Coronary artery disease of the brain what is it

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

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

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

Causes of the disease

Sufficiently different external and internal factors can trigger the development of such a serious disease as cerebral ischemia. Treatment, untimely begun, ends very poorly. That is why it is important to diagnose an ailment in the early stages. And, of course, do not hesitate with the treatment.

The main causes of ischemia in adults include:

  • Atherosclerosis. The build-up of body fat significantly narrows the lumen, obstructing blood flow.
  • The appearance of blood clots. No less rare reason for the development of the disease. Complete blockage of the cerebral artery by a blood clot completely blocks the necessary transportation.
  • Heart failure . One of the serious provoking factors. Acute failure, cardiac arrhythmias lead to the occurrence of ischemia.
  • Hypertension

However, this is not all the reasons why a serious illness can develop.

To additional sources of the onset of the disease, doctors include such factors:

  • cardiovascular problems;
  • blood diseases;
  • vasculitis;
  • diseases associated with the spine;
  • tachycardia;
  • gas poisoning (carbon monoxide);
  • anemia.

At risk for the occurrence of this ailment, doctors include people of advanced age, patients who are diagnosed with diabetes mellitus. It should be noted that lovers of malnutrition and smokers are also considered by doctors to be at risk.

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

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

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

  • If the carotid artery is blocked, then muscle weakness, blindness, and a violation of sensitivity appear.
  • With blockage of the vessels of the vertebral region, a split in the eyes appears, impaired movement.
  • Improper nutrition, in which a person consumes a lot of fatty foods rich in cholesterol.
  • Poisoning by harmful substances. It can be bad habits, nicotine and alcohol – those poisons with which a person is poisoned constantly and voluntarily. But there may be occupational hazards, especially carbon monoxide.
  • Diseases of the spine when blood vessels going to the brain are pinched. This is osteochondrosis, spondylarthrosis, curvature of the spine, trauma, hernia.
  • Inactivity. This leads to obesity, and to weakness of muscles, blood vessels, heart muscle.
  • Kidney ischemia.
  • Vascular diseases: spasms, arteritis, thrombophlebitis, aortic aneurysm.
  • Compression of blood vessels from the outside. It can be tumors, fractures.
  • Blood diseases: anemia, vasculitis, collagenosis, increased blood viscosity. This may include blood loss.
  • Caisson disease. The tissues of the body contain gases, and if a person inhales air under low pressure, they are released into the bloodstream, while destroying the walls of blood vessels, disrupting blood flow. You can find its other names: decompression sickness or disease of divers.
  • Brain ischemia in newborns can develop if there was a lack of oxygen in the mother’s blood during pregnancy or childbirth. This can be if the woman in labor lost a lot of blood, or there was placental insufficiency, late or too early birth.

The pathological mechanism of the development of cerebral ischemia is based on the insufficient supply of oxygen and nutrients to neurons, as a result of which normal functioning is disrupted and their death occurs.

Factors that can lead to the development of a lack of blood supply to the brain are:

  • morphological changes in cerebral vessels – disorders of the shape and configuration of blood vessels (aneurysms, vascular malformations, congenital malformations of the walls), occlusive lesions (prolonged spasm, blood clots, atherosclerotic plaques), anomalies in the structure of large vessels;
  • changes in the rheological properties of the blood and hemostasis system – impaired water-electrolyte balance (diseases of the endocrine system, kidneys), dysproteinemia (changes in serum protein fractions), increased tendency to thrombosis;
  • cerebral and general hemodynamic disorders – severe intoxication, severe anemia of various origins, cardiovascular disease in the stage of decompensation;
  • individual and age-related characteristics of nerve cell metabolism and their response to local deterioration of cerebral blood flow.

Most often, cerebral ischemia develops with a combination of atherosclerotic lesions of cerebral vessels and arterial hypertension. Cholesterol plaques gradually increase and block the lumen of the artery, reducing blood flow in it. An increase in blood pressure causes spasm of the arteries, as a result of which the blood flow through partially blocked vessels is even more disturbed, and in some cases completely stops, leading to severe oxygen starvation of brain cells.

Ischemia of brain structures is attributed to age-related changes, as a result of which the vessels lose their elasticity, become fragile. Vessels affected by atherosclerosis have a narrowed lumen in the cavity due to fat deposits on the walls, thereby disrupting blood flow.

Causes of chronic cerebral ischemia can be caused by concomitant pathologies of the cardiovascular and endocrine systems.

  • Heart rhythm failure (tachycardia, bradycardia);
  • Systemic vasculitis (inflammation of the walls of blood vessels with subsequent destruction);
  • Venous system diseases (phlebitis, varicose veins, obliteration);
  • Pinched vessels (osteochondrosis of the cervical spine);
  • Diabetes;
  • Cerebral amyloidosis (a violation of protein metabolism with deposition in the tissues of the amyloid);
  • Hereditary angiopathy (narrowing of small vessels or complete blockage);
  • Autoimmune diseases (production of antibodies leading to the destruction of healthy tissues);
  • Blood clots;
  • Persistent increase or decrease in blood pressure (hypertension, hypotension);
  • Osteochondrosis.

Chronic ischemia is more common in mixed etiology and occurs in leukoencephalopathic or lacunar form. The leukoencephalopathic form is characterized by bilateral diffuse lesion of the white matter, caused by persistent disorders in hypertension. The lacunar form is expressed by numerous foci due to the defeat of small vessels.

Chronic encephalopathy lowers the brain compensation mechanism, causing a malfunction of the brain structures with an increase in pathological symptoms, which leads to irreversible processes.

Clinical manifestations of pathology in the initial phase of development can be taken for overwork. Symptoms increase with a lesion of white matter occurs in the phase of active progression of the disease.

Symptoms related to the manifestation of chronic ischemia:

  1. Migraine;
  2. Apathy;
  3. Unstable emotional background (mood swings);
  4. Noise in ears;
  5. Unstable blood pressure (possible hypertensive crisis);
  6. Speech impairment;
  7. Violation of the musculoskeletal system (staggering gait caused by a violation of coordination);
  8. Loss of consciousness;
  9. Decreased sensitivity;
  10. Epileptic seizures;
  11. Damage to the motor path of the nervous system (paresis);
  12. Lack of voluntary movements (paralysis).

Chronic cerebral cerebral ischemia can have periods of temporary well-being with no symptoms.

As the main and essentially the only reason for the appearance of pathology, experts call atherosclerosis, which affects the cerebral vessels. Against this background, various fatty deposits gradually begin to build up on the inner walls of the blood channels. Their influence quickly enough spreads to the whole organism, vascular lumens narrow.

This, in turn, completely or partially disrupts the blood supply. Atherosclerosis is considered one of the most dangerous diseases today. Among all deaths, a large percentage of deaths is a consequence of this particular pathology. Coronary artery disease of the brain can also result from clogging of the blood channels by blood clots. Other provoking factors include tachycardia, heart failure, anemia, bradycardia, carbon monoxide poisoning and others.

Forms of the disease

In medicine, there are two categories of ailment:

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

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

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

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

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

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

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

The main factors provoking the disease:

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

In medicine, there are three degrees of severity:

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

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

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

There are three of them. Each stage has its own characteristics.

  • Coronary disease of the brain 1 degree. At this stage, in addition to the symptoms described above, the patient develops sleep disturbances, memory and attention impairment, a feeling of noise and heaviness in the head.
  • Coronary disease of the brain 2 degrees. At this stage, the patient has severe neurological syndromes. In particular, instability appears during the walking process, dizziness intensifies, social adaptation is disturbed, depression and emotional disorders develop. In addition, this stage is characterized by a limited ability to control and plan, a pronounced deterioration in memory, including professional. Nevertheless, against the background of the listed manifestations, the patient still has the opportunity to serve himself independently.
  • Coronary disease of the brain 3 degrees. In addition to the signs already mentioned, the patient’s memory is sharply disturbed, weakness and dysfunction of the extremities develop, and the personality decays. Along with this, urinary incontinence, loss of self-care ability, and speech disorders are noted. In this condition, the patient needs constant assistance. The third stage usually occurs in the absence of therapy.

Chronic brain encephalopathy is divided into the degree of the pathological process. The volume of the necrotic focus affects the severity of symptoms.

Degrees of discirculatory encephalopathy:

  1. Initial stage – slight cognitive impairment occurs (decreased memory and concentration). Work related to intellectual activity causes great fatigue. Unreasonable irritation is growing, panic attacks and depression are possible. Complaints of headaches and changes in gait are noted – uncertain, slow steps. These manifestations are characteristic of diffuse micro-focal lesions – social adaptation is not impaired;
  2. Subcompensation – minor symptoms develop into a mild disease syndrome. Cognitive disorders become pronounced – mental processes slow down, thinking is impaired. The ability to plan and control actions decreases, social adaptation is disrupted;
  3. Decompensation – the manifestations of neuralgic syndromes are increasing, behavior is not controlled, aggression and apathetic-abulic syndrome (psychopathy) are observed. Dysfunction of speech and memory develops into dementia (dementia). The ability to maintain equilibrium is significantly reduced, night enuresis (inability to hold urine) joins. Chronic cerebral ischemia of the degree of decompensation leads to slow maladaptation, both in the professional and in the social sphere. The patient becomes disabled, gradually losing the ability to self-care.

Cerebral ischemia, related to the initial degree, is difficult to diagnose, due to the absence of complaints from the patient due to minor symptoms. The initial manifestations of ischemia can be taken for overwork.

Grade 3 ischemia is very dangerous. The pathological process can proceed without complaints from the patient, with the development of an ischemic attack (microstroke), a person suffering from dementia is not able to explain what worries him. A microstroke is expressed as paralysis or loss of sensation on one side of the body. Localization is possible in a separate area of ​​the body.

Manifestations of a microstroke can also be in the form of one-sided loss of vision. An ischemic attack that does not go away during the day has the consequences of a stroke that affects part of the brain tissue. This degree is diagnosed mainly in age-related patients and leads to disability.

Ischemia refers to organic lesions of the brain and proceeds without an inflammatory process. Nerve tissue and intercellular substance are destroyed due to tissue dystrophy. Symptoms expressed in any part of the body are the opposite of the lesion. An extensive lesion causes paralysis of the limbs. A pathological lesion localized in the brain stem leads to death.

Supratentorial foci of lesion in the occipital lobe have a vascular origin. Symptoms of the pathology depend on the size of the focus and the number of affected neurons. Vast lesion area leads to cerebral infarction and death.

Supratentorial gliosis happens:

  1. A few (in the presence of 2-3 lesions);
  2. Multiple (more than 3 formations);
  3. Small focal (multiple small lesions in various parts of the brain);
  4. Focal (large single lesion with proliferation of neuroglia).

The death of neurons leads to the growth of the supporting tissue of the nervous system (glia), to fill the freed space.

Ischemia of brain structures is found not only in adults, this pathology is often found in perinatal neurology. A difficult pregnancy or difficult birth leads to brain hypoxia in the infant. Lack of oxygen or its absence has a high mortality rate among infants.

  • Marbling of the skin;
  • Weak sucking reflex;
  • Dysphagia (violation of swallowing);
  • Anxious sleep (startle);
  • Shallow breathing;
  • Convulsive syndrome;
  • Crying not related to hunger;
  • Muscle atony (decreased tone);
  • Reduced reactions.

The degree of ischemia in newborns:

  1. The first degree, refers to a mild form and manifests itself a few days after birth. The baby has an excited or vice versa depressed state of the nervous system. The muscles are in a small tone;
  2. The second degree of ischemia in infants refers to moderate, has neuralgic disorders and seizures. Hydrocephalus and a decrease in muscle tone are expressed. Short-term loss of consciousness and apnea is noted (respiratory arrest during sleep);
  3. The third degree, refers to severe encephalopathy and leads to dysfunctions of the central nervous system and a threat to life. Reflexes are completely absent, blood pressure is increased, strabismus is expressed. A respiratory arrest occurs and a coma condition is diagnosed.

First degree ischemia in infants is observed in the maternity hospital, followed by outpatient monitoring by a neurologist. Timely response gives favorable forecasts for the newborn.

Moderate to severe, requires inpatient treatment, after which the symptoms are completely absent. Severe encephalopathy requires resuscitation, dysfunctional lesions of the nervous system lead to developmental abnormalities.

Causes and symptoms of the disease

This pathology is quite easily diagnosed in the early stages. The first signs are fatigue and a decrease in brain activity. Over time, a number of other conditions signaling deterioration are added to these manifestations. Clinical manifestations progress at a fairly high speed, gradually expanding the scope of their influence. The most characteristic signs of pathology include:

  • Severe memory impairment.
  • Frequent dizziness.
  • Vomiting, nausea.
  • Headache.
  • Pressure surges and fainting following.
  • General weakness.
  • Speech disorders

Cerebral ischemia of a chronic nature is manifested quite intensively. Signs of pathology are noted quite early, thus allowing, in a timely manner, to eliminate the violation. Nevertheless, it is necessary to take into account that the clinical signs that accompany ischemic brain disease may vary depending on the individual characteristics of each patient, manifesting in each case in its own way.

The most important sign of the disease is fatigue during the active functioning of the brain. Subsequently, forgetfulness and serious memory impairment are added.

The main symptoms of cerebral ischemia:

  • weakness;
  • dizziness;
  • fatigue;
  • nausea;
  • fainting;
  • headaches, often turning into a migraine;
  • sleep disturbance;
  • irritability;
  • pressure drops;
  • increased excitability;
  • speech impairment.

It is important to understand that the disease has several degrees of development. The above symptoms are the main ones that occur in a person who is diagnosed with cerebral ischemia. Symptoms, treatment directly depend on the degree of the disease. And each new stage adds to the main manifestations additional signs characteristic of this ailment.

The main clinical signs of chronic cerebral ischemia are emotional disorders, memory impairment, learning and memory abilities, as well as motor disorders. There is a marked inverse relationship between cognitive impairment and the presence of complaints: the more cognitive activity suffers, the fewer complaints are made by patients. Therefore, it is impossible to assess the severity of the pathological process on the basis of subjective sensations and complaints of patients.

The main symptom of cerebral ischemia in a chronic course is cognitive impairment. At the same time, motor disorders and disorders of the emotional sphere arise and gradually progress.

Acute cerebral ischemia occurs suddenly, its manifestations:

  • Strong headache ;
  • nausea, sometimes even vomiting, and vomiting does not bring relief;
  • general weakness;
  • vegetovascular reactions (sweating, trembling, flushing);
  • blurred vision;
  • short-term impaired consciousness;
  • focal neurological symptoms (determined by the location of the ischemic process).

With a transient disorder of cerebral circulation, impaired neurological functions are fully restored within 24 hours. If neurological symptoms disappear within a week, then they speak of a minor stroke. The persistence of a neurological deficit over 7 days indicates a completed ischemic stroke.

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

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

Cerebral ischemia in newborns

The development of cerebral ischemia in newborns leads to fetal oxygen starvation during pregnancy or in the process of labor.

The following signs suggest the presence of cerebral ischemia in a newborn:

  • marbling of the skin;
  • startles and causeless crying;
  • sleep disorders;
  • muscle atony;
  • head volume is more than normal;
  • bulging large fontanel;
  • violations of sucking and swallowing;
  • respiratory failure;
  • convulsive seizures.

Extent of the disease

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

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

Causes and symptoms of the disease

Diagnosis of cerebral ischemia is sometimes difficult, as its symptoms are similar to those of a number of other diseases, in particular:

  • cortico-basal degeneration;
  • progressive supranuclear palsy;
  • Parkinson’s disease ;
  • multisystem atrophy;
  • Alzheimer’s disease ;
  • brain tumors;
  • ataxia;
  • idiopathic dysbasia;
  • normotensive hydrocephalus.

A comprehensive examination begins with an examination of the patient, determining the neurological status, assessing the state of the cardiovascular and respiratory systems. In order to determine neurological status assess:

  • clarity of consciousness;
  • the coordination of movements of the eyeballs;
  • pupil reaction to light;
  • face symmetry;
  • ability to make faces, facial expressions;
  • speech;
  • tongue movements;
  • coordination of movements;
  • muscle tone and muscle strength;
  • memory;
  • tendon reflexes;
  • sensitivity.

Chronic cerebral ischemia reduces brain activity, causing metabolic disorders, thereby triggering the formation of microcysts in the cortical layers of the brain. Violation of blood transport leads to increasing oxygen starvation with the gradual development of tissue necrosis.

Diagnosis of pathology is aimed at a comprehensive examination to exclude manifestations of neuralgia with typical changes in the elderly. For the accurate diagnosis of chronic cerebral ischemia, they resort to the help of relatives in order to gradually restore changes in the cognitive sphere.

Based on subjective complaints, the patient is referred to a neurologist who collects a detailed medical history and carries out a preliminary examination.

Assessment of monitoring the nervous system:

  • Consciousness (confused or clear);
  • Violation of the speech apparatus (clarity of speech);
  • Muscle tone;
  • Pupil reaction;
  • Susceptibility of the skin to the irritant;
  • Coordination of movements;
  • Symmetry of facial features;
  • Memory;
  • Eyeball movement;
  • Tendon reflexes;
  • Facial expressions;
  • The muscles of the tongue.

A preliminary examination is carried out to monitor the cardiovascular system. Blood pressure is measured on both forearms and lower extremities, the symmetry of the pulsation in the vessels of the head and lower extremities is estimated. Listening to the heart and abdominal aorta reveals abnormalities in heart rhythm.

To determine the affected hemisphere of the brain and the vastness of the necrotic focus in the white matter, diagnostic research methods are prescribed:

  1. CT scan of the brain (computed tomography);
  2. MRI (magnetic resonance imaging);
  3. Ultrasound examination (ultrasound diagnostics);
  4. Roentgenography;
  5. ECG.

Laboratory analysis of blood and urine, allows to identify concomitant diseases that have become a trigger in the development of chronic brain ischemia. Electrocardiography is prescribed as part of a detailed examination to identify vascular pathologies.

CT of the brain is considered a differential diagnosis and is aimed at identifying: intracerebral hemorrhage, hemorrhagic strokes, consequences after traumatic brain injury, neoplasms, encephalopathy due to hypertensive crisis, purulent foci, infectious diseases.

A snapshot with the information received allows you to evaluate the focus and its location during a stroke, as well as the presence of edema. This diagnosis allows you to evaluate vascular abnormalities in the brain:

  • Violation of the integrity of blood vessels;
  • Thrombosis of veins and sinuses;
  • Regulation of vascular tone and tortuosity;
  • Atherosclerotic changes in the walls of arteries.

To assess blood flow in the cranium, a bolus (intravenous-drip) injection of a contrast agent into the bloodstream, followed by x-ray, is used. Angiography makes it possible to assess the structure of the circle of Wells and to detect stenosis and occlusion in case of encephallopathic stroke. Ischemic stroke appears in the images as dark spots.

Signs of tissue infarction are manifested by difficult visualization of the transition between gray and white matter. At the site of ischemic damage there is dysmetabolic (reversible) or vasogenic edema (increased brain volume).

CT diagnostics are not used to assess damage to the cerebellum and brain stem, a possible image defect due to the temporal bone pyramid. Identification of an early stage of changes in the posterior cerebral artery refers to a sign of embolism or the presence of a blood clot in this vessel.

The lesion as a result of a stroke is diagnosed on the basis of a picture in which there is no visualization of the cortex of the islet and lenticular nucleus due to cytotoxic edema.

Uz study using dopplerography, allows to determine the violation of the vascular bed. The application of this technique allows you to: assess blood flow, detect blood clots, detect vascular reform in atherosclerosis, tissue edema, fluid accumulation and atrophic tissue changes. Duplex ultrasound scanning displays the vessel wall and its location.

The most informative method is magnetic resonance imaging of the brain (MRI) – allows you to identify pathology without puncture arteries. A tomograph based on magnetic fields and high-frequency pulses transmits the image of the brain to a computer. The use of a contrast agent in the procedure improves the visualization of blood vessels in the image.

MRI allows you to get a picture of the skull in three planes, and examine in detail the tissues and vessels in the brain. Tomography is prescribed to identify the pathological focus and its localization, as well as the diagnosis of concomitant diseases leading to cerebral ischemia.

  • Focus of necrosis;
  • Atherosclerotic plaques in the vessels;
  • Blood clots
  • Neoplasms;
  • Cysts
  • Hematomas;
  • Vascular defects;
  • Changes in nerve tissue;
  • Inflammation of the meninges.

Based on the data obtained through a comprehensive examination, the neuropathologist will diagnose and prescribe therapy.

Diagnosis of brain dysfunction in newborns is aimed at identifying the causes of the pathological process. A neonatologist evaluates neurological status, respiratory function, and heart function.

For the diagnosis of ischemia in newborns, apply:

  • MRI scan;
  • Neurosonography (ultrasound diagnostic method in children up to a year);
  • CT scan of the brain;
  • Doppler Encephalogram;
  • Angiography using a contrast agent;
  • ECHO-KG.

Timely detected brain dysfunction has a positive trend in the implementation of therapeutic measures.

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

The disease goes away gradually and several stages of cerebral ischemia are distinguished during the course. The stages are numbered in order, that is, 1, 2, 3 stages of the disease.

At the same time, processes taking place in the brain at the highest level lead to various pathological changes.

According to the forms of the disease, they are divided into two subspecies:

The syndrome of the chronic form of the disease of the higher parts of the central nervous system is gradual. The acute form usually passes instantly with signs of a microstroke or stroke.

Treatment of cerebrovascular insufficiency

Treatment of chronic cerebral ischemia is aimed at stabilizing the destructive process and restoring blood flow to slow the progression of acute hypoxia.

The goal of therapy is to activate physiological compensation mechanisms, as well as the treatment of concomitant pathologies. Complex treatment is prescribed using conservative and surgical methods (according to indications). An absolute indication for hospitalization is a complication of ischemia in the form of a stroke, or severe somatic pathology.

Cognitive impairment of the brain in elderly patients is exacerbated by a change in the usual environment, neuropathologists recommend outpatient treatment. Encephalopathies in the 3 stages of the course are observed with the help of outpatient patronage.

To treat chronic cerebral ischemia, possibly with drug therapy, which is aimed at restoring blood circulation in the lesion and preventing structural disorders.

  1. Support Blood pressure (preventing the development of new foci of necrosis and reducing the risk of dementia);
  2. Restoration of neuroprotection (metabolism in cerebral tissue);
  3. Anticoagulants (dilute blood and prevent relapse of arterial thrombosis);
  4. Cerebroprotectors (protect brain neurons);
  5. Nootropic drugs (improve cerebral circulation).

Medicines are taken in long courses with short breaks. Stabilization of blood pressure and the presence of positive dynamics is an important indicator of properly selected therapy and excludes the appearance of new lesions in hypertensive crises.

A fairly new treatment method with complete tissue regeneration is stem cells. Obtained on the basis of the patient’s biomaterial and administered intravenously. Once in the bloodstream, the cells find the lesion and begin to divide, thereby completely restoring the affected area.

To reduce the syndrome of the disease at the initial stage, are shown: electrophoresis, massage of the collar zone and head, acupuncture, exercise therapy. As part of the complex treatment of chronic cerebral ischemia, a diet with a low content of saturated fats is prescribed.

The treatment of ischemia in newborns with a mild degree does not require drug therapy; a massage course is enough to improve the general condition. Antihypertensive therapy is necessary for severe brain dysfunctions, prescribed drugs stimulate vasodilation and renew brain cell nutrition. According to indications, anticonvulsants and forced diuretics are connected (with cerebral edema).

Chronic cerebral ischemia, which does not have positive dynamics during conservative treatment, or diagnosed occlusion-stenotic vascular lesions, is an indication for instrumental intervention.

It is possible to restore vascular patency and blood flow through them, using stenting of the carotid arteries (used to treat stenosis) and carotid endarterectomy (removal of the inner wall of the carotid artery, with clogging of an atherosclerotic plaque leading to vessel destruction).

Instrumental methods in infants are performed in the presence of cerebrospinal fluid in the cavities of the brain (hydrocephalus). The performed ventriculoauriculostomy allows fluid to be removed through the lateral ventricles and large cisterns of the brain into the right atrium, thereby normalizing cranial pressure.

As mentioned above, to date, no effective medication has been developed to eliminate pathology. As a rule, doctors resort to surgical intervention. In this regard, from the middle of the last century, various operational methods have been quite actively introduced into practice to correct and restore damaged vessels that feed brain tissue.

The essence of surgery is to remove a blood clot or plaque that clogs the lumen of the blood channel. This manipulation allows you to restore brain nutrition with the necessary compounds and oxygen. For experienced professionals, such an intervention, as a rule, is not a big deal.

Dysfunction of cerebral vessels contributes to the development of many ischemic diseases. The most severe of these is cerebrovascular insufficiency. Treatment of a pathological condition after diagnosis is prescribed individually. Often use drug therapy, correct lifestyle. In order to prevent the development of a stroke, sometimes the patient is prescribed surgical treatment.

The disease must be treated comprehensively. To reduce cholesterol, medications are prescribed – statins. Their main action is aimed at reducing the production of enzymes that produce cholesterol in the adrenal glands and liver cells. Statins do not have a mutagenic or carcinogenic effect, but have some side effects, so they are prescribed with caution to the elderly. Atorvastatin, Fenofib, Lovastatin are considered more effective drugs.

To combat high blood pressure that provokes ischemia, low doses of thiazide-like diuretics are prescribed. The drugs remove excess fluid from the body, while reducing the load on the heart muscle. They are used with monotherapy, and in combination with other drugs. A feature of statins is the ability not only to lower blood pressure, but also to correct the negative effects that chronic cerebral ischemia can provoke. Drugs in this group – Ramipril, Perindopril, Enalapril.

Therapy of such a pathology as chronic cerebral ischemia, without fail, needs to restore blood flow by expanding blood vessels and diluting blood. Drugs whose action is aimed at improving brain cell nutrition and normalizing blood circulation are an indispensable part of the comprehensive treatment of the disease. These include derivatives of nicotinic acid (Enduratin, Nikoshpan), calcium antagonists (Adalat, Foridon), vinca alkaloids (Cavinton, Vinpocetine).

Chronic starvation of brain neurons is a dangerous condition that can be improved with vasoactive drugs. They improve blood supply in the vessels by expanding the microvasculature. Vasoactive drugs include: phosphodiesterase blockers (Pentoxifylline, Tanakan), calcium blockers (Nimodipine, Cinnarizine), alpha-blockers (Niceroglyn).

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Neuroprotectors

Neuroprotectors are able to reduce biochemical disturbances in nerve cells. Coronary heart disease destroys neural connections, and these drugs can protect and improve brain adaptation to negative influences. The appointment of neuroprotectors after a stroke is the most effective treatment.

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

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

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

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

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

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

Treatment of cerebral ischemia can be conservative or surgical. Its goal is a complete recovery, or at least a significant improvement in cerebral blood flow.

The drug regimen includes drugs of the following groups:

  • neuroprotectors – protect brain neurons from hypoxic damage;
  • vasodilating – due to the expansion of the lumen, blood flow through the cerebral arteries improves;
  • anticoagulants – reduce the risk of blood clots, improve the rheological properties of blood;
  • lipid-lowering – lower blood cholesterol and thereby reduce the rate of progression of atherosclerosis.

Physiotherapy methods (magnetotherapy, electrophoresis, physiotherapy exercises, massage, myoelectrostimulation) are of no small importance in the complex treatment of cerebral ischemia. A good therapeutic effect is exerted by microcurrent electroreflexotherapy, which normalizes cerebral circulation and improves the function of neurons.

Surgical treatment of cerebral ischemia is indicated for severe stenosis of the cerebral arteries or their blockage with an atherosclerotic plaque, thrombus. Most often perform the following operations:

  • carotid endarterectomy;
  • thrombectomy
  • stenting of the carotid arteries.

One of the experimental methods for treating cerebral ischemia is the use of stem mesenchymal cells. These cells, once in the affected areas of the brain, attach to the tissues and contribute to the development of the collateral (bypass) network of blood vessels.

Possible consequences and complications

The severity and severity of the long-term effects of cerebral ischemia are determined by the form and stage of the disease. The most common complications are:

  • ischemic stroke – is accompanied by softening and death of a portion of brain tissue;
  • articulation disorders, up to dumbness;
  • dysfunctions of the pelvic organs;
  • persistent violations of swallowing and breathing;
  • areflexia;
  • paralysis;
  • paresthesia;
  • encephalopathy;
  • epilepsy.

Common home remedies

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

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

Among the most popular recipes, it is worth noting the intake of dill with hot water before eating. Insist the grass for half an hour, filter and drink. Often used garlic tincture for alcohol. For its preparation, the teeth are finely chopped and filled 1/3 of a half-liter bottle. Garlic is poured with alcohol and left for 14 days in a dark place.

According to traditional healers, taking 5-7 drops of tincture, dissolved in a spoon of milk or water, eases the patient’s condition. It is also believed that the use of walnuts helps prevent the development of spasms of the blood channels and prevents complications. A spoonful of nuts is poured into 0.5 l of boiling water, then infused for 15 minutes in a water bath. You need to drink 1/2 cup 3 times a day before meals (30 minutes).

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

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

Forecast

The main complication is stroke. But even before its onset, the patient clearly senses a variety of signs of circulatory disorders. The harbingers of a stroke are darkening in the eyes, disorientation in space, headache. If a person has allegedly suffered a stroke, then therapeutic measures should be carried out immediately.

It must be borne in mind that damaged areas can be restored within 3-7 hours after the attack. During this time, the death of brain cells and subsequent organ dysfunction can be prevented. On the second day, due to circulatory disorders, there is a final destruction of the structural elements of an irreversible nature.

The foci of chronic cerebral ischemia, detected at an early stage, have a positive trend when drug therapy is connected. Timely requesting qualified help can stop the pathological process.

Identified late stage encephalopathy and burdened with concomitant diseases, has an unfavorable prognosis. Cerebral ischemia of the 3rd degree – disability, or fatal outcome of the disease.

Timely detection of brain ischemia in newborns has a favorable prognosis for life and a complete cure. The consequences of hypoxia, expressed as:

  • Developmental delay;
  • Headache;
  • Sleep disturbance;
  • Learning difficulties;
  • Fast fatiguability;
  • Impaired memory;
  • Cramps (when the temperature rises).

With extensive lesions:

  • Severe neuralgic disorders;
  • Convulsions (not associated with hyperthermia);
  • Psychosomatic disorders;
  • Epilepsy;
  • Cerebral palsy (cerebral palsy).

Chronic cerebral ischemia caused by intrauterine hypoxia, or arising during difficult childbirth, has a low life expectancy – a fatal outcome occurs immediately after childbirth, or in the first days of life.

Identification of brain pathologies requires lifelong observation by a neurologist and course treatment. Prevention and timely treatment of concomitant diseases will help to avoid dysfunctions of the brain structures.

With timely diagnosis and adequate therapy, the progression of chronic cerebral ischemia significantly slows down. The prognosis worsens in the presence of severe concomitant pathology (hypertension, arrhythmia, diabetes mellitus).

Complications of cerebral ischemia usually develop in the case of late seeking medical help or severe acute cerebrovascular insufficiency, which occurs with intracranial hypertension, damage to stem structures and massive death of neurons.

Preventive measures

Since coronary artery disease of the brain can occur at any age, measures must be taken to prevent its occurrence as early as possible. As a basic preventive measures should be put in order daily regimen and food. It is necessary to protect yourself from physical inactivity, smoking, frequent overeating, drug and alcohol abuse.

You should also try to avoid stressful situations. Maintaining such a lifestyle will protect the body not only from ischemic, but also from many other diseases. Equally important is nutrition. Trace elements and vitamins should come with food. Lipid-lowering drugs will help protect internal organs from damage and reduce blood viscosity.

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

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

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

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

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

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

Proper nutrition

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

The main thing is to understand the essence:

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

Conclusion

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

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

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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