What is cerebral ischemia and what consequences can this condition lead to?
- 1 Ischemia of the brain: basic concepts
- 2 Peculiarities of normal and abnormal blood circulation in the human brain
- 3 Classification of circulatory disorders of the brain
- 4 Acute cerebrovascular accident
- 5 Circulatory disorders of the brain in old age
- 6 Infringement of cerebral circulation in childhood
- 7 Conclusion
Ischemia of the brain: basic concepts
The brain is the main organ of the person, belonging to the central nervous system. In humans, the large brain represents:
- 2 large hemispheres;
- intermediate brain;
All structures of the skull have a unique histological structure and perform specific functions. With the defeat of one of the parts of the organ of thinking, somatic disorders occur, which over time can be compensated by transferring functions from one department to another. For example, during a stroke in the cerebellum, coordination of movements is disturbed, and the person stops moving. With well-chosen rehabilitation measures, the bark (gray matter) takes control of the coordination of movements, and the person begins to move normally.
Brain ischemia is a painful condition that is associated with the inability of the blood vessels to provide adequate nutrition to the cells that make up the brain. This condition can be acute (stroke, cerebral infarction) or chronic. Ischemic brain disease causes a common disease among the elderly – encephalopathy. For its full existence, the brain needs a sufficient supply of oxygen and glucose. When malnutrition begins signs of insolvency.
Peculiarities of normal and abnormal blood circulation in the human brain
To properly understand the problem of circulatory insufficiency of the brain in adults and newborns, it is necessary to know how nutrients reach the desired organ cells.
The main organ of the central nervous system receives nutrition through the branches of the internal carotid and basilar arteries. The common carotid artery, on which its own pulse is palpated, lies near the larynx. It is near the thyroid cartilage (where the male adnexus is located) that this vessel is divided into the external and internal carotid arteries, the latter goes into the cavity of the skull.
In the blood supply to the hemispheres, the cortical branches play a large role, which feed almost all their departments. Often, with the development of their pathology, ischemia of cerebral vessels occurs.
The vertebral artery has long been known among the population, since the diagnosis of “vertebral artery syndrome” is often made by neuropathologists. This blood vessel from the 6th cervical vertebra through the holes in the transverse processes rises into the cavity of the skull and there diverges into 2 branches: the basilar and anterior spinal cord. They, in turn, supply blood to the departments of the medulla oblongata, cerebellum, and partly the spinal cord. With the pathology of the neck muscular corset, the vertebral artery is partially clamped, which causes oxygen starvation of the brain regions for which it is responsible for nutrition. This is how vertebral artery syndrome arises.
A special role in the blood supply to the brain is played by the arterial circle of the large brain, or the so-called Willis circle. This formation helps to compensate for the blood supply to the brain in the event of failure of one of the arteries and to save a person’s life. Doctors are guided by this particular feature of the blood supply to the brain when they develop tactics for the treatment of cerebral ischemia, taking into account the symptoms that occur in old age.
Outflow of venous blood occurs through the great cerebral vein. If a violation of this structure occurs, an increase in intracranial pressure occurs, which can be a life-threatening condition.
Classification of circulatory disorders of the brain
A cerebral vascular disorder is classified into:
- Acute cerebral ischemia.
- Chronic cerebral ischemia.
Chronic disease affects the quality of life and may lead to a decrease in its duration. But the cause of sudden death does not become, in contrast to the acute state.
Acute cerebrovascular accident
This diagnosis describes a pathological condition that lasts at least a day. Pathogenetic condition is associated with a sharp violation of the vascular permeability, which is very quickly restored.
Often the diagnosis is “TIA”, which stands for a transient ischemic attack.
The causes of such conditions are often:
- Arterial hypertension.
- Heart disease (often combined with hypertension).
- Pathology of major vessels (congenital or acquired).
- Varicose veins.
- Vasculitis of various genesis (rheumatic diseases, systemic syphilis).
Cerebral clinical symptoms of transient vascular pathologies:
- Dizziness, flies before eyes.
- Nausea and vomiting that does not bring relief.
- Disorder of consciousness, a sharp change in the nature or mood of the patient.
Focal clinical symptoms of transient vascular pathologies:
- Short-term disturbance of sensitivity in the zone of innervation of a separate nerve.
- Muscle or limb movement disorder.
- Often patients complain of numbness of the limb on the one hand, curvature of a smile, loss of visual fields.
The main difference of this category of diseases is the reversibility of clinical symptoms.
E.V. Schmidt identifies 3 severity TIA:
- The first light degree is characterized by an attack length of not more than 5 minutes.
- The second degree, moderate severity – 10-15 minutes without registering residual effects after an attack.
- The third degree, severe – the attack lasts for hours or days and can be characterized by microsymptomes of organic pathology. At the same time, there are no clinically significant violations of cerebral circulation.
The danger of TIA (transient ischemic attacks) is related to the fact that they most often recur in the same place, affecting the same vessel and the part of the nerve cells that supply them with blood. This leads to the gradual development of organic pathology, to which can be attributed a critical decrease in the ability to memorize, a change in intellectual activity and a pronounced asthenic syndrome with increased emotional exhaustion.
A more severe sudden pathology is a acute stroke, which may be of a hemorrhagic or ischemic nature.
Treatment of transient cerebral circulatory disorders
First of all, patients with such a diagnosis should be in a state of emotional rest. It is necessary to follow the rules of inpatient treatment:
- To persistent disappearances of the clinic compliance with strict bed rest.
- Compliance with the ward for 14-21 days after the disappearance of clinical manifestations.
- Milk and vegetable diet.
- Fresh air and / or inhalation of oxygen.
- Detoxification therapy (ascorbic acid).
- Vitamins of group B.
- The prescription of drug treatment is not regulated, because it must be consistent with concomitant diagnoses (diabetes, erysipelas, varicose veins, rheumatoid arthritis, etc.) and the prevention of their complications.
Constant reception of a rational scheme of treatment of arterial hypertension, atherosclerosis, diabetes mellitus and other chronic diseases leads to a minimal percentage of the occurrence of transient disorders of the brain.
For non-pharmacological prophylaxis of this pathology it is necessary:
- Comply with the mode of work and rest, to alternate between hard and easy work.
- Eat right.
- To refuse from bad habits. Smoking is especially harmful, as tobacco smoke contributes to the uneven narrowing of blood vessels.
Circulatory disorders of the brain in old age
The most difficult and debatable problem in the diagnosis is chronic cerebral ischemia, it is a chronic progressive vascular pathology called dyscirculatory encephalopathy. The ICD-10 is code I 60-I 69.
Most often, this condition manifests itself in old age and develops against the background of pronounced atherosclerotic lesion of the bloodstream, uncontrolled blood pressure with coronary heart disease (CHD) and the presence of rheumatism. Less often, the cause of such a severe disease is diabetes mellitus, sexually transmitted diseases (syphilis), and other pathological conditions that affect the brain’s blood vessels.
The pathogenetic cause of the disease is a change in the blood vessel. This may be noted:
- Closure of the vessel lumen by thrombus, embolus, foreign body (catheter), helminth, tumor, atherosclerotic plaque, etc.
- The narrowing of the lumen due to the tumor-like process from the outside, edema, etc.
Most often, encephalopathy disappears without clear clinical symptoms, but with constant and long-term observation of the patient, one can see how his personality is changing.
The initial period of dyscirculatory encephalopathy is manifested by the following patient complaints:
- Irritability and forgetfulness.
- Distraction and concentration disorder.
- Disruption of performance.
The second stage of encephalopathy is manifested:
- Disorder articulation of speech.
- Difficulty walking without manifestation of paresis.
- Decreased coordination and awkward motions.
- Gradual enhancement of reflexes, sometimes the definition of pathological reflexes.
Severe stage is manifested:
- Sphincter Disorder.
- Objective manifestation of monoparesis (lack of movement in one limb or part of the body). And at first it is temporary, then permanent symptoms.
- Severe movement coordination.
- Speech disturbance, up to aphasia.
At the second stage of the disease, the patient needs disability clearance, as his working capacity is sharply impaired.
Treatment of dyscirculatory encephalopathy
Treatment of cerebral ischemia in old age, as well as the symptoms of this pathology, is more symptomatic, since the initial cause of the vascular pathology is not fully understood.
Drugs that are used for encephalopathy of a vascular nature:
- Vitamin preparations (group B vitamins, ascorbic acid, glutamic acid, nicotinic acid).
- Vasodilators (Platifilin, Papaverine).
- ATP drugs (Riboxin).
- Biostimulants (aloe, Eleutherococcus, Schisandra tincture).
- Anti-sclerotic drugs (potassium iodide (2% solution 25 ml 3 / d) and similar drugs).
- In case of mental disorders, you can apply Seduxen, Elenium, Bromine, valerian tincture.
Acceptance of any medicinal product must begin with a clear weighing all the pros and cons. Such tactics will prevent the wrong combination of drugs and deterioration.
It is necessary to realize that it is very difficult to cure such violations; in this connection, the doctors set themselves the task of preventing the patient’s condition from deteriorating. Prevention of dangerous consequences (stroke or cerebral infarction) is necessary.
Infringement of cerebral circulation in childhood
Ischemia of cerebral vessels in newborns is most often associated with congenital abnormalities. Several factors can lead to it, but more often it is their combination:
- Mother accepts medicines with a pronounced teratogenic effect (antibiotics, analgesics, and others).
- The influence of pathogenic environmental factors (radiation).
- Bad habits (smoking and alcohol).
Sometimes the cause of brain disease can become sexually transmitted infections.
Pathological conditions of the brain can be triggered by birth trauma. Such cases often cause cerebral palsy and are mainly due to the fact that the mother was not qualitatively examined during pregnancy.
In any case, it must be said that vascular pathologies do not arise just like that. Often they are caused by the patient himself. Of course, one should not exclude heredity and individual characteristics, but the maintenance of a correct and healthy lifestyle has always led to a more favorable old age and the absence of incurable diseases.
The main thing that needs to be clarified is that acute disorders of cerebral circulation are cured only with high-quality and timely therapy. It is necessary to use preventive methods to prevent its complications with the help of folk and traditional methods.