According to the latest classification by ICD-10, atherosclerosis refers to “other cerebrovascular diseases” and is code I67. Symptomatology is directly related to cerebrovascular insufficiency – sleep disturbances, memory disorders, multiple sclerosis, and other disorders of mental activity up to dementia.
Treatment is always prescribed complex with the use of nootropics, lipid-lowering, antiplatelet drugs. With the ineffectiveness of conservative therapy, surgical intervention is indicated.
In modern neurology, special attention is paid to sclerosis of cerebral vessels, since it is he who provokes such complications as dementia with stroke. The term “atherosclerosis” refers to a violation of hemodynamics (blood flow) due to the narrowing of the lumen of blood vessels. In addition to age-related changes, lipid metabolism affects the capacity of the circulatory system. With an excess of low-density lipoproteins (or just fat), they are deposited on the walls of large and small arteries.
The vascular tone decreases accordingly, as the body tends to isolate potentially dangerous objects. Hence the growth of fibrous fibers and calcification of deposits. This phenomenon is considered a disease of the elderly, although with certain congenital abnormalities it can even occur in children. What causes vascular insufficiency with appropriate diseases?
There are quite a few prerequisites for the development of cerebral atherosclerosis. First of all, it’s age. Even with a healthy lifestyle, proper nutrition, the body’s resources are not infinite. The metabolism inevitably slows down, metabolic processes begin to prevail over anabolic, and fat is deposited on the walls of large and medium arteries. Against the background of alcohol abuse, smoking process is much faster.
Any diseases and conditions that adversely affect the tone of the vascular wall at a younger age:
- arterial hypertension;
- chronic infections;
- intoxication (including smoking, drug use, alcohol abuse);
- unfavorable psycho-emotional background – chronic stress or experiences, events that cause both positive and negative emotions.
To unequivocally identify the cause of sclerosis of cerebral vessels in each case is not possible. Since the provoking factors usually act in aggregate, one can speak about the polyetiological nature of the pathology. That is, violations of the central nervous system – the result of several reasons.
As a result of impaired fat metabolism (increasing the concentration of low-density lipoproteins in the blood), deposits — cholesterol plaques — form on the walls of blood vessels. Over time, they increase in size, calcify, and then begin to pose a threat to life.
These formations are the cause of thromboembolism – blockage of vital vessels. Tearing away from the place of attachment, such a plaque circulates with the blood flow, and subsequently falling into a vessel of smaller diameter, blocks it. This is one of the causes of heart attacks.
The other is the formation of a massive plaque in the lumen of a large vessel without separation. Gradually blocking the bloodstream, it contributes to the ischemia of the body (blood supply insufficiency). If we are talking about the cerebral arteries, the presence of cholesterol plaques provokes a nutritional deficit of the brain and, accordingly, its dysfunction.
Individual neurons die under conditions of oxygen deficiency, which is manifested by dyscirculatory encephalopathy. The degree of damage depends on the size of the vessel, the size of the plaque, as well as the possibility of developing a collateral vascular network.
Symptoms of atherosclerosis stages
Clinically, the disease for a long time may be asymptomatic. That is, under certain disorders of vascular tone, the appearance of general well-being will remain. When the signs of cerebral atherosclerosis become more obvious, they can be divided into three stages.
It begins with forgetfulness, memory impairment. Not only the ability to memorize, but also the concentration of attention decreases. At the same time, asthenic syndrome is observed: general weakness, fatigue when performing physical work.
At the same time, there are often complaints of dizziness, desire to sleep, various sleep disorders. Characteristically, a decrease in the rate of thinking and mental reactions to events occurring around.
At this stage of development of atherosclerosis of the cerebral vessels, there is a persistent deterioration in the patient’s memory, together with a depressive state. A person suffering from atherosclerosis is not able to remember and reproduce the events of the recent past. His relatives, trying to remind of the facts, provoke suspiciousness, anxiety, and depression in the patient.
At this stage, vestibular ataxia (lack of coordination of movements), tremor of the limbs, and sometimes hearing loss occur. Accordingly, the basic skills of social interaction, ability to work are lost.
Social skills are already completely lost on the background of progressive dementia. The patient is unable to contact with others, demonstrates a complete lack of memory. Speech at the same time difficult, incoherent.
Since hygiene cannot be maintained and the patient cannot eat because of mental disorder, he needs constant supervision and maintenance.
The initial diagnosis is made, as always, on the basis of history and complaints. During the survey and examination of the patient with cerebral atherosclerosis are identified:
- nystagmus – abnormal oscillatory eye mobility;
- lethargy or symmetrical lowering of reflexes;
- tremor of extremities in an extended condition;
- instability in the so-called Romberg position – staggering in a standing position with legs shifted and eyes closed.
In the subsequent studies are appointed, giving a more complete picture of the state of the brain vessels of the head. Rheoencephalography, USDG, allowing to judge their filling, patency, the presence of atherosclerotic plaques, as well as MRI, duplex scanning.
In order to visualize (especially for strokes), such diagnostic procedures as an encephalogram, MRI, CT are performed. Profile specialists are also involved: an otolaryngologist to determine the degree of hearing loss and an ophthalmologist to confirm atherosclerotic retinal changes.
The main constant question of the patient’s relatives is: “Is it possible to completely cure sclerosis of the brain?” No, this disease cannot be cured. You can only slow the growth of symptoms, the development of pathology.
Treatment is always complex (medicament in combination with diet, psychotherapy), since it is impossible to reliably determine and exclude the cause. Conducted mainly on an outpatient basis – at home.
The diet of patients with neuropathy should always include a significant amount of products containing B-group vitamins. These are cereals, soybean, legumes, liver, some types of greenery. In atherosclerosis, it is strictly forbidden to eat high-cholesterol eggs, animal oils, canned fish. The ban also includes all varieties of fast food, including soda, sugar, and other easily digestible carbohydrates.
What can you eat without limitation with signs of atherosclerosis of cerebral vessels? Everything except fatty animal products. That is, poultry, lean fish, egg white, skimmed milk. Any cereals, vegetables, fruits. Banned confectionery (there are always a lot of trans fats), chocolate, sweet pastries. Often it is the characteristics of nutrition that play a key role in maintaining intellectual abilities and maintaining a high level of quality of life.
To stabilize the condition of patients with a diagnosis of cerebral atherosclerosis, there are many proven treatment regimens and drugs. Appointment depends on the cause of the pathology, individual characteristics, contraindications. What can be treated vascular insufficiency:
- Lipid-lowering drugs that reduce the content of “harmful” low-density lipoproteins in the blood. These include: Fluvastin, Simvastatin, Atromidine.
- Antihypertensive drugs. Shown in patients with high blood pressure.
- Nootropics (such as Cortexin, Piracetam). Medications of this group are used primarily to stimulate cerebral circulation, improve cognitive functions. They also improve cortical subcortical connections, compensate for neurological deficit.
- Antiplatelet agents interfere with gluing and adhesion of platelets, thus optimizing the fluidity of the blood, increasing the period of its clotting. The most commonly prescribed tablets are Tiklid, in addition, conventional acetylsalicylic acid (Aspirin) can be used as an antiaggregate agent.
- Means, corrective cerebral blood flow with neuroprotective action – Vinpocetine, Pentoxifylline, Nifedipine.
Along with the increase in food content of B vitamins, it is recommended to regularly take appropriate multivitamin complexes.
For the treatment of vascular atherosclerosis, various alternative medicine recipes are often used. They have no advantage over the above medications and can be used exclusively as an additional therapy. Among the most effective can be distinguished decoction of birch buds (boil a spoonful of raw materials in a glass of water for about 5 minutes) or a mixture of onion juice and honey in equal parts.
Honey-nut mix (walnuts are used), sea kale in fresh, canned or dried form have a good effect on brain activity. Useful decoction of parsley, plantain, strawberry leaves, elecampane, as well as pharmacy or homemade tincture of Eleutherococcus. These folk remedies help reduce the symptoms of the disease.
However, they cannot treat atherosclerosis without a doctor’s permission, since side effects or other negative reactions may develop.
Various sleep disorders, increased anxiety, and depression are often the first signs of cerebral arteriosclerosis. Stopping or treating such conditions during psychotherapeutic sessions often helps to slow down degenerative changes, improve the patient’s quality of life.
In addition, relatives of the patient can independently create at home a favorable psycho-emotional background. Such an atmosphere helps to maintain cognitive functions and stabilize a person’s condition with signs of atherosclerosis.
Under certain conditions — no effect of conservative drug therapy — surgery may be prescribed. Indications for it are a reduction in the lumen of a blood vessel by more than 70%, relapses of transient ischemic attacks, or so-called minor strokes.
Surgical intervention involves either removing the plaque from the inside of the vessel, or creating an artificial collateral shunt around the affected area.
Prevention and prognosis
The consequences of atherosclerosis of the brain are stroke and dementia. The success of treatment depends on the age of the patient. The younger the patient, the more likely it is to slow the progression of the pathology. Also of great importance is the possibility of eliminating risk factors: psycho-emotional stress or the use of narcotic substances (including alcohol), and smoking.
Common preventive measures include a healthy lifestyle. What does this concept include? First of all – a normal psycho-emotional background. That is, the absence of shocks, negative consequences of experiences of any type.
The diet is very important: lack of B-group vitamins, excess of fat with protein deficiency contribute to the development of neuropathies. It is necessary to move more – both at home and in the fresh air, not to concentrate on bad impressions, to receive positive emotions, to go in for sports.