees are divided into:

    Also, signs of DEP often include similar manifestations of concomitant diseases.

    Common include dizziness, headache, general weakness, tinnitus, “flashing flies” and “veil” before the eyes, nausea (rarely – vomiting).

    Cognitive changes mainly affect the emotional sphere, intelligence and memory. The combination of such disorders further exacerbates the manifestations of pathology. So, the patient becomes aggressive towards others, forgetful. The habitual logical thinking, ability to draw conclusions is broken. Unreasonable fears often appear that interfere with life both for the patient and for those around him.

    Movement disorders relate to coordination, the accuracy of small movements. Shakiness of gait, small tremor of fingers, facial muscles appears. The strength of the limbs decreases, the amplitude of the joints decreases. The restriction of physical activity adversely affects the development of the disease, worsening its course.

    DEP usually causes uniform changes in the entire substance of the brain. But focal lesions of specific areas will cause exact symptoms.

    So, changes in the area of ​​the precentral gyrus on the one hand will cause a violation of conscious movements on the opposite side. Ischemia (lack of blood flow) in the visual cortex will cause visual impairment, and so on.

    Grade 2 circulatory encephalopathy is an irreversible change in the vessels of the brain, but with the help of treatment it is possible to stop the development of pathology and prevent its complications.

    Medicines should be used to treat the underlying cause. If the patient has arterial hypertension, antihypertensive agents are needed that can reduce pressure and maintain it at a normal level – no more than 130/90 mm Hg.

    Anticholesterolemic drugs will lower blood cholesterol and lipoproteins, thereby stopping the development of atherosclerosis and help plaques decrease. Mandatory treatment of concomitant diabetes mellitus, if any.

    Often prescribed by neurologists, “vascular” drugs, nootropics, and metabolites do not have proven effectiveness, so modern medicine does not recommend their use.

    diet therapy

    Proper nutrition is important not only for the treatment of DEP, but also to prevent it. There are no nutritional features. It should be full, constant, contain less fatty, fried food. We need rehydration – the constant drinking of fluids in age quantities, taking into account other diseases.

    Folk remedies

    For the treatment of stage 2 DEP, there is a simple folk recipe that is suitable for people living in clover growth regions. The dried leaves are placed in a jar, filling it by a third. The remaining volume is hot water, but not boiling water. Drink tincture no more than one tablespoon after 3 days of infusion.

    With a second-degree DEP:

    1. First of all, mental disorders are noticeable:
      • The patient’s ability to focus is impaired, memory is reduced, fatigue during mental work occurs faster.
      • Since the ability to critical thinking is reduced, the patient does not consider himself sick and often overestimates his abilities.
      • Indications that the mental work that used to be feasible for him now causes quick fatigue are stubbornly ignored.
    2. Over time, the patient undergoes such changes as:
      • Higher mental functions are also violated – generalization and goal-setting.
      • There are emotional disorders – apathy, depression, in some cases an aggressive disposition to others is possible.
      • There is a complete loss of interest in past hobbies, indifference to events around the world.
    3. Movement disorders were called lower Parkinsonism, because the gait of patients with DEP is similar to the gait of those suffering from Parkinson’s disease – they take slow, shallow, shuffling steps, while having difficulty starting and ending the movement. But, unlike Parkinson’s disease, with DEP, there is no characteristic tremor of the hands (“counting coins”). The gait of patients is very unstable, they can easily fall when walking. Read about the first signs of Parkinson’s disease here.
    4. In severe cases, episodic incontinence of urine and feces, epileptic seizures are noted. Diseases are most often affected by older people, so serious injuries can turn out to be consequences of motor disorders.

    DEP treatment should always be comprehensive.

    Preparations

    In addition to them, drugs are prescribed that improve hemodynamics in the vessels of the brain, these are:

    1. calcium channel blockers;
    2. phosphodiesterase inhibitors;
    3. antiplatelet agents that prevent red blood cells from sticking and clogging blood vessels.

    Additionally, general strengthening drugs, and vitamin complexes are prescribed. If the disease is caused by a violation of the structure of blood vessels, then the most effective treatment is surgical.

    The described disease gradually progresses over time. For a degree 2 DEP, an increase in the brightness of symptoms is characteristic. Patients and their loved ones notice a deterioration in memory and intelligence, cease to cope fully with work. Even at the household level, problems appear. For long hours, such patients can sit or lie idle without showing any interest. The mood becomes apathetic.

    The complexity of the diagnosis is that a degree 2 DEP is problematic to differentiate from a degree 3 DEP.

    In the second degree of development of DEP, treatment is aimed primarily at restoring normal blood supply to the brain and preventing the development of possible complications. Therapy of the disease includes:

    • Nootropic drugs that improve memory and mental activity;
    • Drugs that normalize blood pressure;
    • Blood viscosity lowering agents for the prevention of vascular thrombosis;
    • Medicines that reduce the content of low density lipoproteins in the blood involved in the formation of atherosclerotic plaques in blood vessels.

    IMPORTANT! Medicines should be prescribed exclusively by a doctor! The necessary course of treatment is selected individually by a neurologist. All appointments depend on the state of health and the presence of concomitant diseases.

    Therapeutic and preventive diet, which involves reducing the use of foods with high fat content and low salt content:

    • Decrease in the consumption of meat, all fried, smoked;
    • Regular use of low-fat fish and other seafood in the diet;
    • Daily use of fresh vegetables, fruits;
    • Nuts and dried fruits;
    • Dairy products;
    • Cereal;
    • As well as smoking cessation and alcohol abuse;
    • Physiotherapy.
    • Baths that contribute to the expansion of blood vessels – for example, radon or carbon dioxide;
    • Therapeutic massage of the collar zone helps relieve tension from the cervical spine and vasospasm;
    • Collar zone galvanotherapy – the procedure helps to normalize blood circulation;
    • Ultra-high-frequency therapy (UHF) – is aimed at increasing blood flow velocity, accelerating the delivery of oxygen and nutrients to tissues, has an anti-inflammatory effect;
    • Electrosleep – the essence of the technique is to stimulate low-frequency currents of the white and gray matter of the brain, therapy helps to relax, improve the formation of new neural connections;
    • Treatment with infrared laser radiation – the principle of therapeutic action is similar to UHF therapy.

    Prevalence

    Sad statistics provide disappointing data – approximately 6% of the world population has a diagnosis of DEP.

    Among population groups, persons suffering from a degree 2 DEP are identified among 35-55-year-olds. The likelihood of DEP increases significantly in older people over 60.

    A disease was found to be related to the profession – a greater number of cases were from people engaged in mental work. This is due to the forced position of the body, lack of motor activity during the day – and, as a result, the development of cervical osteochondrosis, which provokes DEP.

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    Causes and risk factors

    And also the causes of the appearance of discirculatory encephalopathy of the 2nd degree are:

    • Vascular inflammation;
    • Thrombosis of veins;
    • Intoxication of the body;
    • High pressure;
    • Atherosclerosis of blood vessels and arteries;
    • Constant stress;
    • Emotional stress and frustration;
    • Pinching of blood vessels;
    • Diseases of the blood.

    All these reasons lead to a violation of blood circulation in the vessels of the brain. This is conducive to the development of oxygen starvation, as well as the development of heart attacks.

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    There are a large number of factors that can lead to the appearance of discirculatory encephalopathy of the 2nd degree. There are two main groups:

    1. The first is associated with congenital abnormalities that cause a violation of the blood supply to the brain.
    2. The second is associated with acquired defects due to past neurological diseases or head injuries.

    To date, doctors are aware of such main causes of DEP of the 2nd degree:

    • atherosclerosis of arteries and blood vessels, which is accompanied by dyscirculatory atherosclerotic encephalopathy 2 degrees;
    • vascular inflammation or vasculitis;
    • osteochondrosis of the cervical spine, which causes pinching of the vessels, which leads to the appearance of symptoms of the disease;
    • vegetovascular dystonia plays an important role in the appearance of discirculatory encephalopathy of the 2nd degree;
    • the ingestion of various kinds of toxins in the blood during diseases of internal organs, poisoning, alcoholism and smoking;
    • blood clots in the veins;
    • the presence of elevated cholesterol, which can be deposited on the walls of blood vessels and cause obstruction.

    Risk groups

    Patients aged 2 to 35 years, but who have not yet reached retirement age, are diagnosed with grade 55 DEP. This mainly concerns people whose profession is associated with active brain activity, since in their case the brain is in constant tension, but there is no physical activity.

    After 60 years, the risk of contracting dyscirculatory encephalopathy increases 5-6 times.

    People suffering from alcoholism, neurological diseases, and diabetes are very susceptible to the disease.

    At present, grade 2 dyscirculatory atherosclerotic encephalopathy is one of the main causes of disability or even death.

    In recent years, the number of patients begins to grow more and more, this has led to the fact that, according to statistics, about 6% of the world’s population suffers from this disease.

    The risk of disability in a grade 2 DEP is quite high compared to stage 1 of this disease.

    In turn, disability can be of different groups depending on the condition of the patient:

    1. Disability group 3 is given to patients suffering from a grade 2 DEP. At the same time, vital activity is not too disturbed, but in the performance of his labor duties the patient has some difficulties.
    2. Disability group 2 can be given only to a patient with 2 or 3 degrees of DEP. In this case, the vital activity of the patient is impaired, he has memory lapses, there may be strokes, and he cannot perform the labor function at all.
    3. Disability group 1 is given only with a degree 3 DEP.

    Thus, this type of disease is quite serious and it is necessary to approach its treatment with all responsibility, and not let it drift.

    Classification

    There are several main types of discirculatory encephalopathy of the 2nd degree, which are characterized by their clinical picture and flow characteristics:

    1. Hypertensive type dyscirculatory encephalopathy can appear at a very young age, and the disease is very acute and fast. It is characterized by the frequent appearance of hypertensive crises, during which it can worsen, which is why the course of the disease is aggravated. The main symptoms are a violation of neuropsychological processes, lethargy, mood swings.
    2. The most common type of DEP of the 2nd degree is atherosclerotic discirculatory encephalopathy. The cause of this disease is cerebral arteriosclerosis. The progression of the disease leads to obstruction of blood flow and impaired brain function.
    3. Venous discirculatory encephalopathy occurs due to a violation in the outflow of venous blood, this leads to the accumulation of blood in the veins and their compression. Over time, this leads to swelling of the brain, which causes a disturbance in brain activity.
    4. There is also a mixed type that combines the characteristic features of hypertonic and atherosclerotic discirculatory encephalopathy.

    There are several key varieties of discirculatory encephalopathy of the 2nd degree, differing in the specifics of the course and symptoms:

    1. The most common type of DEP of the 2nd degree is atherosclerotic.

    The reason is banal and terrible in the scale of its occurrence – blockage of the cerebral vessels with atherosclerotic plaques that impede blood flow and normal brain activity.

    1. The second most common type is hypertonic

    It appears both in young patients and in the elderly. Often develops to severe form in a short time. The main symptom is a spasmodic sharp increase in blood pressure to high numbers. A change in the psychoemotional state is characteristic of the type of apathy and lethargy.

    1. The third type is venous encephalopathy.

    The reason lies in the obstructed outflow of blood from the brain through the veins, this leads to an effusion of the liquid phase of the blood in the tissues surrounding the vessels of the brain and its swelling. Chronic stagnation of venous blood provokes an aggravation of DEP.

    This form combines the features of all three of the above forms. The symptomatology is variable, which is why the attending physician may experience certain difficulties in making a diagnosis.

    The symptoms encountered are vomiting, discoordination, loss of attention, paucity and lethargy of thinking, instability of mood, changes in the fundus, memory lapses.

    A disease such as DEP implies the presence of a number of syndromes:

    • Vestibular coordination syndrome – this syndrome is characterized by a violation in the functioning of the vestibular apparatus, which is responsible for the normal coordination of movements and spatial sensation.
    • Dissomnia syndrome – sleep disturbances in all manifestations.
    • Cephalgic syndrome – literally means a severe headache, as well as the presence of ringing in the ears, noise, sometimes vomiting.
    • Cognitive syndrome – implies a violation of thinking, especially pronounced after active mental work, more often in the evening.

    There are several classifications of DEP, each of which takes into account any one characteristic:

    1. For reasons:
      • Hypertonic;
      • Atherosclerotic;
      • Venous;
      • Mixed;
    2. By severity:
      • 1 degree – subjective disorders;
      • 2 degree – cognitive impairment and movement disorders;
      • Grade 3 – persistent neurological defects, dementia;
    3. By the rate of development of symptoms:
      • Slowly progressing – lasts for many years;
      • Remitting – there are periods of deterioration and normalization of the condition;
      • Fast progressing – develops within a year or two, sometimes less often.

    With a rapidly progressive form, the risk of patient disability is much greater than with a slowly progressing one.

    1. First of all, mental disorders are noticeable:
      • The patient’s ability to focus is impaired, memory is reduced, fatigue during mental work occurs faster.
      • Since the ability to critical thinking is reduced, the patient does not consider himself sick and often overestimates his abilities.
      • Indications that the mental work that used to be feasible for him now causes quick fatigue are stubbornly ignored.
    2. Over time, the patient undergoes such changes as:
      • Higher mental functions are also violated – generalization and goal-setting.
      • There are emotional disorders – apathy, depression, in some cases an aggressive disposition to others is possible.
      • There is a complete loss of interest in past hobbies, indifference to events around the world.
    3. Movement disorders were called lower Parkinsonism, because the gait of patients with DEP is similar to the gait of those suffering from Parkinson’s disease – they take slow, shallow, shuffling steps, while having difficulty starting and ending the movement. But, unlike Parkinson’s disease, with DEP, there is no characteristic tremor of the hands (“counting coins”). The gait of patients is very unstable, they can easily fall when walking.
    4. In severe cases, episodic incontinence of urine and feces is noted. epileptic seizures. Diseases are most often affected by older people, so serious injuries can turn out to be consequences of motor disorders.

    Diagnosis of DEP 2 degrees

    Diagnosis of discirculatory encephalopathy of the 2nd degree should be handled by a doctor. To make a final diagnosis, a full-fledged examination by a general practitioner, a consultation of a neurologist, and diagnostic doctors are needed.

    Making any diagnosis begins with communication with the patient and his attendants. Close relatives who know the patient and live with him are desirable. Their opinions and complaints on their part will help to make an accurate diagnosis.

    After receiving complaints similar to the symptoms described above, the doctor may already suspect DEP and make a preliminary diagnosis. To confirm it, you need to fully collect the medical history (history of its development from the very beginning to the current moment), medical history (a brief description of the life of the patient, his parents and close relatives).

    After that, the doctor should proceed to an objective examination – to check for the presence of cerebral and focal symptoms, disruption of other organs and systems (cardiovascular, respiratory, endocrine, musculoskeletal, endocrine and others). A full examination will help in differential diagnosis – detecting differences from other diseases.

    Laboratory-instrumental examination will be mandatory. For the diagnosis of discirculatory encephalopathy, 2 stages are desirable:

    • clinical (general) blood test;
    • clinical (general) urinalysis;
    • lipid profile (cholesterol, blood lipoprotein levels);
    • blood glucose measurement;
    • blood pressure measurement;
    • electroencephalogram (EEG);
    • computed tomography (CT) scan of the head;
    • magnetic resonance imaging (MRI) of the head;
    • cerebral angiography (visualization of cerebral vessels);
    • ophthalmoscopy;
    • examination of coronary vessels (arteries of the heart);
    • other methods.

    Some of the research methods described are considered mandatory for the diagnosis of any disease, while others are specific. So, ophthalmoscopy is an examination of the fundus (the inner surface of the eyeball), conducted by an ophthalmologist to detect changes in the vessels. Arteries and veins of the eye almost always change in the same way as similar vessels of the brain, therefore, a preliminary non-invasive diagnosis of the state of the vessels of the brain can be carried out.

    Angiography will show changes in the blood vessels of the brain, but requires the use of x-ray units and entails a radiation load. MRI can give less accurate results, but without patient exposure.

    The diagnosis of “Discirculatory encephalopathy of the 2nd degree” is the competence of a specialist neurologist. The doctor always collectively evaluates the patient’s complaints, taking into account the complaints of the patient’s relatives and friends, and objective examination indicators.

    The complex of instrumental examinations necessarily includes:

    • Computer and magnetic resonance imaging of the brain – these studies reflect the most complete picture of the state of brain tissue at the time of
    • Rheoencephalography of cerebral vessels – allows you to assess the state of the cerebral vessels themselves by their degree of expansion and filling with blood.
    • Neurologist;
    • Cardiologist;
    • Ophthalmologist;
    • Endocrinologist;
    • Psychotherapist.

    In order to diagnose a disease, you first need to have the symptoms of various relevant clinical findings.

    In order to correctly diagnose, the doctor should note changes in the patient’s condition, based on such criteria:

    1. Neurological disorders and and x gain;
    2. The study of the neuropsychic state of the patient;
    3. Changes that were detected by computed tomography;
    4. Changes that were identified in the study of the patient’s blood.
    • Rheoencephalography – what is it? This is one of the methods for diagnosing DEP, which includes a study of the state of the vessels of the brain, which provides information about their tone, as well as how saturated they are with blood. This method is absolutely not painful, it is carried out by a neuropathologist or neurologist.
    • Computed tomography is a painless research method that provides information about the presence of atrophic processes in the brain.
    • Assessment of neurological manifestations of the disease. This method is characterized by the fact that the neuropathologist examined the patient, checked the reflexes. But it is important to consider that in order to diagnose DEP, one must rely not only on the manifestations of neurological diseases, but also on various signs.
    • Ultrasound dopplerography of cerebral vessels is a method of ultrasonic examination of cerebral vessels, which allows you to objectively assess the speed of blood flow through the vessels.
    • Neuropsychological research is a method for diagnosing the patient’s mental state. This method determines various damage to the higher functions of the psyche.
    1. Neurological disorders and their amplification;
    2. The study of the neuropsychic state of the patient;
    3. Changes that were detected by computed tomography;
    4. Changes that were identified in the study of the patient’s blood.
    • Rheoencephalography – this is one of the methods for diagnosing DEP, includes a study of the state of the vessels of the brain, which provides information about their tone, as well as how saturated they are with blood. This method is absolutely not painful, it is carried out by a neuropathologist or neurologist.
    • Computed tomography is a painless research method that provides information about the presence of atrophic processes in the brain.
    • Assessment of neurological manifestations of the disease. This method is characterized by the fact that the neuropathologist examined the patient, checked the reflexes. But it is important to consider that in order to diagnose DEP, one must rely not only on the manifestations of neurological diseases, but also on various signs.
    • Ultrasound dopplerography of cerebral vessels is a method of ultrasonic examination of cerebral vessels, which allows you to objectively assess the speed of blood flow through the vessels.
    • Neuropsychological research is a method for diagnosing the patient’s mental state. This method determines various damage to the higher functions of the psyche.

    Prevention

    All people at risk should daily monitor their blood pressure systematically. Once a year, check the blood for cholesterol, sugar. Lead a healthy lifestyle: eat right and wholesome, give up smoking and alcohol, be physically active, and avoid stress. Consist of medical supervision at the attending physician.

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    Dyscirculatory encephalopathy (ICD code 10 – G93.4 – unspecified encephalopathy) is a form of chronic cerebrovascular disease with further slow progression. This disease is a consequence of various diseases, common in which there is damage to the small arteries and arterioles.

    The disease is characterized by a complication of impaired cognitive and mental functions, which interacts with motor and sensory disorders. The conclusion is made by a neurologist after examination, as well as studies completed.

    It consists of observing a healthy lifestyle, proper nutrition, minimal exercise and giving up bad habits. Treatment of concomitant diseases is also necessary to prevent the development or worsening of DEP.

    There are not so many methods for the prevention of second-degree DEP, but with their proper implementation, if you do not prevent the disease, then slow down its development.

    Prevention should be carried out at the initial stages of the development of the disease. To do this, you need:

    • constantly monitor blood pressure, trying to maintain it within normal limits;
    • the level of cholesterol and its fractions in the blood;
    • any stressful situations, emotional stress, psychological disorders should also be avoided.

    With an existing DEP of the 2nd degree, it is necessary to undergo a full course of examinations and therapy 1-2 times a year to prevent the progression of the disease.

    Dyscirculatory encephalopathy of mixed genesis 3 degrees

    Julia Kovaleva Master (2127), closed 6 years ago

    Irina Androshchuk Master (1239) 6 years ago

    Cerebrovascular disease (CEH). among which acute (stroke, transient ischemic attack) and chronic (discirculatory encephalopathy) forms are distinguished, they are the most important medical and social problem both in our country and around the world due to their significant prevalence and severe consequences – disability, disability, impaired function higher nervous system up to the development of dementia, etc. In recent years, there has been a significant increase in CEH.

    Hypertensive encephalopathy (HE) is a slowly progressive diffuse and focal lesion of brain matter caused by chronic circulatory disorders in the brain associated with long-term uncontrolled arterial hypertension (AH). The addition of cerebral arteriosclerosis (in hypertension, this process occurs early and at an accelerated pace) contributes to a further deterioration in the blood supply to the brain, which leads to progression of HE;

    • vestibulo-cerebellar in the form of dizziness, swaying, instability when walking; • pseudobulbar in the form of blurred speech, violent laughter and crying, choking when swallowing; • extrapyramidal in the form of trembling of the head, fingers, hypomimia, muscle stiffness, slow movement; • vascular dementia in the form of impaired memory, intelligence, emotional sphere.

    More often combined syndromes. Prevention of the development and progression of GE is composed of several directions: 1. Treatment of vascular disease, which served as the cause of the development of GE, – AH. 2. Impact on factors exacerbating the course of GE: hypercholesterolemia, increased platelet aggregation and blood viscosity, diabetes mellitus, atrial fibrillation (if these diseases join).

    Grade 3 dyscirculatory encephalopathy – how long can you live?

    No expert can say for sure how long you can live with grade 3 discirculatory encephalopathy (DEP). The thing is that this disease is considered severe, since it affects the functioning of the brain. The disease primarily affects the blood vessels, as a result of which some parts of the brain cease to receive oxygen and essential nutrients.

    The disease has three degrees of progression. Each stands out for its symptoms and their severity. The most severe form is considered the third. In addition, the disease is also divided into four main types:

    1. Atherosclerotic DEP. This disease develops as a result of atherosclerosis of the vessels of the head. It is considered the most common type of ailment. The main canals, which are responsible for the main blood flow to the upper part, are mainly affected. In addition, they regulate the entire cerebral blood flow. This disease makes it difficult to supply blood in the same volume, which is why brain functions deteriorate.
    2. Venous The disease appears as a result of a violation of the outflow of blood from the skull. The resulting stagnation leads to the fact that the veins begin to squeeze. Because of this, cerebral activity noticeably worsens.
    3. Hypertonic. This type of ailment is different in that it is able to develop in young people. The disease is directly associated with hypertensive crises, during which the exacerbation passes. They also exacerbate the course of the disease, which speeds up the development process.
    4. Discirculatory encephalopathy 3 degrees of mixed origin. Combines the signs of atherosclerotic and hypertensive types of disease. The work of the great vessels of the head begins to deteriorate. Moreover, the situation is exacerbated by hypertensive crises, which only exacerbate existing symptoms.

    The disease occurs as a result of a violation of the structure of blood vessels. Moreover, it can be both acquired and congenital. According to statistics, brain disease in people from 25 to 50 years old is observed only in the first and second degrees. It comes suddenly, but it is treated quickly. After 70 years, the risk of acquiring an ailment of the second and third stage is several times greater. Disability with grade 3 dyscirculatory encephalopathy in old age occurs in 80% of cases.

    The first thing that happens is a spasm of the brain vessels. As a result, a small lesion appears where oxygen does not enter – nerve cells begin to die. Because of this, even in the second stage, there is a great risk of the body refusing to perform important functions. Sometimes there are situations in which individual organs cease to work.

    Grade 2 circulatory encephalopathy – brain damage in which you can live for a long time, and how much depends on the person himself.

    The disease progresses slowly and is manifested by chronic insufficiency of blood supply. This affects the structural changes in the brain, which affects many of its functions.

    The disease has three stages of development and several main types. Each of them shows its own forecasts, consequences and course of treatment.

    1. 1 degree occurs in the form of small organic brain lesions, which can often be confused with other diseases, for example, intoxication or even with the consequences of a mechanical injury. At this stage, one can achieve remission for several decades or complete recovery. It manifests itself with the following symptoms:

    • noise in the head;
    • pain;
    • dizziness;
    • poor sleep;
    • memory problems;
    • decreased desire to learn new things.

    2. The diagnosis of degree 2 discirculatory encephalopathy is manifested by the desire to blame other people for their own failures. In this case, before this is preceded by a period of self-control, and hard. The patient has a feeling of heightened anxiety. This stage is manifested:

    • impaired attention;
    • poor control of one’s own movements;
    • increased irritability;
    • unexplained depression.

    The second variant of the disease already implies disability, but the patient can still maintain the ability to serve himself.

    3. 3 degree means the transition of the disease into vascular dementia, which is mainly manifested by severe dementia and the practical impossibility of acquiring any new skills.

    The work of the musculoskeletal system is deteriorating, severe Parkinson’s syndrome appears, impossibility of self-care, dementia.

    The disease can progress at various rates: from a year to five or more.

    The disease is treated with methods that are prescribed for such diseases. Usually this is a comprehensive course consisting of procedures, taking medication, diet and changing life activities. It is attributed based on the results of the survey.

    In addition to eliminating the brain pathology itself, it is also necessary to remove all the resulting symptoms. At the same time, several doctors are examined at once: a neurologist, cardiologist, therapist and, if necessary, a psychiatrist.

    Typically, treatment consists of:

    • restoration of blood circulation in the brain and the body as a whole, for this, nootropic medicines are prescribed along with normalizers;
    • blood thinners that help lower platelet counts;
    • tablets and injections that reduce the degree of vascular hypertension;
    • therapy that will help achieve a lipid-lowering effect.

    Depending on the symptoms, the following are also prescribed:

    • UHF neck;
    • electric;
    • galvanic currents to the collar zone;
    • laser therapy;
    • baths;
    • massages.

    To reduce dizziness, it is advised to conduct stabilometric training. If necessary, psychotherapy.

    Nobody can say how much exactly they live with 2nd degree discirculatory encephalopathy – it depends on many factors: the patient’s current condition, the treatment used, and most importantly, the lifestyle. To prevent the disease you need:

    • monitor blood pressure;
    • maintain blood sugar in the right amount;
    • control cholesterol and lipoproteins;
    • track weight;
    • completely abandon bad habits.

    Nervous system cells (neurocytes) require a sufficient amount of energy for normal functional activity, therefore they are very sensitive to insufficient intake of glucose (the main energy supplier) and oxygen (necessary for the glucose oxidation process). These substances enter the neurocytes with a blood stream.

    With changes in blood vessels (arteries, veins or capillaries), the flow of necessary compounds into neurocytes decreases, which leads to their starvation and the development of discirculatory encephalopathy. This term is translated from the Latin language as a pathology of the brain caused by a violation of blood circulation in its tissues. With this disease, a decrease in blood flow intensity occurs gradually.

    Causes of

    A change in the blood circulation of the brain, leading to starvation of neurocytes, is a polyetiological condition. Various etiological provoking factors can lead to its development, which include:

    • A prolonged increase in blood pressure (hypertension), which leads to reflex spasm (narrowing) of the arterial vessels of the brain.
    • Neurocirculatory (vegetative-vascular) dystonia is a condition associated with impaired regulation of the tone of the arteries, which leads to their periodic spasm.
    • Cerebral atherosclerosis is a lesion of the walls of arteries that are localized in the brain, in which cholesterol is deposited in them in the form of plaques that reduce lumen.
    • Toxic damage to arteries after infectious diseases, against the background of the systematic use of alcohol, smoking (alcohol and nicotine are vascular toxins).
    • Venous thrombosis – the formation of microthrombi inside the veins of the brain with a deterioration in the outflow of blood from them and a decrease in the intensity of blood flow.
    • Inflammation of the arteries, leading to swelling of their walls and a decrease in clearance.

    Discirculatory encephalopathy (abbreviation for DEP) under the influence of various provoking factors develops over a long period of time (years). Sometimes a combined effect of several etiological factors at once is possible, which leads to a more rapid development of the disease.

    Forms of the disease

    Depending on the influence of what provoking factors, circulatory disturbance in the brain tissue progresses, several main forms of discirculatory encephalopathy are distinguished:

    • Atherosclerotic form – the main factor in the development of the pathological process is the formation of atherosclerotic plaques in the arteries.
    • Venous form – is a consequence of the deterioration of the reverse flow of blood from venous vessels, in particular with thrombosis or an increase in the level of intracranial pressure.
    • Discirculatory encephalopathy of mixed genesis – several factors take part in the development of the disease at once, this form is characterized by faster progression of the pathology.

    The division into forms is primarily necessary for subsequent effective treatment aimed at eliminating the effects of the cause of the disease.

    Since discirculatory encephalopathy is a slowly progressing disease, the course of the pathological process is conditionally divided into several degrees of severity:

    • Grade 1 – characterized by minimal changes in blood vessels and neurocytes, may occur with a slight tinnitus, periodic dizziness and insomnia.
    • Grade 2 – changes in the vessels are more pronounced, which leads to more significant starvation of neurocytes. This is manifested by pronounced tinnitus, insomnia, headache, focal symptoms (muscle weakness up to paralysis, impaired skin sensitivity), impaired coordination of movements. In the case of a predominance of headache over other symptoms, a pathology with cephalgic syndrome occurs.
    • Grade 3 – against the background of a progressive disturbance in blood supply, damage and death of part of the neurocytes of the brain occur. This is accompanied by a sharp decrease in the intellectual abilities of a sick person (dementia), memory loss, intense headache. At this degree, disability takes shape, since in most cases a sick person is not able to serve himself due to irreversible changes in neurocytes.

    DEP 2 degrees: what is it and how to treat it?

    DEP is an abbreviation that stands for discirculatory encephalopathy, that is, impaired brain function caused by impaired blood supply.

    It is divided into three degrees depending on the severity of the lesion:

    1. In the first degree, most of the symptoms are subjective – fatigue, decreased mental performance.
    2. The second degree is obvious disorders of thinking and memory, as well as neurological symptoms.
    3. The most severe, third degree is dementia with obvious neurological disorders.

    The danger of DEP is that the disease is slow. but inevitably violates a person’s ability to think clearly and can lead to disability.

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  • Tatyana Jakowenko

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

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

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

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