Causes of cerebral ischemia. Symptoms, treatment methods and consequences for cerebral ischemia

Hi all!

I spoke on the phone with my mother. Agree, you can immediately hear from the voice when an active, cheerful person feels bad, even if he does not want to make it clear? She did not immediately admit that yes, her head hurts, she felt sick, she felt very tired, but she would not get to the doctor. And then I got scared. What if my relative dear person ischemic cerebrovascular disease?

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I have heard many times how dangerous this disease is. Of course, I dragged her to specialists. Learn more about what causes it and how you can fight this disease. I think everyone should be aware of such serious things. Therefore, I tell you.

Why does the brain suffer?

What is ischemia? This term refers to the lack of oxygen in the tissue.

You probably know that there is coronary artery disease - coronary heart disease. She is more heard. However, many do not know about cerebral ischemia, although it is just as common.

Blame the notorious cholesterol. It covers the walls of both large and small vessels, and there is a narrowing of the lumen through which blood enters the tissues, and with blood - oxygen, others useful material. Metabolic products stagnate in the organ, gradual poisoning occurs, and functions fade.
And the brain - how many functions it has! There is a famous phrase - a person uses only 5% of the brain. It is a myth, every part of it functions.

Colossal load. Despite the fact that the mass of the brain relative to the body is small, a quarter of the BCC, the volume of circulating blood, passes through it. And it must consume huge amounts of oxygen like no other organ.

What is the main danger: with acute ischemia of the brain, a stroke develops. How many lives he ruined, you can not even mention.

What causes a violation of the blood supply to the brain:

These are the main reasons that occur most often. However, there is more:

• Wronge nutrition, in which a person consumes a lot of fatty foods rich in cholesterol.
• Poisoning with harmful substances. This may also be bad habits, nicotine and alcohol are those poisons with which a person is poisoned constantly and voluntarily. But professional hazards can also, especially carbon monoxide.
• , when the vessels leading to the brain are pinched. These are osteochondrosis, spondylarthrosis, curvature of the spine, trauma, hernia.
• . This leads to obesity and weakness of the muscles, blood vessels, and heart muscle.
• Renal ischemia.
• : spasms, arteritis, thrombophlebitis, aortic aneurysm.
• Vascular compression from the outside. It can be tumors, fractures.
• Blood diseases: anemia, vasculitis, collagenosis, increased blood viscosity. This may include bleeding.
• Caisson disease. The tissues of the body contain gases, and if a person inhales air at low pressure, they are released into the blood, while destroying the walls of blood vessels, disrupting blood flow. You can find other names for it: decompression sickness or divers' disease.
• Cerebral ischemia in newborns can develop if during pregnancy or childbirth there was a lack of oxygen in the mother's blood. This may be if the woman in labor has lost a lot of blood, or there was placental insufficiency, late or too early birth.

How to recognize cerebral ischemia

And not for a long time. Well, either it seems to a person that nothing of the sort happened. Just tired, nothing serious. However, the disease can develop for a long time, even longer than five years. Therefore, the symptoms coronary disease brain depends on the degree of development:
Cerebral ischemia 1 degree:

• Weakness, constant fatigue.
• , dizziness.
• Emotional swings, irritability,.
• Decreased reflexes, attention, memory. WITH different parties reflexes can manifest themselves in different ways, asymmetrically.
• Chills.
• Gait strange, shuffling, unsteady.
• Reflexes of newborns may appear when they stretch when they touch the lips.

Great luck if you managed to notice the disease at this stage. It is called compensated, and it will be possible to cure the disease even without complications. However, if treatment is not started, then there is a transition to the next degree (basically, it takes from 2 to 5 years, but if the provocateurs are strong, then it can be a couple of months).

Cerebral ischemia of the 2nd degree:

• The same signs, but they appear much brighter.
• Apathy, passivity, indifference to what is happening around.
• Personality disorder. It is difficult to concentrate on reading, watching a movie, talking. There may even be mental disorders.
• Coordination is broken already quite strongly.

This stage is called subcompensatory. Not to notice that something is wrong with a person, and not to sound the alarm is already quite difficult. However, it also happens. And then it develops
Cerebral ischemia grade 3:

• Urinary incontinence.
• Difficulty in swallowing.
• Dementia, forgetfulness, stupor.
• Fainting.
• Inappropriate behavior: from strong excitement to complete apathy.
• Loss of orientation in space, difficulty in moving, maintaining balance. Mimic is broken. A person cannot even squeeze anything in his hand.
• Trembling of the hands, head, twitching of the body.
• Constant muscle tension.
• There may be epileptic seizures.

Agree, the picture is terrible. Moreover, such an ailment provokes serious complications.

What can coronary disease lead to:

• Stroke, cerebral infarction.
• Sclerosis of cerebral vessels.
• encephalopathy.
• Silence.
• Paralysis.
• Epilepsy.

As you can see, this case cannot be delayed. Therefore, if you or your loved ones notice similar signs, visit a doctor as soon as possible. Moreover, there are many clinics that specialize in the treatment of such diseases.

Often people believe that the disease will wait a little, but until there is time, there is no opportunity - work, children, grandchildren. This is especially true of our beloved mothers, fathers, grandparents. Don't refuse hospitalization, don't neglect sanatorium treatment.

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Indeed, at stake are such priceless things as the ability to independently serve oneself, recognize relatives, feel vivid emotions, and live a full life.

For the sake of this, it is worth starting treatment, and even more so, trying to avoid the onset of the disease in general. And this will help you, a good rest, regular, healthy lifestyle life in general.
Be healthy you and your loved ones.
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28.04.2017

Cerebral ischemia is a disease that occurs due to oxygen starvation of the brain as a result of poor blood supply to its tissues.

With this disease, there are many symptoms associated with the deterioration of the brain: inhibition of information perception, decision-making, speech disorders, motor coordination, visual impairment, and others. At the beginning, the symptoms are latent, but as the disease progresses, they begin to manifest themselves clearly.

fatigue, insomnia, frequent headaches, bad memory may be symptomscoronary artery disease of the brain (circulatory disorders).The disease can occur in acute or chronic form.

Causes

Brain cells cannot function effectively if there is not enough oxygen to feed them. This can happen when the lumen is narrowed. cerebral artery. Vasoconstriction occurs when fatty deposits build up on the inner walls.

A cerebral artery may be blocked by a thrombus (blood clot). Sometimes clots break away from the vessel wall and travel through the body with the bloodstream, they are called emboli. Such a clot will get stuck in the narrowest part of the artery and can clog it. With complete blockage (obturation), hypoxia occurs, leading to necrosis (death) of brain tissue.

Cerebral ischemia symptoms and treatment

The main reason: partial or complete blockage of the lumen of the cerebral artery. With age or due to the use of foods (with cholesterol), the blood vessels become clogged. Cholesterol plaques, fatty deposits on the walls reduce the patency of blood vessels. Normal blood flow is disrupted. Blood delivers oxygen to all human tissues and organs. The lack of oxygen is detrimental to the cells of any organ. The brain is especially dependent on oxygen.

Atherosclerosis, the appearance of blood clots heart failure, hypertension - main factorscerebral ischemia. It is very important to diagnose this serious illness in time. Do not start the disease that provokes it. After all, the consequences of the disease lead not only to disability, but often to death.

Additional causes of ischemic brain damage:

• diseases cardiovascular system, affecting central hemodynamics;
• blood diseases leading to its thickening;
• various angiopathy - diseases that affect the walls blood vessels;
• diabetes;
• obesity;
• carbon monoxide poisoning;
• anemia;
• elderly age;
• heredity;
• smoking.

acute form - occurs with a sharp onset of oxygen starvation of the brain, it is necessary to immediately treat it to avoid ischemic attacks. It is characterized by loss of sensation in some areas, seizures, temporary blindness, paralysis of body parts.

After the acute stage of the disease and in the absence of proper treatment developschronic cerebral ischemia. Gradually develops and progresses. Can lead to stroke, myocardial infarction.

Symptoms

The disease is manifested by fatigue during mental stress, forgetfulness, memory impairment.

The main symptoms of cerebral ischemia:

• fatigue, weakness in the limbs;
• dizziness, fainting;
• hearing loss, vision loss;
• sleep disturbance;
• pressure drops;
• headache, migraine;
• speech disorder;
• increased excitability;
• irritability;
• facial asymmetry.

Degrees of the disease

• Ischemia of the brain 2 degrees. It is characterized by more vivid and noticeable symptoms. There are frequent headaches, nausea, loss of professional skills, worldly skills. The patient cannot plan his actions. Critical self-esteem is reduced.
• Ischemia of the brain 3 degrees. This severe stage occurs in the absence of treatment. All neurological functions are affected. The patient has impaired motor functions, Parkinson's syndrome occurs (tremor of the limbs, shaking paralysis), loss of balance, difficulty walking, urinary incontinence. The psyche is upset: speech disorder, memory loss, lack of thinking. The end result is the disintegration of personality.

Elderly people, patients suffering from atherosclerosis, diabetes mellitus are more often diagnosed with chronic cerebral ischemia. If a part of the brain, due to cholesterol plaques, does not receive right amount oxygen, transient ischemic attacks (TIA) occur.

A day later, the functions of the damaged area of ​​the brain are restored. If this did not happen, then a stroke occurred (hemorrhage in the area of ​​the bursting vessel). This is manifested by neurological symptoms.

Diagnosis of cerebral ischemia

Illness in initial stage proceeds imperceptibly, almost asymptomatically, therefore early diagnosis difficult.

Physical examination: the doctor examines the patient, listens to complaints, studies the list of transferred and chronic diseases to clarify the degree of risk andsigns of cerebral ischemia. Orders examinations:

• examination of the heart, blood vessels (cardiography);
• blood tests (sugar, cholesterol, hemostasis indicators);
• Vascular ultrasound;
• electroencephalography;
• doppler tomography.
• MRI.

Treatment

It is very important to respond quickly in cases of a hypertensive crisis or in the event of an acute oxygen deficiency of brain regions. Otherwise, the following consequences may occur:

• ischemic stroke;
• death.

If a stroke is suspected, timely medical assistance. It is impossible to immediately eliminate the consequences caused to the brain by deterioration or cessation of blood circulation in its individual sections. The complex of applied measures is aimed at restoring the blood supply to the brain and eliminating symptoms. Then apply various methods to restore brain functions (complete or at least partial). This process can take a long time.

When treating cerebral ischemia, doctors use:

• Antiplatelet agents are drugs that prevent the formation of blood clots and blood clots. They prevent blood particles from sticking together, thin the blood (aspirin, aspirin-cardio, thrombo-AS). Use only as directed by a doctor, as it has many contraindications.
• Thrombolytics (TLT) - have the ability to dissolve blood clots (actilyse, activase). CVA (acute cerebrovascular accident) leads to severe neurological consequences: half of the patients die within a month, and many survivors become disabled. The use of TLT reduces the lethal outcome by up to 20%. Patients who survive stroke are fully recovered. TLT is an effective method for the treatment of cerebral ischemia and stroke. The procedure is simple but expensive. Effective within the first 3 hours. But in an emergency, it saves lives.
• Drugs that dilate blood vessels, restoring metabolic processes in brain tissues (piracetam, omarone).
• Anticoagulants (heparin) - reduce blood clotting. More often used for prevention, in the acute phase of the disease - less often.

Physiotherapeutic treatment (electrophoresis, magnetophoresis), massage and physiotherapy to restore impaired functions.

Surgery is used very rarely. Only with the rapid deterioration of the patient's condition and the ineffectiveness of other methods. Operations on the brain are done only in specialized clinics and highly qualified surgeons, since the risks are extremely high.

Folk remedies

At treatment of chronic cerebral ischemia, in addition to mandatory medications, as additional ones, you can use and folk remedies. It is recommended to take:

• carrot juice (freshly squeezed);
• decoctions of mint, oak bark;
• decoction of adonis;
• herbal compresses.

The disease cerebral ischemia develops from a lack of oxygen supplied to the brain tissue. It can be chronic or congenital. The congenital form - the pathology of newborns and young children - this is what cerebral ischemia is.

Diagnosis ischemic brain disease in children is especially dangerous. Cerebral ischemia that occurs in children can be detected in the prenatal period or after an unsuccessful birth. And the disease proceeds in 3 stages: mild, moderate and severe. Mild ischemia is characterized by excitation or excessive depression and lasts up to 7 days. In moderate ischemic injury, convulsive state in a child, which can last a long time. In a severe form of the child, it is necessary to treat inintensive care unit.

The diagnosis of cerebral ischemia of the 1st degree in newborns can be made by doctors using a special test (Apgar scale) even in the hospital. The first degree is the mildest, manifested by neurological symptoms and is easily cured. (increased excitability).

If cerebral ischemia of the 1st degree, then dotherapeutic massage without the use of drugs and without hospitalization. Massage performed by a specialist improves the child's well-being, muscle tone, and has a beneficial effect on the central nervous system.

If a child has cerebral ischemia of the 2nd degree, treatment should be started without delay. This stage of the disease is manifested by a decrease in the activity and mobility of the child, spontaneity of movements, shudders, convulsions, muscle twitches, dizziness. These symptoms indicate the occurrence of areas of damage to brain tissue. Requires hospitalization

Insufficient supply of oxygen to the brain (ischemic brain disease) causes:

• irritability and sleep disturbances;
• frequent headaches;
• developmental delays;
• learning difficulties.

With the 3rd severe degree of ischemia, babies are placed in intensive care. If measures are taken in a timely manner, then the restoration of blood circulation will make it possible to eliminate the consequences of brain hypoxia, and create conditions for the normal functioning of brain regions.

Prevention

Completely cured with a diagnosis -cerebrovascular ischemia, especially after serious damage to brain tissue, is extremely difficult.

At risk for disease chronic cerebral ischemia include the elderly, hypertensive patients, patients with diabetes mellitus, heavy smokers, supporters of malnutrition. It is important to start treatment on time and not to start the disease.

Follow the rules of prevention, treatment of cerebral ischemia is often started when the consequences have already occurred.

After 40 years (especially for people at risk) with the risk ofCerebral ischemia can be avoided by observing the following rules:

• monitor daily arterial pressure take medications prescribed by your doctor;
• timely treat heart disease, hypertension;
• follow diets to lower cholesterol and blood sugar;
• undergo an annual ultrasound examination of the vessels of the brain;
• donate 2 times a year biochemical analysis blood (for sugar, cholesterol, hemostasis indicators);
• take drugs to improve cerebral circulation, especially for people engaged in mental work;
• give up smoking and alcohol abuse.

cerebral ischemia - chronic illness, a serious illness caused by a violation of the supply of oxygen to brain cells. The mechanism of the disease is simple. Many probably had to change old water pipes and observe their "inside" in the cut. Multi-layer lime deposits almost completely block the pipe channel, leaving a thin channel for the movement of water, where a finger can hardly enter. Of course, a normal flow of water through such a "diseased" pipe is simply impossible. Blood vessels human body essentially the same pipes that perform the same function - the transportation of fluid. And just like water pipes, blood vessels are prone to buildup of deposits.

The role of salts and lime deposits in the "blockages" of blood vessels is played by cholesterol, the very harmful cholesterol, for the restriction of consumption of which nutritionists advocate so much. There is a chronic disease atherosclerosis (blockage) of the blood vessels of the brain, the so-called.

A vessel clogged with a cholesterol plaque becomes unable to perform its main function - transporting blood. Oxygen starvation is a severe stress for any tissue of the body, and for the brain, whose cells, as you know, do not recover, the consequences can be fatal. After all, the brain is the most powerful consumer of oxygen in the human body. With a brain mass of only 2-3% of the total body weight, up to 20% of all blood circulating in the body passes through the brain. In oxygen-starved brain tissue, ischemia occurs.

Risk factors for coronary artery disease include:

• advanced age;
• diabetes disease;
• heart disease;
• unhealthy diet that increases blood cholesterol levels;
• smoking.

Symptoms and Diagnosis

Diagnosis of ischemia is complicated by the fact that in the initial stages of the disease the patient may not show any complaints: blood vessels do not have nerve endings, a person cannot physically feel the development of the disease inside the vessel. Unpleasant sensations begin at the moment when the negative consequences for the body as a whole have already occurred.

A patient with cerebral ischemia may complain of such symptoms as a feeling of coldness in the palms and feet, numbness of these parts of the body, as well as a decrease in memory and performance, fatigue. The patient experiences constant drowsiness while complaining of insomnia. Headaches, nausea, vomiting are possible.

The most common symptom of cerebral ischemia is dizziness. Up to a third of all patients complain about it.

Diagnosis consists in studying the symptoms, complaints of the patient and general course the course of the disease (anamnesis). The probability of detecting coronary brain disease is increased if the patient's history includes diseases such as myocardial infarction, atherosclerosis, diabetes, coronary kidney disease.

In addition, diagnostics includes various laboratory and instrumental methods of examination:

• a physical examination consists in determining the state of the cardiovascular system as a whole by measuring the pulsation in the blood vessels of the limbs and head.
• laboratory studies are aimed at studying the physical and chemical composition of the blood, in particular the level of sugar and cholesterol.
• instrumental examinations include cardiography, electroencephalography, ultrasonography etc.

Among the methods of examination, a special place is occupied by high-frequency ultrasound tomography.. This method is based on a computer analysis of the differences in the nature of the passage of the echo signal from tissues of different density.

Another important method of research is Doppler tomography (or Dopplerography) - a study based on a change in the frequency of the signal when reflected from a moving object (the so-called Doppler effect or Doppler shift), in this case, from the blood flowing through the vessels. Measuring the magnitude of the signal frequency change makes it possible to measure the speed of an object or medium. Thus, by measuring the speed of blood flow in different parts of the vessel, it is possible to identify and localize the places where cholesterol plaques form.

How the disease progresses

There are three degrees of development of coronary artery disease of the brain.

1. Ischemia of the first degree. The patient's state of health is generally normal, complaints of mild malaise, dizziness and chills are possible. Complaints of pain in the hands during and some time after physical work are also characteristic. Changes in gait ("shuffling", smaller steps) may be noticeable. Family members and colleagues of the patient may pay attention to changes in the patient's character and temperament, such as increased anxiety, irritability, depression. More careful observation can reveal mild behavioral (cognitive) disorders in the initial stage: the patient's attention is scattered, it is difficult for him to concentrate on any business, thinking is slightly slow.
2. Ischemia of the second degree. Ischemia of the brain of the second stage is distinguished by an increase in the symptoms of the disease. The patient is increasingly expressing complaints of general malaise (headaches, nausea, etc.). Violations of behavioral activity become noticeable and pronounced. Disappear professional and everyday skills, the patient loses the ability to long-term planning of actions. The critical assessment of one's own behavior is reduced.

Ischemic stroke on MRI results

1. Ischemia of the third degree. As a rule, occurs if there is no treatment. There is an acute lesion of neurological functions. The patient suffers from Parkinson's syndrome, impaired motor functions of the limbs, urinary incontinence. Walking is difficult, and sometimes completely impossible, firstly, due to the patient's reduced ability to control the legs, and secondly, due to the loss of such a function. nervous system like a sense of balance. The patient cannot adequately determine his own position in space, sometimes he does not understand whether he is standing, sitting or lying. Speech, memory, thinking are impaired. Psychiatric disorders reach a peak up to the complete disintegration of the personality.

According to the pace of development or acute. In the acute course of coronary disease, immediate treatment is required, otherwise so-called ischemic attacks or attacks of acute cerebrovascular accident (ACV) may occur. CVA manifests itself as sudden attacks of zonal loss of sensitivity, paralysis of a part or half of the body, monocular loss of vision (blindness in one eye). Symptoms of an ischemic attack usually go away within a day.

The apogee of the chronic development of coronary artery disease of the brain is or ischemic stroke. Ischemic stroke is a serious impairment of brain function due to acute oxygen starvation of brain cells.

Ischemic stroke is the most frequent view stroke (up to 75%) and ranks second (after coronary heart disease) among the causes of human mortality.

Treatment

Treatment of ischemic brain disease and its consequences includes:

In severe cases, apply surgical intervention for the purpose of physical removal of sclerotic plaques from the vessels of the brain. Operations on the human brain are among the most complex types of surgical intervention, require the highest qualifications from the operating doctor and are fraught with extremely serious, sometimes unpredictable consequences. That's why surgery ischemia is used as a last resort when treatment with conservative (non-surgical) methods does not work.

Disease prevention

To date, there are no ways complete cure and restoration of health in severe forms of coronary artery disease of the brain. The less effective the treatment, the more important it becomes to prevent the disease.

Significantly reduces the risk of coronary disease active lifestyle, especially in old age. Physical activity, physical education and sports contribute to increased blood circulation and metabolism, which prevents the deposition of cholesterol and the formation of blood clots and plaques.

Effective preventive measures are avoiding alcohol and smoking. Thus, serious risk factors for the disease are eliminated.

After forty years, it is necessary to undergo regular annual general medical examinations. If an increased risk of ischemic diseases is detected, the doctor may prescribe a course of preventive therapy, which includes taking anticoagulants, vasodilators. Increasingly, such an, in the recent past, undeservedly forgotten preventive measure as hirudotherapy - prevention and treatment of thrombotic and ischemic diseases with the help of medicinal leeches.

Cholesterol content in staple foods
finished products	Quantity	Cholesterol (mg)
Brain	100 g	2000
kidneys	100 g	1126
Liver	100 g	438
chicken stomach	100 g	212
Crabs, squids	100 g	150
Boiled lamb	100 g	98
Canned fish in own juice	100 g	95
Fish caviar (red, black)	100 g	95
boiled beef	100 g	94
Fat cheese 50%	100 g	92
Chickens, dark meat (leg, back)	100 g	91
Poultry meat (goose, duck)	100 g	91
Rabbit boiled	100 g	90
Raw smoked sausage	100 g	90
Language	100 g	90
Lean boiled pork	100 g	88
Bacon, loin, brisket	100 g	80
Chicken, white meat (breast with skin)	100 g	80
Medium fat fish (sea bass, catfish, carp, herring, sturgeon)	100 g	88
curd cheese	100 g	71
Processed cheese and salted cheeses (brynza, etc.)	100 g	68
Shrimps	100 g	65
boiled sausage	100 g	60
Fat cottage cheese 18%	100 g	57
ice cream ice cream	100 g	47
Creamy ice cream	100 g	35
Curd 9%	100 g	32
Milk ice cream	100 g	14
Fat-free cottage cheese	100 g	9
Egg (yolk)	1 PC.	202
sausages	1 PC.	32
Milk 6%, fermented baked milk	1 glass	47
Milk 3%, kefir 3%	1 glass	29
Kefir 1%, milk 1%	1 glass	6
Fat-free kefir, fat-free milk.	1 glass	2
Sour cream 30%	1/2 cup	91
Sour cream 20%	1/2 cup	63
Butter	1 tsp	12
Mayonnaise	1 tsp	5
Sour cream 30%	1 tsp	5
Condensed milk	1 tsp	2

Of great importance is the so-called secondary prevention - the timely treatment of other cardiovascular disease such as, as well as hypertension.

The most important means of preventing coronary artery disease of the brain is, including various diets aimed at lowering blood sugar and cholesterol. There are a huge number of "anti-cholesterol diets", it makes no sense to analyze their specific options in detail, it is important to understand the basic principles:

1. The proportion of fat in the diet should be no more than a third.
2. Animal fat intake should be kept to a minimum. The meat should be lean, it is better to completely exclude pork. It is better to give preference to a bird - chicken or turkey.
3. The supply of carbohydrates must be replenished with the help of vegetables and fruits, giving up muffins, confectionery and sugar.
4. You need to limit your salt intake. Salt moderately during cooking, remove the salt shaker from the table.
5. Eat often, five to six times a day, but reduce the amount of food consumed at a time.
6. Daily intake of carbohydrates should not exceed 300 mg. The content of cholesterol in staple foods is shown in the table.

Cerebral ischemia is one of the diseases that are easier to avoid than to treat later. Do not ignore simple preventive measures, move more, be active. Remember that it is better to take care of health when it is still there.

Ischemia can develop in the vessels supplying various organs and human systems, for example, if this occurs in the vessels supplying blood to the intestines, they speak of mesenteric ischemia, in case of nerve damage, they speak of compression ischemia or, in other words, nerve ischemia. Transient ischemia can develop in the brain and myocardium, if arterial spasm is associated with exposure to various stimuli on the artery, angiospastic ischemia occurs, and with a sharp decrease in blood flow in a certain part of the organ, local ischemia develops. All this different kinds ischemia, but today we will talk about cerebral ischemia.

Essence of pathology

What is cerebral ischemia? Decreased blood supply caused by cerebral atherosclerosis.

The brain performs the following functions:

• mental;
• data processing;
• body movement coordination;
• creating an emotional background and mood;
• attention;
• speech;
• information storage.

Reference! Violations in the work of this most important organ poses a threat to the life of the organism as a whole.

In order for the brain to work correctly, it, like other organs human body requires oxygen. If the blood flow in the vessels of the brain is disturbed, oxygen is supplied to the organ in smaller quantities than necessary. What actually provokes the development of pathology. The long course of the disease provokes a chronic course of the pathology, and this entails severe and irreversible consequences - paralysis, stroke, epilepsy.

Ischemic brain disease is not a single disease, but a consequence of a whole complex of pathological processes that were once left to chance by the patient.
Head ischemia is diagnosed not only in the adult population, but also in children and even infants.

The pathophysiology of ischemic brain disease is as follows:

• reduced energy production;
• blocking the utilization of glucose with the help of oxygen;
• activation of oxygen-free utilization of glucose;
• failures in the transport of ions;
• disturbance in the work of excitatory mediators.

Etiology of the phenomenon

The causes of ischemia can be different, but the main one is the syndrome of atherosclerosis of cerebral vessels. Internal walls vessels are torn by fatty deposits, as a result of which the vascular lumens become narrower, and the movement of blood through them is difficult.

Ischemia can be caused by diseases of the cardiovascular system, especially if they occur in a chronic form and are accompanied by heart failure.

Vascular ischemia can be triggered by:

• failure in the heart rhythm;
• constriction of blood vessels;
• various vascular anomalies;
• problems of venous vessels;
• genetic diseases (angiopathy);
• hypotension and hypertension;
• diabetes mellitus;
• blood diseases;
• vasculitis;
• thrombosis.

As for cerebral ischemia in infants, it is also associated with a lack of oxygen in the brain, but in this case, the lack is provoked by the pathological course of pregnancy and childbirth.

Posthypoxic vascular ischemia of the noncongenital is associated with the following factors:

• severe toxicosis at the end of childbearing;
• multiple pregnancy;
• detachment or placenta previa;
• intrauterine heart defects;
• circulatory disorders in the placenta;
• prolongation of pregnancy;
• delivery before the due date.

Symptomatic manifestations

Signs of ischemia directly depend on which foci of the brain suffer from impaired blood flow.

Ischemia symptoms are as follows:

• Blindness in one eye, weakness on one side, trouble moving one arm or leg. Such symptoms are observed in case of poor blood flow in the internal carotid artery.
• Double vision, general weakness, dizziness are signs of ischemia of the posterior regions of the brain, which are supplied with blood from the branches of the vertebral vessel.

Besides, Clinical signs ischemia can manifest itself as problems with speech, poor coordination of movements, etc.

Reference! Symptoms may be mild or severe. The focal type of the disease can lead to impaired consciousness. With regard to the duration of symptoms, they can last from a few seconds to several hours, and even longer if a stroke occurs. If irreversible processes have occurred in the brain, ischemic signs (as the consequences of ischemia) may remain forever.

What duration of ischemia is dangerous for the body of the victim? If the blood supply to the brain is interrupted for more than 10 seconds, this leads to loss of consciousness, and if blood does not flow to the brain for more than a few minutes, tissue damage occurs in the brain that cannot be reversed.

Important! Due to the fact that global ischemic processes are irreversible, it is necessary to identify the symptoms of pathology and carry out treatment as soon as possible.

Disease classification

Pathology has 3 stages, each of which has its own characteristics.

Cerebral ischemia 1 degree

Cerebral ischemia of the 1st degree is called compensated by physicians. In the case of treatment of the disease at this stage, one can count on the reversibility of all existing pathological processes. The disease begins with the following symptoms:

• weakness;
• insomnia;
• headache;
• chills;
• depressive states;
• noise in ears;
• problems with cognitive functions;
• emotional instability and so on.

Reference! This degree is amenable to therapy quite easily, with no negative consequences after treatment, the disease is not observed. We can say that this degree of coronary disease is completely curable.

2 degree of pathology

Cerebral ischemia of the 2nd degree is accompanied by the following symptoms:

• deterioration of well-being;
• frequent dizziness;
• decrease in labor activity;
• severe headaches;
• memory deterioration.

3 degree of disease

Chronic ischemia Grade 3 is characterized by a number of neurological syndromes:

• urinary incontinence;
• impaired coordination of movements;
• parkinsonian syndrome;
• behavioral and personality disorders;
• violation of mental activity;
• speech disorder.

Important! In the 3rd degree of a disease, a person is most often recognized as a non-able-bodied person, and in addition, the patient may lose self-care skills.

cerebral ischemia in infants

What is neonatal cerebral ischemia? This is a pathology that develops in an infant as a result of insufficient blood supply to the brain.

Symptoms of the pathology are as follows:

• the child cries for no apparent reason and is often naughty;
• skin becomes marbling;
• the baby does not sleep well;
• there are problems in feeding the child, since the swallowing reflex is gradually lost;
• the child is lethargic;
• the presence of disproportionate head sizes;
• respiratory failure;
• convulsive syndrome.

Reference! Periventricular ischemia is also divided into three degrees, the first two of which can be completely cured. If the 3rd degree of the disease is diagnosed, then the child will lag behind in development, he may experience deviations in the work of the central nervous system, and also suffer from hearing and vision.

Chronic cerebral ischemia

Let's understand what is chronic ischemia? This concept encompasses several pathological conditions:

• small-focal damage to brain tissue - dicirculatory encephalopathy;
• violation of the functionality of blood vessels - vascular encephalopathy;
• vascular atherosclerosis;
• vascular epilepsy or vascular dementia.

The chronic form of the disease is a consequence of the acute form, the treatment of which was not carried out or was carried out incorrectly. The chronic form is manifested by periodic periods of exacerbation, each of which affects more and more areas of the brain.

Important! One of the symptoms of chronic brain damage is sleep disturbance.

In order not to miss the time when you can still cure the disease, you need to pay attention to the following symptoms:

• sharp mood swings;
• weakness;
• sudden forgetfulness and loss of attention;
• insomnia or excessive sleepiness.

People often attribute such symptoms to banal fatigue, and do not go to doctors, missing the time when you can completely get rid of ischemic processes in the brain.

Acute ischemia

Severe hypoxia provokes an acute attack. This form of the disease requires immediate treatment, otherwise a transient attack develops.
Symptoms:

• part of the body is paralyzed;
• unilateral blindness develops;
• hotel areas of the body lose sensitivity.

These symptoms go away within a day.

Untreated acute ischemia leads to chronic form an ailment that is amenable to therapy is much more difficult.

Diagnostic methods

Diagnosis begins with a questioning of the patient and clarification of the patient's history.
Physical examination:

• pressure measurement;
• determination of the symmetry of the pulse of the head vessels and limbs;
• search for heart rhythm failure.

Laboratory research:

• clinical blood test;
• blood test for sugar and cholesterol;
• lipid spectrum.

Instrumental diagnostics:

• determination of signs of ischemia on the ECG;
• ophthalmoscopy;
• vascular scanning;
• study cervical spine;
• doppler of head vessels;
• vascular angiography;

Reference! Ischemia in atherosclerosis has a number of symptoms similar to other pathologies (brain tumors, hydrocephalus, and some psychosomatic diseases, so research should clearly differentiate the pathology.

Treatment of pathology

How to treat ischemia in a particular case can only be explained by a neurologist, based on the results of the tests. Treatment can be conservative or surgical. In the first case, the administration of drugs and means is indicated. traditional medicine, as well as a review of lifestyle and diet.

conservative methods

With a conservative approach to treatment, doctors prescribe the following drugs:

• Ginko Biloba;
• Piracetam;
• Betagistim;
• Vestibo;
• Actovegin;
• Cinnarizine;
• Nimopidine.

All drugs and their dosage should be prescribed only by a competent neurologist. It is important to understand that each medicine has contraindications, not only for health reasons, but also for age.

Surgical intervention

Surgical treatment of ischemia is reduced to the removal of blood clots or cholesterol plaques from the vessels, which interfere with normal blood flow. In some cases, stem cells are used that trigger tissue regeneration mechanisms.

Folk remedies

As for the treatment of folk remedies, they are effective only in combination with traditional therapy. The most commonly used agents that have a thinning effect on the blood, improve metabolic processes, and also normalize blood pressure.

Important! To use only folk remedies for treatment is life-threatening!

The diet for ischemia is quite simple:

• reduce the amount of salt;
• exclude the use of animal fats;
• increase carbohydrate levels with sweet fruits;
• eat fractionally.

Prevention of pathology

Prevention is proper nutrition, healthy and active way life, timely treatment of chronic diseases. Every person after 40 years of age needs to undergo preventive examinations by a neurologist once a year, which will help to detect the development of the disease in the early stages.

One of the most dangerous manifestations is ACA ischemia. The duration of recovery after this disease can take decades, significantly worsening the quality of life of the patient. Therefore, doctors so strongly recommend that you be more attentive to your health and, at the first symptoms of pathology, seek help from a specialist.

Cerebral ischemia is a condition that occurs due to a lack of oxygen as a result of insufficient blood flow to its tissues. Such pathological process can occur in any organ that is supplied with arterial blood. It carries a lot of vital substances, without which normal functioning is impossible.

Cerebral ischemia is manifested by a rich clinical picture. At the beginning of the process, signs may not show themselves, but progression leads to pronounced symptoms. The disease proceeds as acute form, and in chronic (CIGM). Among the causes of ischemia, there are basic and additional.

The first includes:

• Insufficiency of cerebral circulation with the transition to hypoxia - oxygen starvation. This condition is associated with a narrowing of the arterial lumen or its blockage - obturation. The progression of the process leads to necrosis - tissue necrosis - irreversible changes. If ischemia can be reversed, then the necrotic area can never be restored;
• Arterial hypertension, violating vascular tone. The outcome of such a process is angiospasm, which causes oxygen deficiency, and as a result, ischemia;
• Atherosclerosis, which creates a mechanical obstruction inside the artery. Blood entering the brain meets a barrier. As a result, oxygen delivery is disrupted. And the ischemia begins;
• Thrombosis is the blockage of a vessel by a blood clot. Such an obstacle can arise, both initially in the brain, and be transferred from other foci;
• An embolism is a formation that can block an artery and move from one vessel to another. The nature of this compound can be different - fatty, airy, medicinal. Sometimes an embolus is called a "travelling" thrombus.

Among additional reasons in the development of cerebral ischemia play an important role:

• Diseases of the cardiovascular system;
• kidney failure;
• decompression sickness;
• Abnormal structure of the vascular network according to the type of compression and local arterial spasm;
• External compression of the artery by a tumor or stone;
• Intoxication syndrome with carbon monoxide poisoning;
• hereditary angiopathy;
• Large blood loss;
• Amyloidosis is the deposition of an abnormal protein in the cerebral arteries;
• Systemic vascular inflammation - vasculitis, angiitis;
• Diabetes mellitus of any type;
• Blood pathology - anemia or erythrocytosis;
• Elderly age;
• Overweight;
• Bad habits such as smoking.

There are many reasons for the formation of ischemic disorders. But the main ones are spasms or blockades of the vascular bed various entities- blood clots, emboli, tumors or plaques.

Symptoms

The main signs of cerebral ischemia include:

• Increased fatigue and weakness;
• Increased fatigue during mental and physical stress;
• Decreased memory;
• Dizziness, up to fainting;
• Deterioration of vision and hearing;
• sleep change;
• Spasmodic changes in blood pressure;
• Headaches, migraines;
• speech disorders;
• Irritability.

The decrease in the lumen of the vessel is directly proportional to the increase in symptoms. The less space remains for blood flow, the more pronounced manifestations of cerebral ischemia. Depending on the rate of progression, several types of pathological process are distinguished:

• Fast, which took up to 2 years to develop;
• Medium - up to 5;
• Slow - more than 5.

Cerebral ischemia goes through several stages of development:

• Initial, in which there is pain in the head and memory loss. Signs are expressed moderately and do not bother constantly;
• Subcompensation - symptoms initial stage diseases progress. They are joined by personality changes in the form of apathy, a decrease in the range of interests. Neurological syndromes are observed - vestibular and pyramidal, as well as coordinating;
• Terminal, which is characterized by a gross defect due to the formation of multiple lacunar and cortical infarcts. vascular dementia develops.

Diagnostics

Evaluation of patients with cerebral ischemia is usually not early. It is prescribed in the stage of active symptoms due to the fact that before that the disease does not make itself felt. All diagnostic measures divided into physical and instrumental. The first is carried out by the doctor on his own without hardware methods. This includes:

• Examination of the patient;
• Collection of anamnesis with fixation of complaints, concomitant pathologies.

In addition, routine laboratory tests for blood and urine are prescribed.

Instrumental diagnostics involves:

• Vascular ultrasound;
• Doppler tomography.

Morpho-physiological features

The process of ischemia formation has peculiar features. Pathology occurs due to insufficient blood supply to organs, including the brain. This leads to hypoxia - oxygen starvation. Against the background of such modifications, symptoms of the disease appear.

At the morphological and physiological level, during ischemia, the vessels undergo serious changes. Normally, an artery can be compared to a hose that passes the required amount of water. From the inside, its surface is even and smooth - it does not interfere, but only helps the liquid move to its destination.

The same applies to vessels. When an obstacle arises inside its lumen, whether it be an atherosclerotic plaque or a blood clot, the blood flow is mechanically disturbed. With compression from the outside - by a tumor or an abnormally formed artery, as well as as a result of repeated spasms in hypertension, the structure and shape of the vessel changes.

He is no longer able to perform his functions as before. A block inside an artery results in reduced inflow. Outwardly, it swells, as new blood flows in and meets an obstacle, and the old one does not pass to the organ that needs it. Such a vessel can burst and lead to bleeding.

However, even without this, there are many problems. The brain is one of the most demanding human organs. Its bark is the most developed department, unable to do without oxygen for more than a few minutes. Ischemia cannot last long. Soon it undergoes irreversible structural changes that cannot be corrected.

External obstructions also modify the shape of the vessel and interfere with the flow of oxygen to the brain. A change in the tone of the cerebral arteries in hypertension does not have a beneficial effect. Physiologically, with age, the arteries change their state. Their throughput is violated. Therefore, many elderly people suffer from a brain microcirculation disorder - ischemia.

Smoking predisposes to such processes. Nicotine causes reflex angiospasm, which is undesirable for blood vessels.

Principles of disease therapy

With cerebral ischemia, treatment with drugs of the following drug groups is possible:

• Anticoagulants;
• Vasodilator;
• Adrenoblockers;
• Means that restore blood circulation.

In addition to drug therapy, surgery is also possible. Often it is used to remove atherosclerotic plaques, blood clots and emboli. In ischemic brain disease, treatment may be of a different nature. As additional methods physiotherapy exercises and massage are used.

Antiplatelet drugs

These drugs are aimed at reducing blood viscosity. They prevent platelets from sticking together. Such medicines are dispensed by a doctor. Self-medication is unacceptable. The most common include:

• Clopidogrel. It is not recommended for use in hypersensitivity, pregnancy, lactation, liver damage;
• Warfarin. Contraindicated in case of predisposition to bleeding, cerebrovascular hemorrhage, pericarditis, aneurysms, malignant hypertension, severe liver or kidney damage;
• Dipyridamole is used both in the form of tablets and as a solution for injection;
• Indobrufen is not indicated for stenosing atherosclerosis, decompensated chronic heart, kidney and liver failure, peptic ulcer.

Beta blockers

This pharmacological group aimed at reducing the heart rate. They provide oxygen to the heart, and they are also prescribed for cerebral ischemia. Good feedback got:

• Metaprolol - a contraindication to its use are heart blockade, arterial hypertension, lactation period;
• Carvedilol;
• Bisoprolol.

Beds and fibrates

Such medications are designed to lower blood cholesterol levels in cerebral ischemia for treatment. So, to reduce the formation of atherosclerotic plaques - one of the causes of pathology. These drugs are used in complex therapy to cure cerebral ischemia:

• Lovastatin - indicated only for adults;
• Fenofiba in tablet form. Not recommended for renal and hepatic pathologies, as well as during lactation;
• Atorvastinin.

Nitrogen-containing organic preparations

Such medicines create conditions for the expansion of the blood vessels of the brain. They provide fast positive action. However, such drugs cannot be used for hypotension - a low level of pressure. Among side effects noted pain in the head, lowering blood pressure. Among the main drugs in this group are:

• Nitroglycerin, which is used both in tablets, capsules, spray, and in the form of a solution for injection. In some cases, the medicine is also indicated for pregnant women. If the benefit of the drug is greater than the risk of it;
• Isosorbite mononitrate, which is contraindicated in myocardial infarction, glaucoma, anemia, thyrotoxicosis, renal and hepatic insufficiency, lactation.

Anticoagulants

These funds are aimed at reducing blood clotting. It also prevents the formation of clots in the lumen of the artery - blood clots. With cerebral ischemia, such treatment is often necessary. The most commonly used anticoagulant is heparin. These funds are mainly used for the prevention of pathological conditions and less often in an acute process.

Diuretics

These drugs are capable of removing excess liquid. This reduces stress on vital organs. Diuretics help fight edema of any origin. They are usually used in complex treatment. Common drugs are:

• Hypothiazide, which is contraindicated in anuria, diabetes, renal and hepatic insufficiency. It is also not recommended for children under 3 years old, including newborns;
• Furosemide should not be used in women in the first half of pregnancy, with glomerulonephritis, gout, myocardial infarction;
• Veroshpiron tablets are not indicated for hyperkalemia, hyponatremia, during lactation.

Nootropic dosage forms

This pharmacological group of drugs is aimed at stimulating brain cells. The lack of oxygen has negative impact to this vital organ. And nootropics have a positive effect on memory function and mental abilities. Common tools include:

• Cerebrolysin in the form of a solution for injection. It is contraindicated in kidney failure, pregnancy;
• Nootropil tablets are not recommended for hypersensitivity, chorea, stroke, lactation.

Antioxidants

These drugs are aimed at inhibiting oxidative processes. These include vitamins and bioflavonoids, enzymes and minerals which contain calcium, selenium and manganese. The most powerful antioxidants include vitamins A, B, C, E, as well as Vazopro or Mexidol preparations.

Folk remedies

In addition to the main line of therapy, ischemia is tried to be treated with home medicine recipes:

• Freshly squeezed carrot juice;
• A decoction of mint and oak bark, adonis;
• Herbal compress.

Prevention

It is not easy to treat the consequences of ischemia and the pathology itself. The prognosis for each patient is individual. Allocate a risk group for this disease. Such people especially need to monitor their health. This includes:

• Elderly;
• Hypertension;
• Suffering from diabetes;
• Heavy smokers;
• Proponents of malnutrition.

• Constantly monitor the level of blood pressure and take the medication prescribed by the doctor;
• Promptly seek help for alarming symptoms;
• Adhere to a diet that excludes increased intake of cholesterol and sugar;
• Annual passage of ultrasound examination of cerebral vessels and laboratory tests;
• The use of drugs that improve cerebral circulation. This is especially important for people at risk and engaged in mental work;
• Eliminate smoking and alcohol abuse from life.