Hypoplasia of the p1 segment of the right posterior cerebral artery

From this article you will learn: what is hypoplasia of the right vertebral artery, the causes of this pathology, its characteristic symptoms and treatment methods.

Vertebral artery – a paired vessel extending from the subclavian artery and together with the carotid arteries providing blood supply to the brain.

With vascular abnormalities, prerequisites are created to reduce cerebral blood flow.

This is what happens with hypoplasia of the right vertebral artery, and what is it? Hypoplasia is an underdevelopment of an organ, which results in a decrease in its functionality.

In the case of the vertebral artery, hypoplasia occurs when the diameter of the vessel is reduced to less than 2 mm. This type of anomaly is congenital in nature and is often a consequence of pregnancy pathology.

Symptoms often occur only in adulthood due to the deterioration of vascular elasticity and the attachment of atherosclerosis. In such a situation, there may be a decrease in blood flow to certain parts of the brain. To a certain extent, the pathology of blood supply can be compensated, but the protective mechanisms of the body may be depleted or not work in emergency situations.

Differences from lesions of the left vertebral artery are usually absent. The only difference is that the right-sided lesion of the vessel occurs several times more often than the left-sided – according to some observations, in a ratio of about 3 to 1.

Computed tomography image

It is difficult to give an unambiguous answer about the danger of the condition. Brain neurons are particularly sensitive to malnutrition due to impaired blood supply.

Therefore, hypoplasia of arteries leading to the brain can lead to more serious consequences for the body compared with the underdevelopment of other vessels.

The degree of danger depends on the severity of hypoplasia and related health problems (vascular diseases, pathology of the cervical spine, heart disease).

A complete cure of the disease is impossible, even after surgery only temporary compensation of local blood flow can be achieved.

Neuropathologists are usually involved in the treatment of vertebral artery hypoplasia.

Only those patients in whom hypoplasia is manifested by one or another symptom of deterioration of cerebral circulation need medical attention.

With a significant narrowing of the lumen of the vessel with severe symptoms of circulatory disorders, consultation of a vascular surgeon is necessary to resolve the issue of the need for surgery.

Underdevelopment of vertebral vessels is often detected by chance in adulthood during the examination. However, this pathology is congenital in nature. Underdevelopment of blood vessels can lead to various health problems of a pregnant woman, trauma during gestation, a hereditary predisposition.

List of possible causes of vertebral artery hypoplasia:

  1. Infection transferred during pregnancy: rubella, flu, toxoplasmosis.
  2. Bruises or injuries to the mother.
  3. Drinking alcohol, pregnant drugs, smoking, drug addiction.
  4. Genetic features that increase the risk of formation of defects in the circulatory system.

Pathology can be asymptomatic for a long time. With a slight severity of circulatory disorders and symptoms, the condition may be erroneously attributed to other pathologies: osteochondrosis, vegetative-vascular dystonia.

Hypoplasia is considered one of the most common abnormalities of the vertebral arteries. Data on the prevalence of hypoplasia among the population differ in different sources and range from 2,5 to 26,5% of cases.

But it is known that vertebral artery hypoplasia on the right is noticeably more common than on the left or on both sides simultaneously. This is probably due to the anatomical features of the formation of vascular formations.

The vessel on the right departs from the subclavian artery at an acute angle, the left is almost at a right angle, the diameter of the right artery is often less than the left, and its length is greater.

The asymptomatic course of an abnormality of the right vertebral artery indicates sufficient compensation of blood flow due to the existing connections (anastomoses) between the vessels and due to the developed network of collaterals – branches of other vessels supplying the same areas as the vertebral artery.

Ensuring a uniform flow of blood to all parts of the brain is largely due to the presence of closed circulatory systems, when the arteries of different vascular pools merge with each other. The listed protective mechanisms often often compensate for insufficient blood flow through the right vertebral artery.

Therefore, clinical manifestations often occur gradually as age-related changes develop.

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Symptoms of pathology

Symptoms of this ailment are very diverse and can vary significantly from patient to patient.

Description of the manifestations of the disease:

  • Pain in pathology can vary significantly in intensity and other characteristics.
  • Often patients feel a throbbing or shooting pain with a spread from the neck and back of the head to the temporo-frontal areas.
  • The pain intensifies when turning the head, at night and after waking up.
  • Often hypoplasia is manifested by dizziness, a feeling of disorientation, a distortion in the perception of the position of the body in space. Such episodes are often associated with tilting the head, with sudden movements. They can lead to staggering or even falling.
  • Sudden bouts of dizziness are sometimes accompanied by loss of consciousness, fainting.

In addition to pain, with the pathology, the following violations can occur:

  • impaired vision, pain in the eyes, double vision, feeling of sand or flickering flies;
  • hearing loss, tinnitus, sensorineural hearing loss, vestibular disorders;
  • problems with the cardiovascular system;
  • mood variability, depression;
  • fatigue, weakness;
  • sleep disturbance;
  • meteosensitivity.

Arterial hypertension, angina attacks are not always a direct consequence of abnormalities of the vertebral vessels. Usually, a combination of cardiological pathology with hypoplasia leads to an aggravation of the course of the disease. At the same time, a reduced blood flow in the vertebrobasilar pool provokes episodes of myocardial ischemia and an increase in blood pressure.

Hypoplasia of the right vertebral artery increases the risk of cerebral stroke due to impaired blood flow in the vertebrobasilar system and due to damage to the vascular wall in the case of atherosclerosis.

Therapies

In the case of vascular hypoplasia, a complete cure of the disease is impossible. Even after reconstructive surgery, only temporary compensation of local blood flow can be achieved.

Conservative treatment includes taking medications, physiotherapeutic methods, physiotherapy exercises, acupuncture. To improve blood supply to the brain, several groups of drugs are used:

  1. Vasodilators (Cavinton, Actovegin, Ceraxon).
  2. Neuroprotectors and nootropics (piracetam, glycine, picamilon, mexidol) that improve metabolic processes in the brain tissue.
  • Betahistine, effective in the presence of dizziness.
  • Antihypertensive agents are necessary in case of high blood pressure: calcium antagonists (amlodipine), beta-blockers (bisoprolol), ACE inhibitors – angiotensin-converting enzyme (lisinopril).
  • The prevention of blood clots is carried out using antiplatelet agents (aspirin, pentoxifylline, clopidogrel).

    From physiotherapeutic methods can be applied:

    • diadynamic currents;
    • magnetotherapy;
    • electrophoresis with drugs that have a vasodilating, analgesic effect.

    Surgical intervention can be performed in an open way or using the endovascular method (through small holes, without large incisions).

    To restore blood flow apply:

    • Stenting, in which a stent frame is inserted into the narrowing of the vessel to expand the narrowed area. Such stents may be impregnated with drugs.
    • Angioplasty, in which a balloon is injected into the narrowing zone, which is pumped with air to expand the vessel. Angioplasty and stenting can complement each other.
    • In difficult situations, a more complex reconstructive operation is performed: removal of the deformed area and prosthetics using the patient’s own vein.

    Forecast

    The prognosis for pathology of hypoplasia of the right vertebral artery depends on the degree of underdevelopment, the compensatory mechanisms of the body, and concomitant pathologies. In the absence of symptoms of deterioration of cerebral blood flow or minimal manifestations of pathology, the prognosis can be considered conditionally favorable.

    Hypoplasia is a predisposing factor in the development of stroke. According to statistics, 70% of transient disorders of cerebral circulation and 30% of strokes are associated with impaired blood flow in the vertebrobasilar system. Therefore, the detection of anomalies requires the adoption of active preventive measures, especially in the presence of other risk factors.

    The presence of pronounced manifestations of vertebrobasilar insufficiency significantly worsens the prognosis. With the lack of effectiveness of conservative therapy, only surgical treatment can improve the situation. Good results are obtained using the endovascular method, which can be carried out even in patients with high “surgical risk”.

    What is brain PMA? PMA stands for medicine as the anterior cerebral artery. The blood supply to the brain is quite complex. Blood enters the brain through two internal carotid and two vertebral arteries. Carotid arteries form a carotid pool. They begin in the chest cavity: right from the brachiocephalic trunk, left from the aortic arch.

    PMA (anterior cerebral artery) begins at the site of separation of the internal carotid artery into the terminal branches. At the beginning of her journey, she gives away a series of small branches that penetrate through the front perforated substance to the basal nuclei of the base of the large brain. At the level of visual intersection, the anterior cerebral artery forms an anastomosis (anastomosis) with the same artery of the opposite side through the anterior connecting artery.

    Hypoplasia of the p1 segment of the right posterior cerebral artery

    To understand the causes of the development of hypoplasia of the right PA, one should deal with the anatomical structure of the vessels that feed the brain. Blood supply to this organ is carried out from two large vascular systems consisting of carotid and vertebral arteries. All these vessels are paired and supply blood to a particular hemisphere of the brain.

    The terminal branches of the two arteries are connected at the base of the brain, forming a vicious circle called the Willis circle. This education plays a crucial role in the functioning of the hematopoietic system. In the event that there is a blockage of one or several large arteries, the Willis circle compensates for the lack of blood supply by flowing blood from other vascular systems.

    Due to this possibility, the brain is able to independently regulate blood flow, avoiding oxygen starvation.

    The right and left vertebral arteries are the main components of the Willis circle. They depart from the subclavian arteries, falling into the cranial cavity through the transverse processes of the cervical vertebrae. However, they do have vulnerabilities due to their anatomical location. Vertebral arteries in several places have strong bends, in addition, they pass through narrow bony holes.

    symptomatology

    The following factors negatively affect the process of formation of cerebral arteries, including PMA:

    • Drug or alcohol addiction in a pregnant woman;
    • Infection of the fetus during fetal development;
    • Intoxication of a woman’s body during the period of gestation;
    • Burdened by heredity;
    • Taking pregnant drugs with teratogenic effects.

    Symptoms of the disease and their severity depend on the degree of underdevelopment of the vessel that feeds the brain. In each patient, the symptoms may appear differently. Some people learn that they have PMA hypoplasia only during a physical examination. Often the disease is asymptomatic.

    Hypoplasia of PMA can manifest itself with the following symptoms:

    • Headaches of varying intensity;
    • Frequent dizziness;
    • Decreased or loss of sensitivity of the skin;
    • Blood pressure instability;
    • Emotional distress;
    • Impaired perception and sensations.

    All of these symptoms indicate inadequate cerebral circulation, so if they occur, contact the neurologists of the Yusupov hospital. Doctors will first conduct a comprehensive examination, which includes the following diagnostic procedures:

    • Ultrasound examination and dopplerography of cerebral vessels;
    • Contrast angiography
    • Computed or magnetic resonance imaging.

    Sonologists use modern ultrasound devices that combine a triplex scanner and a Doppler unit. They allow you to visualize the extracranial and intracranial departments of the arteries of the vertebral-basilar basin, to reveal the asymmetry of blood flow in the MCA and PMA. To determine the state of neurons in brain ischemia, magnetic resonance imaging and computed tomography are performed using premium class devices.

    CT angiography of cerebral vessels in the Yusupov hospital is done on a modern scanner. Using it, not only step-by-step images of cerebral vessels are obtained, but also their three-dimensional model. These images can be viewed on a computer monitor, printed on film or transferred to DVD R disc.

    If the symptoms of cerebrovascular accident caused by PMA dysplasia are not pronounced, they are treated with drugs that expand the arteries and normalize cerebral blood flow. Conservative therapy helps to reduce the intensity of headaches and improve the functioning of the vestibular apparatus.

    If a thrombus is detected in an abnormal vessel, the doctor ascribes drugs to dissolve it. Neurosurgeons of the partner clinics of the Yusupov hospital carry out correction of the pathology of PMA in cases when there is no positive dynamics during drug treatment. Mostly with PMA hypoplasia, a stenting technique is used.

    Pathology can manifest itself with a large number of symptoms. Each patient feels disturbances in different ways. In some, pain and underdevelopment of the spinal arteries are more pronounced, while in others it is less.

    The diagnosis is often made during a routine examination. The disease is characterized by a blurred clinical picture. Its symptoms are quite difficult to distinguish from other pathologies.

    Arterial hypoplasia can be suspected by the presence of:

    1. Headaches of varying intensity.
    2. Frequent and causeless dizziness.
    3. Nervous dysfunction.
    4. Distorted perception of space.
    5. Frequent jumps in blood pressure.
    6. Violations of subtle movements.
    7. Decreased sensitivity, especially in the limbs.
    8. Motor impairment.
    9. Visual hallucinations.
    10. Shaky gait.
    11. Violations of coordination of movements. The patient often encounters objects, falls, feels like on a carousel.

    Aging of the body enhances the manifestations of hypoplasia.

    This pathology is manifested by the underdevelopment of blood vessels that nourishes a vital human organ. Damaged arteries have a defective shape, tortuosity, and can not perform their tasks. More often hypoplasia is a congenital anomaly that forms at the stage of creation of the vertebral arteries. A child with such a pathology has an extremely painful appearance.

    The classification of this disease indicates three main forms of hypoplasia:

    Normally, these lines feed most of the brain. Their damage is a serious blow to the nervous system and health in general.

    Violations in the structure of the vascular wall do not allow the brain to receive the necessary substances in sufficient volume. Oxygen and nutritional compounds do not reach their destination. The brain is starving.

    A defect in the vascular wall is fraught with the risk of aneurysm or stroke.

    Therefore, this pathological condition is considered extremely dangerous for human life. Due to the seriousness of the consequences, hypoplasia of cerebral arteries, special attention is paid to neurosurgical and neurological practice. An extreme condition in the development of blood vessels is aplasia. This is a defect in which the brachiocephalic artery (BCA) is absent at birth.

    These vessels are important contributors to brain nutrition. They are especially active in supplying its rear parts with the necessary substances – the cerebellum and occipital lobes, partially temporal, hypothalamus, and also the trunk. These arteries provide the brain with about 30% of all incoming blood.

    The left ventricle of the heart gives rise to the aorta – the largest and largest artery of the human body. The shoulder-head trunk, which is the progenitor of the subclavian vessel, departs from it. And he, in turn, has two large branches – the right and left PA. In diameter, such a vessel reaches about 2-4 mm.

    The cervical vertebrae form a narrow canal that serves as a receptacle for PA and leads it to the brain. The vertebral artery goes next to the vein of the same name. These vessels enter the canal at level 6 of the cervical vertebra, and exit at 1. The large occipital foramen is the conductor of the vessel to the cranial cavity. Approaching the base of the brain, the right and left PA merge into one common main – basilar.

    This vessel also branches into two – the posterior cerebral. The basilar and vertebral arteries form a single system – vertebrobasilar. It has short branches that penetrate the cavity of the brain, as well as long, enveloping it. The cerebellum feeds on the vessels of the same name – the lower anterior, posterior and superior.

    Vascular pathology of the brain can spread to both one and the other PA. In the case of left-sided hypoplasia, symptoms do not appear immediately. The pathology of the vessels of the brain is long compensated by the mechanisms of the body. Therefore, artery dysfunction slowly sets in, which is manifested by difficulty in patency of nutrients, blood stasis, ischemia.

    Symptoms are gaining momentum along with age-related changes in tissues and organs. The main sign of damage to this branch of PA is pain that spreads along the cervical spine.

    Trying to compensate for reduced blood flow, the body creates anastomoses – vascular anastomoses. This allows blood to bypass the main pathway affected by hypoplasia.

    A change in condition for the worse usually leads to a decrease in the functionality of the anastomosis. Compensation breaks down.

    The cause of the defective structure of the second branch of PA is often intrauterine anomalies. Their appearance can be provoked by the following factors affecting a pregnant woman:

    • Injuries and bruises;
    • Irradiation;
    • Prolonged exposure to the sun;
    • Alcohol and nicotine;
    • Viral infection with influenza or rubella.

    Signs of the disease usually overtake a person in adulthood. Intensity is gaining:

    • Headache;
    • High blood pressure – hypertension;
    • Drowsiness;
    • Emotional weakness with frequent mood swings, lethargy;
    • Vestibular disruptions;
    • Reduced sensitivity.

    Basilar artery

    Merging together, two PAs form a single vessel on the base of the brain, supplying blood to the entire central nervous system. It carries oxygen and important nutritional compounds to the occipital lobes, cerebellum and trunk – the most significant formations of the brain. The basilar artery is divided into several vessels.

    Like a tree, they send many branches to the significant elements of the central nervous system. The posterior cerebral arteries feed the temporal and occipital lobes. The superior and anterior cerebellar vestibular organ, respectively. Additional paramedial and annular vessels provide nutrients to the deep paths and nuclei. Varoliev bridge supplies the eponymous artery with blood.

    15% of people have a basilar vessel with another branch – the internal auditory and labyrinth.

    The sinus is called the venous drain. At its core, it is a collector that connects the internal vessels of the brain with the external. The right transverse provides reverse absorption of the cerebrospinal fluid. From the collector, blood flow rushes into the jugular veins, and then moves into the intracranial space.

    A disease of the right transverse sinus leads to a decrease in venous lumen. This condition can cause a direct threat of hemorrhagic cerebral infarction.

    With hypoplasia of the left sinus, ophthalmic complications often occur. Venous drainage, located symmetrically to the right, in violation causes edema of the optic nerve head.

    It is common for a patient to complain of headache and dizziness, fatigue.

    Causes of pathology

    Many factors are capable of starting the process of hypoplasia. These include the following:

    • Fetal infection in fetal development;
    • Abuse of alcohol, nicotine, drugs, drugs by a woman during pregnancy;
    • Intoxication of the pregnant woman during gestation;
    • Hereditary predisposition to vascular pathology.

    The lifestyle during pregnancy mentioned above is unacceptable. Some cases suggest that these factors are not necessary for the occurrence of hypoplasia. It can start on its own spontaneously, regardless of the predisposing cause, even in a newborn. The provoking conditions that accelerate the appearance of hypoplasia are as follows:

    • Subluxation of the cervical vertebra;
    • Spondylolisthesis leading to spinal canal deformity;
    • Osteochondrosis, in which bone growths squeeze the arteries;
    • Ossification, which affects the vertebral-occipital membrane;
    • Thrombosis of an internal abnormal vessel;
    • Atherosclerotic changes.

    Signs of PA Hypoplasia

    Hypoplasia of the left vertebral artery occurs quite rarely. Therefore, it is advisable to consider the symptoms of the disease, characteristic of the pathology of the right artery. However, they arise only if the disease goes into the stage of decompensation.

    As brain cells begin to experience oxygen starvation, patients are concerned about the following symptoms:

    • frequent headaches;
    • dizziness;
    • violation of coordination of movements;
    • visual impairment or visual impairment.

    The following manifestations indicate impaired blood circulation in the brain;

    • weakness in the limbs, mainly in one;
    • numbness of any part of the body, or partial loss of sensitivity;
    • motor function disorders.

    Since the blood flow in the narrow artery is significantly impeded, the body tends to push it through, increasing the pressure. Thus, in all sick people, blood pressure is constantly increased.

    The presence of certain symptoms in a particular person depends on his physiological characteristics and the general condition of the body. Some patients may be disturbed at once by all manifestations of the disease, while others – only some of them. Moreover, signs of the disease are always coming. They can periodically arise, and after a while subside.

    It is the incoming character of the manifestations that significantly complicates the diagnosis of the disease, since often all these signs are taken for the manifestations of other diseases. If treatment is not started in time, insufficient oxygen supply to the brain cells can lead to the development of a stroke.

    Hypoplasia of the p1 segment of the right posterior cerebral artery

    The elderly, middle-aged and middle-aged people are often worried about headache, noise and dizziness, increased fatigue, memory impairment, and decreased performance. Often, patients are not very serious about such complaints. Meanwhile, these may be signs of vasospasm in the left cerebral arteries, SMA (middle cerebral artery) and PMA (anterior cerebral artery).

    After rupture of the aneurysm, the patient begins a temporary period of improvement or stabilization of the condition until the symptomatic vasospasm occurs. Neurological symptoms of cerebral spasm from the fourth to the fourteenth day after the first rupture of the aneurysm. The resulting neurological symptoms correspond to cerebral ischemia in specific arterial pools. The severity of cerebral vasospasm determines the likelihood of developing ischemia and cerebral infarction.

    Signs of vasospasm in the left arteries of the brain, SMA and PMA often occur in those patients in whom coagulation blood layers of 1 mm or more thick in the grooves of the brain or spherical blood clots larger than 5 mm3 in the basal tanks were detected on early magnetic resonance or computed tomography of the brain.

    Doctors of the Yusupov hospital determine the localization and severity of vasospasm in PMA and SMA using magnetic resonance or computed tomography. To make the prognosis accurate, computed tomography of the brain is performed in the interval from 24 to 96 hours after subarachnoid hemorrhage.

    Clinically pronounced cerebral vasospasm is manifested by symptoms that relate to a particular pool of blood supply to the brain of a particular artery. When the trunk or main branches of the middle cerebral artery (SMA) are involved, the patient develops the following symptoms:

    • Contralateral hemiparesis – muscle weakness of the half of the trunk from the side opposite to the intracerebral hemorrhage;
    • Dysphasia – speech impairment with spasm of the arteries of the dominant hemisphere of the brain;
    • Anosognosia, apractoagnosia – a recognition disorder with spasm of arteries of the non-dominant hemisphere of the brain.

    Signs of vasospasm in the left arteries of the brain, SMA and PMA may not be expressed due to the fact that collateral blood flow forms in the brain through fusion of adjacent cerebral blood supply zones.

    Ischemia due to vasospasm of the PMA is manifested by abulia. The patient is awake, lies with his eyes closed or open, he is lagging behind the instructions. He cannot actively engage in conversation, but answers questions with short phrases that he utters in a whisper, chews food for a long time, and often holds it between his gums and cheek.

    If the entire area of ​​the brain in the MCA basin (middle cerebral artery) undergoes ischemia or heart attack, then its edema develops, which can lead to an increase in intracranial pressure. Early magnetic resonance or computed tomography of the brain can predict an adverse outcome if a large blood clot is detected in the sylvian cistern or in the lumen of the sylvian cleft and a second significant clot is found in the basal frontal slit located between the cerebral hemispheres.

    If spasm of the arteries of the brain occurs against a background of subarachnoid hemorrhage, drug prophylaxis and treatment are ineffective.

    Since patients with cerebral vasospasm have an increase in blood volume and swelling of the brain parenchyma, even a slight increase in intracranial volume, which occurs when exposed to vasodilators, can exacerbate neurological disorders. If the patient has a pronounced symptomatic cerebral vasospasm, neurologists do not prescribe vasodilators.

    All the efforts of doctors are aimed at increasing cerebral perfusion pressure by increasing the average blood pressure. This is achieved by increasing the volume of plasma and the appointment of vasopressor drugs (phenylephrine, dopamine). Since treatment aimed at increasing perfusion pressure leads to an improvement in the picture of the neurological status in some patients, but high blood pressure is associated with a risk of re-hemorrhage, using this method of treatment, neuroscientists at the Yusupov hospital determine cerebral perfusion pressure and cardiac output, a direct study of the central venous pressure. In severe cases, the patient measures intracranial pressure and the pressure of jamming of the pulmonary artery.

    The introduction of the osmotic diuretic mannitol while maintaining an adequate intravascular volume and mean arterial pressure increases the osmolarity of the patient’s blood serum. In a severe case, a barbiturate coma is used to reduce intracranial pressure.

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    Hypoplasia of the brain causes circulatory problems in the head. This is a congenital disease affecting the vessels in the spine. The first signs appear in middle age. In some situations, symptoms of hypoplasia develop in people younger.

    Methods of treatment

    Since cerebral hypoplasia does not have specific symptoms, the doctor cannot make a diagnosis based on the patient’s complaints. Only hardware diagnostic methods allow you to recognize the disease. These include:

    • Ultrasound of the vessels of the head and neck;
    • angiography;
    • computed and magnetic resonance imaging of the head and neck.

    In the process of ultrasound, the doctor receives an image that allows you to assess the diameter of the artery and its throughput. This method is absolutely safe, therefore it can be used for any concomitant diseases, as well as during pregnancy.

    When conducting angiography, a special conductor and a contrast agent are introduced into one of the vertebral arteries. This procedure allows you to evaluate the structure of the artery by external characteristics.

    Computed tomography and magnetic resonance imaging are also performed using a contrast medium, which fills the artery.

    It should be noted that no drugs can eliminate vertebral artery hypoplasia. Drug therapy is aimed at eliminating the symptoms of the disease, improving blood properties and protecting the brain from irreversible changes.

    For these purposes, the following pharmaceutical preparations are used:

    • blood viscosity lowering drugs.

    Surgical intervention is used only in exceptional cases, if other methods of treatment are not able to improve cerebral circulation.

    The most radical treatment is surgery called spinal artery stenting. During this intervention, a stent is inserted into a narrow section of the artery – a metal mesh tube whose diameter is equivalent to the lumen of a healthy artery. As a result, normal blood flow is restored.

    To reduce the risk of blood clots, patients are prescribed blood thinners after surgery, such as Aspirin or Curantil. It is also recommended that physical activity be reduced over time.

    Another type of surgical intervention is angioplasty – an operation during which the pathological part of the artery is replaced with a prosthesis or own vessel. However, in recent years, it is practically not used due to low efficiency.

    How to treat PMA hypertonicity

    The tone of the cerebral arteries is the tension of the vascular walls, which is supported by the muscular wall of these vessels. It is a factor determining the blood supply to brain tissue. Thanks to the muscle walls of the cerebral vessels, brain tissue is protected from a lack or excess of blood. With disorders of the nervous system or diseases of the internal organs, the tone of the arteries can change.

    The muscular wall of arterial vessels is spasmodic, their lumen decreases, as does the volume of blood entering the neurons. As a result of hypertonicity, tissue hypoxia develops (brain cells do not receive enough oxygen and nutrients). The hypertonicity of PMA, like other cerebral arteries, causes organic and functional disorders in the brain.

    Pathological hypertonicity of PMA occurs due to diseases of the internal organs, glands and metabolic disorders. Prolonged pronounced spasm of the arteries can lead to acute cerebrovascular accident (ischemic stroke), resulting in the development of irreversible organic tissue changes, the subsequent loss of motor functions and intellectual capabilities.

    The following causes lead to hypertonicity of PMA:

    • Psychological (anxiety disorder, vegetovascular dystonia, stress, mental stress, sleep disturbance, personality pathologies – psychopathy, accentuation);
    • Somatic (arterial hypertension, atherosclerosis, endarteritis, systemic diseases, diseases of the endocrine organs, dystrophic diseases of the musculoskeletal system, hyperthyroidism, inflammation of the tissue of the nerve nodes of the sympathetic parts of the autonomic nervous system);
    • Indirect (smoking, large doses of caffeine, diabetes mellitus, burdened by heredity, age from 50 years, weather sensitivity, prolonged stay in stuffy, unventilated rooms).

    PMA vasospasm is manifested by the following symptoms:

    • Headache spilled localization;
    • Deterioration of intellectual and mnestic activity (slowing down the pace of thinking, reducing the volume and concentration of attention);
    • A change in the physiological state (rapid fatigability, exhaustion);
    • Emotional disorders (mood lability, irritability, low threshold of excitability);
    • Nausea and vomiting;
    • Feeling of fullness in the head;
    • Impaired coordination of movements.

    Rarely in the clinical picture of PMA vasospasm is a syncope, but especially sentimental people, even with happiness, may lose consciousness.

    Comprehensive therapy of the disease is aimed at restoring brain function and increasing the body’s performance. Doctors at the Yusupov hospital begin treatment of hypertension of PMA with the treatment of the pathology that caused an increase in the tone of the cerebral vessels. Patients are advised on a dosed regimen of work, rest, full sleep, aromatherapy. Nutrition should be balanced: reduce the use of alcohol, coffee and caffeinated products, exclude the use of tonic drinks.

    Before going to bed, it is recommended to take a warm shower or bath, drink tea from rose hips or mint with the addition of honey. Drug therapy consists in stabilizing blood pressure, taking phytopreparations with a sedative effect. In order to undergo the diagnosis and treatment of ischemia, hypoplasia and asymmetry of the blood flow of the brain PMA, make an appointment with a neurologist by calling the contact center of the Yusupov hospital at any time, regardless of the day of the week.

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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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