Treatment of vascular encephalopathy. What is cerebrovascular encephalopathy? Treatment of post-traumatic encephalopathy

Vascular (dyscirculatory) encephalopathy is a slowly progressive insufficiency of blood supply, as a result of which multiple small focal necrosis develops in the brain tissue. Vascular damage in most cases is caused by hypertension and atherosclerosis, which cause pathological changes in vascular wall. Less commonly, vascular encephalopathy occurs after injuries, tumors, infectious diseases brain, as well as in the presence of pathology in the cervical spine.

Discirculatory encephalopathy can develop at any age, but the disease is most common in older people. age groups. This disease progresses steadily, which can ultimately lead to disability and death.

Most common reasons

For the reason that led to the development of vascular encephalopathy, the following types are distinguished:

1. Atherosclerotic encephalopathy develops as a result of deposition cholesterol plaques into the wall of the vessel. At the same time, the elasticity of the blood vessels decreases, and they no longer independently regulate the flow of blood to the brain tissue; later, as cholesterol deposits increase, the small vessels of the brain become blocked and the blood supply to any small areas in which development occurs is stopped. small lesions necrosis.

2. Hypertensive encephalopathy is the result of long-term arterial hypertension. For high blood pressure numbers small vessels They shrink so much and decrease in diameter that some of them may stop blood flow, which also leads to the formation of small areas of necrosis of brain tissue.

In most cases, hypertension and atherosclerosis are “inseparable companions”; with an increase in blood pressure, atherosclerosis necessarily develops over time, and, conversely, the deposition of cholesterol in the vascular wall contributes to the occurrence of hypertension. But sometimes there are isolated variants of purely vascular or hypertensive encephalopathy.

3. Vertebrogenic vascular encephalopathy develops as a result of pathology of the cervical spine. Salt deposits when cervical osteochondrosis compress blood vessels blood bearers to the head, the brain receives little blood, which leads to ischemia of the most distant areas.

4. Post-traumatic.

5. Vascular encephalopathy as a result of the presence of a brain tumor.

6. Post-infectious (after meningitis, encephalitis).

How does vascular encephalopathy manifest: all the signs

Symptoms depend on the type and stage of vascular encephalopathy:

Stage I - stage of compensation when the function of lost brain cells is taken over by neighboring ones. arise initial symptoms, the appearance of which signals the brain that its reserves are being depleted. There are no visible changes in the brain; everything happens at the microscopic level.

Characteristic features:

Stage II - subcompensation:

Stage III - decompensation. Nervous tissue begins to deteriorate, and the brain itself atrophies (decreases in size). The manifestations worsen, become more severe, the decline in memory and intelligence, and motor and coordination disorders progress. Changes can reach such an extent that a person turns out to be a bedridden invalid, unable to care for himself and in dire need of help from others.

The change of these stages occurs during the development of the disease, however, even in patients with stage I, periods of deterioration (decompensation) may occur, which, with proper treatment, pass, and the person quickly returns to the original state.

Treatment of the disease

Be sure to take:

drugs to lower blood pressure - lisinopril, amlodipine;

medications that normalize blood cholesterol levels - atorvastatin;

nootropics and neuroprotectors (to nourish the remaining brain cells and increase their reserves) - piracetam, Actovegin, Ceraxon;

antiplatelet agents (for blood thinning) - cardiomagnyl, polocard;

drugs to improve memory and intelligence - alzepil, bilobil, memodex;

painkillers - analgin, ibuprofen;

drugs for dizziness - betastin, cinnarizine;

vascular - sermion, aminophylline;

B vitamins.

Medicines for blood pressure, cholesterol and antiplatelet agents are used for life, the rest - in courses under the supervision of a doctor.

An important role in treating and slowing the progression of the disease is played by:

ethnoscience

1. Hawthorn tincture for improvement cerebral circulation: 3 tablespoons of dried hawthorn berries are brewed in a thermos with 3 cups of boiling water. Drink the next day exactly half an hour before each meal, 1 glass at a time.

2. Beetroot with honey to lower blood pressure: honey is mixed with red beet juice in a ratio of 1:1 in equal quantities, consume 1 tablespoon 3 times a day immediately before meals.

3. Clover for noise in the head: Brew 2 tablespoons of clover flowers with 2 cups of boiling water. This amount of infusion should be drunk in 3 doses. Each of three servings is taken half an hour before meals.

4. Onion tincture: Shake onion juice with honey (in a 1:2 ratio), drink one tablespoon 3 times a day before meals.

The duration of treatment courses with such folk remedies can be 1-1.5 months, then a break of 1-2 months is required.

Vascular encephalopathy and the army

If a conscript is diagnosed with “vascular (dyscirculatory) encephalopathy,” he is not subject to conscription into the army in accordance with Art. 24 point “c”, but in this case the presence of the so-called pseudoneurotic syndrome is required (memory deterioration, fatigue, nervousness and irritability, tinnitus).

This pathological lesion brain due to death nerve cells, which is caused by impaired blood supply and oxygen deficiency brain tissue.

Encephalopathy is not separate disease, this is a collective concept meaning various pathological conditions and diseases .

Encephalopathy can occur in both adults and children.

Mixed encephalopathy is a disease with several causes of brain damage.

Types of encephalopathy

• Wernicke encephalopathy (with alcohol impairment brain, some others toxic lesions brain, severe deficiency of vitamin B1);
• toxic encephalopathy;
• encephalopathy;
• progressive multifocal leukoencephalopathy;
• progressive vascular leukoencephalopathy;
• progressive vascular leukoencephalopathy with hypertension;
• hypertensive encephalopathy.

Hypoxic encephalopathy

Hypoxic encephalopathy is a unifying term for a whole group of pathologies of the brain and central nervous system in connection with oxygen starvation brain Oxygen starvation can occur both with insufficient oxygen content in the surrounding atmosphere and with certain pathological conditions. Encephalopathy can manifest itself as individual symptoms, such as sleep disturbances, memory impairment, headaches, increased intracranial pressure, dizziness, increased excitability, or as more serious diseases.

Hypoxic encephalopathy can cause the development of infantile cerebral palsy, epilepsy, myelopathy, neuropathy, severe delay mental development, up to oligophrenia. This type of hypoxic encephalopathy, such as residual encephalopathy, can appear several years after birth trauma.

The main causes of hypoxic encephalopathy are various cephalohematomas resulting from birth trauma, intrauterine infections, or brain hypoxia caused during childbirth. An oxygen deficiency of 50% can cause serious consequences for the development of a child.

Circulatory encephalopathy

There is also a distinction between circulatory encephalopathy, in which a progressive change in the brain tissue develops, with the formation of a pseudoneurasthenic syndrome. With transient perinatal encephalopathy episodic cerebrovascular accidents occur, which can cause whole line complications such as transient ischemic attacks, hypertensive cerebral crises, or attacks of cerebrovascular disease.

Hypoxic ischemic encephalopathy

This common and often devastating condition is caused by a lack of oxygen supply to the brain due to hypotension or respiratory failure. Sometimes both of these factors play a pathogenic role, and it is impossible to identify the predominant significance of any of them - hence the dual references to a history of cardiorespiratory failure.

The conditions most often leading to anoxic (ischemic) encephalopathy include:

• myocardial infarction;
• cardiac arrest of various origins;
• hemorrhage with shock and circulatory collapse, in these cases, the blood supply to the brain suffers earlier than the respiratory function;
• infectious and traumatic shock;
• asphyxia (due to drowning, strangulation, aspiration of vomit or blood, compression of the trachea by hemorrhage or a surgical tampon, contact with foreign body into the trachea);
• diseases leading to paralysis respiratory muscles and disruption of the regulation of breathing by the central nervous system (traumatic, vascular lesions brain, epilepsy) with respiratory failure, followed by heart failure;
• carbon monoxide (CO) poisoning, in which respiratory depression first occurs, and then the function of the cardiovascular system.

Experimental data confirm that hypoxia can induce various clinicopathological conditions on its own, and not only in combination with low perfusion (ischemia).

Hypertensive encephalopathy

Hypertensive encephalopathy is a slowly progressive diffuse and focal lesion of the brain substance caused by chronic disorder blood circulation in the brain associated with long-term uncontrolled arterial hypertension. The addition of cerebral vascular atherosclerosis contributes to a further deterioration of the blood supply to the brain, which leads to the progression of the disease. In this case, they talk about dyscirculatory encephalopathy mixed origin: hypertensive and atherosclerotic. Combination with diabetes mellitus, lipid metabolism disorders and smoking also have a damaging effect on the vascular system of the brain.

There are three stages of hypertensive encephalopathy. At the 1st stage, subjective complaints predominate, at the 2nd-3rd stage, clinical neurological syndromes are formed:

• vestibulocerebellar in the form of dizziness, staggering, instability when walking;
• pseudobulbar in the form of blurred speech, forced laughter and crying, choking when swallowing;
• extrapyramidal in the form of trembling of the head, fingers, hypomimia, muscle rigidity, slowness of movements;
• vascular dementia in the form of impairment of memory, intelligence, and emotional sphere.

Combined syndromes are more common.

Toxic encephalopathy

Toxic encephalopathy is disseminated organic lesion brain, which can develop both after severe acute poisoning neurotropic poisons, and with chronic occupational neurointoxication.

For initial form toxic encephalopathy The following symptoms are typical: complaints of persistent headaches, dizziness, memory loss, general weakness, increased fatigue, sleep disturbance, etc. Against the background of severe asthenia, scattered organic symptoms appear that do not fit into the picture of any clearly defined nosological unit (asymmetry of facial innervation, deviation of the tongue, mild hypomimia, reflexes of oral automatism, high tendon reflexes, often anisoreflexia, weakening or disappearance of skin reflexes). Along with this, there are violations psycho-emotional sphere: decreased memory, attention and mental performance, slowness, lethargy, apathy, unmotivated anxiety, depressed mood, severe emotional lability.

Post-traumatic encephalopathy

Post-traumatic encephalopathy is called pathological condition resulting from severe or moderate brain injury. In all cases, this type of vomiting is accompanied by both behavioral and neuropsychological disorders. In the case of post-traumatic encephalopathy, most often there is a violation of both thinking and attention, memory and control over personal behavior. It should also be noted that all these unpleasant symptoms make themselves felt not so much immediately after injury, but rather after a certain period of time after recovery. Patients do not immediately notice all these deviations. As a rule, they become noticeable only when a person notices that he does not have enough strength or ingenuity to solve any vital problems. important issues. Along with these disorders, patients also experience excessive aggressiveness, epileptic seizures, insomnia, sexual disorders, neurological disorders.

Dyscirculatory or vascular encephalopathy

Discirculatory encephalopathy (vascular encephalopathy) is an organic brain lesion of a non-inflammatory nature due to cerebral circulatory failure. Vascular encephalopathy can occur due to a number of reasons: past infection, tumors and injuries, cerebral vascular pathologies.

Alcoholic encephalopathy

Alcoholic encephalopathy - severe form alcoholic psychosis, developing mainly in the third stage of alcoholism. In fact, this is a group of several diseases united by a similar clinical picture and cause. This disease is characterized by a complex combination of neurological and somatic manifestations with mental symptoms, which come first in the picture of the disease. Depending on the speed of development and course of the disease, acute and chronic types of alcoholic encephalopathy are distinguished, but there may also be transitional forms between them. Very often, people with alcoholic encephalopathy have a history of alcohol abuse. various kinds alcohol substitutes.

Residual encephalopathy

Most often, residual encephalopathy is a persistent, slightly progressive neurological deficit resulting from exposure to diseases and pathological factors. It is characterized by neurological symptoms such as regular headaches, paresis, reflex pyramidal insufficiency, vegetative-vascular dystonia, fainting, decreased cognitive function and intelligence, fatigue and even mental disorders. Therefore, quite often due to medical error residual encephalopathy is diagnosed as mental illness, and treatment is prescribed symptomatically.

Unfortunately, residual encephalopathy in children is difficult to diagnose. Encephalopathy in children occurs due to perinatal and neonatal hypoxic and ischemic lesions brain, birth injuries and bruises, previous vaccinations, if any congenital anomalies brain and genetic mutations. Insidiousness of this disease is that the first symptoms can appear at any age, and the disease can make itself felt several years later.

Causes of encephalopathy

There are both congenital and acquired encephalopathy. Congenital forms imply the occurrence of the disease in perinatal period, starting at 28 weeks of pregnancy and ending at the end of the first week of the child’s life.

Pathological changes can be caused by oxygen starvation of the fetus, birth injuries, and other risk factors include:

• maternal illnesses during pregnancy;
• complicated pregnancy;
• premature birth;
• large fetal body weight;
• umbilical cord entanglement;
• difficult opening of the birth canal;
• neuroinfections, etc.

The causes of acquired encephalopathy are usually:

• various types of infections;
• intoxication of the body;
• vascular changes in the brain;
• traumatic brain injuries;
• tumors;
• atherosclerosis;
• ischemia;
• diabetes;
• liver failure;
• vegetative-vascular dystonia.

It should be borne in mind that the head does not exist on its own, with everything necessary from oxygen to proteins, minerals, stable intracranial pressure etc. , it is provided by the entire body, or rather all the internal organs: the kidneys, the liver, the intestines, the heart, the thyroid gland, etc. That is why situations happen when a child does not have encephalopathy after a birth injury, while another has it even without receiving a birth injury. It’s just that the first one’s entire body is so strong that it allows the central nervous system(CNS) to recover quickly, but for the second, a lot of hidden problems in the body make the CNS unhealthy.

Symptoms of encephalopathy

Symptoms of encephalopathy are very diverse.

Early signs are:

• decreased mental performance, memory (especially for recent events);
• difficulty changing activities;
• sleep disturbance;
• lethargy during the day;
• general fatigue;
• diffuse headaches;
• noise in ears;
• general weakness, unstable mood, irritability;
• nystagmus;
• decreased visual and hearing acuity;
• promotion muscle tone and tendon reflexes;
• the presence of pathological pyramidal and oral reflexes;
• coordination problems;
• autonomic disorders.

These disorders can progress as the underlying disease, which is accompanied by encephalopathy, develops.

In such cases, clear neurological syndromes are revealed in the later stages:

• parkinsonian;
• pseudobulbar.

Some patients may experience mental disorders. With severe generalized brain damage, significant microcirculation disorders, cerebral edema, acute development is possible clinical picture encephalopathy:

• general anxiety;
• strong headache, often in the occipital region;
• nausea, vomiting;
• visual impairment;
• dizziness;
• staggering;
• sometimes numbness of the fingertips, nose, lips, tongue.

Then anxiety gives way to lethargy, sometimes clouding of consciousness. Disorders of consciousness, sometimes seizures may manifest themselves in acute renal, hepatic, pancreatic encephalopathy. Acute development encephalopathy with intense headache, nausea, vomiting, nystagmus, paresis, mental disorders, less often convulsions are observed with pulmonary embolism, infarction pneumonia, in some cases and with exacerbation of chronic pneumonia.

The most common symptoms of encephalopathy:

• disorders of memory and consciousness;
• lack of initiative;
• headache;
• dizziness;
• depression.

Patients with similar symptoms encephalopathies often complain of fatigue, irritability, absent-mindedness, tearfulness, bad dream, general weakness. At the same time, when examining them, apathy, viscosity of thought, verbosity, narrowing of the circle of interests and criticism are noted, daytime sleepiness, difficulty pronouncing certain words and other symptoms of encephalopathy.

Diagnosis of encephalopathy

The diagnosis of encephalopathy is usually made after clinical examinations performed during the examination - tests for psychological condition, memory state, coordination of movements. Research may show changes mental state. Typically, a diagnosis is made when a change in mental status is accompanied by another diagnosis, such as chronic illness liver, renal failure, hypoxia and so on.

Thus, to identify the cause of the disease and the encephalopathy itself, doctors can use several different tests simultaneously. This approach is practiced by most doctors thanks to existing point vision: encephalopathy is a complication resulting from an underlying health problem.

The following are the studies and tests most often prescribed by doctors when making a diagnosis, as well as some possible underlying causes of the disease:

• Complete blood count (infections, blood loss).
• Blood pressure measurement (high or low pressure).
• Metabolic tests (levels of electrolytes, glucose, lactic acid, ammonia and oxygen in the blood, the number of liver enzymes).
• Levels of toxins and drugs (alcohol, cocaine, amphetamines).
• Creatinine (kidney function).
• CT and MRI (brain tumors, anatomical abnormalities, infections).
• Doppler ultrasound (pathological blood circulation in tissues, abscesses).
• Encephalogram or EEG (brain dysfunction, pathological electroencephalogram indicators).
• Test for autoantibodies (dementia caused by antibodies that destroy neurons).

This list is not exhaustive, and not all of the above tests are necessary to make a diagnosis. Typically, the physician will order certain tests based on the patient's symptoms and medical history.

Treatment of encephalopathy

To prescribe adequate treatment, the doctor must very well assess the patient’s symptoms and the data of the studies performed. Typically, the complex includes drugs that improve cerebral blood circulation in the brain, nootropics, vitamins, and adaptogens. Also applicable additional methods treatment. The problem of treating encephalopathy has so far been quite complex; in some cases it is only possible to somewhat stabilize the patient’s condition.

Treatment for encephalopathy is aimed at eliminating the symptoms as well as treating the disease that led to the brain damage.

In acute severe encephalopathy, hemoperfusion, hemodialysis, ventilation, parenteral nutrition. They use drugs that reduce intracranial pressure and prevent the development of seizures. Drugs that improve blood circulation in the brain are also prescribed.

Additional treatment of encephalopathy involves the use of physiotherapy and reflexology, breathing exercises.

For acute encephalopathies it is used various systems life support: hemodialysis, artificial ventilation lungs, hemoperfusion, prolonged parenteral nutrition. Measures to reduce intracranial pressure and eliminate convulsive syndrome are often necessary.

Subsequently, drugs are prescribed that improve brain metabolism:

• nootropic core (pyriditol, piracetam);
• amino acids (cerebrolysin, alvesin, methionine, glutamic acid);
• lipotropic compounds (essentiale, lecithin);
• vitamins A, E, group B;
• ascorbic and folic acid: according to indications - angioprotectors (cinnarizine, xanthinol nicotinate, parmidine, cavinton, sermion);
• antiplatelet agents (pentoxifylline);
• biostimulants (aloe extract, vitreous).

Medicines are prescribed in combination, repeated courses lasting 1-3 months.

The prognosis is determined by the dynamics of the underlying disease, the degree of brain damage, the possibility of specific therapy. In some cases, it is possible to ensure only stabilization of the patient's condition.

The term encephalopathy describes a number of disorders or diseases of the brain and modern concept do not refer to a single disease, but rather to a syndrome of general brain dysfunction. The syndrome can have many different organic and inorganic causes.

Timely detection of vascular encephalopathy of the brain and its timely treatment helps to slow down the development of dangerous pathological symptoms and alleviate the course of the disease.

Encephalopathy is a complex term because it can be used to refer to any disease or pathological feature in a patient.

When we're talking about about the observed pathological sign, this disease refers to permanent or degenerative, relating to traumatic brain injury or any reversible process.

When we talk about this disease, we can talk about its relationship to a wide range of brain diseases of various etiologies, forecasts and consequences.

Certain signs found on clinical trial patient and indicating the presence of encephalopathy include intellectual impairment, irritability, agitation, delirium, confusion, somnolence, stupor, psychosis and coma.

Many people wonder: Is this serious? complex disease, caused by the entry of toxins of various chemical structures into the brain, while some of the vessels and nerves die.

Read about the risks of encephalopathy.

See about post-traumatic encephalopathy.

Types of encephalopathies

Chronic traumatic

This type of encephalopathy occurs when there is (usually multiple) brain injuries.

Impacts to the head damage nerves in the brain.

Commonly found in boxers, football players or military personnel who have suffered impact injuries from explosions.

Glycine

Glycine encephalopathy is genetic or hereditary disease. This is a condition in which there is abnormal high levels glycine (amino acid) in the brain. Glycine-type symptoms usually appear in children soon after birth.

Hashimoto's encephalopathy

This is a rare type of encephalopathy that is associated with autoimmune condition, known as Hashimoto's disease. For Hashimoto's disease, the immune system mistakenly attacks the thyroid gland. The thyroid gland is responsible for the production of many hormones that regulate the functions of human body. It is not yet known exactly how these conditions influence the development of encephalopathy.

Hepatic

Hepatic encephalopathy is the result of liver disease.

When the liver does not function properly, toxins normally removed from the body by the liver accumulate in the blood and reach the brain, damaging it.

Hypertensive

Hypertensive encephalopathy is the result of high blood pressure if left untreated for too long. This can cause brain tissue to swell and become damaged.

Hypoxic ischemic

This type occurs when the brain does not receive sufficient quantity oxygen, which causes damage. This can lead to permanent brain damage or dysfunction. This encephalopathy, in particular, can occur when developing child exposed to alcohol in the womb.

Toxic-metabolic (toxic)

This type is the result of infections, toxins, or organ failure.

When electrolytes, hormones and others chemical substances in the body lose their normal balance, they can affect brain function.

This type of encephalopathy usually resolves when the body's basic chemical balance is restored or when toxins are removed from the body.

The disease may also include the presence of an infection in the body or the presence of toxic chemicals.

Infectious encephalopathies

Transmissible spongiform encephalopathies are also known as prion diseases. Prions are proteins found in the body. In some cases, these proteins can mutate and cause neurodegenerative changes that damage the brain.

Prion diseases include:

• chronic wasting disease;
• fatal familial insomnia;
• Creutzfeldt-Jakob disease;
• Kuru disease.

Uremic appearance

Uremic encephalopathy results from kidney failure. It is thought to be caused by the accumulation of uremia toxins in the blood. The disease can cause mild disorientation or deep coma.

Wernicke's encephalopathy

Also known as Wernicke's disease, it results from a deficiency of vitamin B-1 in the body. Long-term alcoholism, poor nutrition and poor absorption of food can cause a deficiency of this vitamin.

If Wernicke's disease is not treated promptly, it can lead to Wernicke-Korsakoff syndrome.

Mechanism of vascular encephalopathy

As a result of a certain pathological effect on the tissues and blood vessels of the brain, these tissues begin to gradually change.

Atherosclerotic degenerative changes in the vessels of the brain they provoke thrombosis (blockage) of the arteries, causing embolism - the appearance in the blood of particles (embolus) that are not found in the blood under normal conditions.

Blockage of blood vessels with atherosclerotic plaques

Embolism leads to increased blockage of blood vessels and increasing problems cerebral blood supply, causing hypoxia (lack of oxygen) in surrounding tissues.

These degenerative changes provoke disorders in the cells of the central nervous system due to developing failure in the neurons of the brain, which leads to destabilization of the entire internal neural environment, causing the formation free radicals, damaging cell membranes.

As a result of these processes, the number of active cells of the central nervous system of the brain - synapses and neurons - decreases.

These changes, in turn, cause numerous pathological symptoms in patients associated with vascular encephalopathy.

Signs of the disease

Mental changes associated with vascular encephalopathy may include difficulty with memory or focusing the patient's attention. There may be problems with habitual skills in solving current problems, and lethargy and drowsiness may appear.

Changes in the patient's personality and character are also one of the signs of this disease.

• Neurological symptoms of encephalopathy often include:
• difficulty making decisions or concentrating;
• muscle weakness of one part of the body;
• involuntary muscle twitching;
• difficulty speaking or swallowing;
• muscle trembling (tremor);

seizures. Due to the variety of signs and symptoms of the disease exact description his clinical picture is complicated. If these signs appear, it is important to seek medical attention. medical care staged accurate diagnosis And timely treatment

diseases.

About the principles of treatment

Treatment includes medications to treat symptoms and the underlying cause of the disease, or even surgery.

In some cases of the disease, for example, with oxygen deficiency, a person may fall into a coma. In severe cases, life support may be required to prevent death.

Vascular encephalopathy of the brain treatment with folk remedies

Besides treatment medicines, alternative medicine offers many treatment recipes blood vessels. Folk remedies for vasodilation can be used as an emergency measure or for long-term treatment of the disease.

The following methods are very popular:

• a compress on the forehead from decoctions of herbs (chamomile, sage, etc.) to strengthen blood vessels;
• thyme decoction and rose hip tea help normalize blood pressure and dilate arterial walls;
• aromatherapy essential oil lavender, mint or pine has a calming effect and beneficial influence on the circulatory system;
• decoctions of viburnum, burdock or periwinkle have a vasodilating effect and eliminate spasmodic effects.

It is known that this is a slow-acting brain dysfunction, when tissue damage occurs slowly and the blood supply gradually deteriorates.

Read about hypertensive encephalopathy here.

Conclusion

Some types of encephalopathy, for example, hereditary ones, occur in humans regardless of external causes.

However, some types vascular diseases brain damage can be prevented.

First of all, it is important to avoid excessive alcohol intake, reduce exposure toxic substances, apply healthy diet and visit your doctor regularly.

The long-term prognosis of the disease depends on the cause and severity of the disease. Many forms of encephalopathy are reversible if their cause can be identified and treated. Healthy image life may help reduce risk factors for brain diseases.

Video on the topic

The vascular form of encephalopathy is general defeat brain, which is caused by insufficient blood supply to the organ, causing ischemic changes, oxygen deficiency, causing hypoxia, and a number of diseases. Cerebral circulation disorders and, as a consequence, hypoxia have a detrimental effect on neuronal cells. On initial stage pathological process, a small focus of neuronal death occurs, but in the absence of appropriate therapy, more and more areas of the brain are affected, the symptoms intensify, leading to irreversible changes.

IN last years Vascular encephalopathy has become a hot topic, since the age threshold for the disorder has noticeably decreased; medical practitioners are increasingly diagnosing it in young patients who complain of symptoms characteristic of brain pathologies. Besides, similar condition The brain develops against the background of common ailments: hypertension, atherosclerosis, venous thrombophlebitis.

According to the nature of origin, encephalopathy is divided into:

• Congenital- caused by intrauterine disorders of brain development, intracranial injury, which the child received during childbirth, hereditary disorders metabolic processes and etc.
• Purchased- develop throughout a person’s life due to exposure to negative external factors, injuries, various diseases, metabolic disorders.

Reasons for the development of the disorder

As we have already said, a pathological condition can occur in a child during intrauterine development or during childbirth. IN different periods life disturbance may be caused by:

• Hypertension associated with pressure surges, pathological hypotension.
• Exposure to toxic compounds.
• Traumatic brain injuries.
• Kidney and liver diseases, disorders of the pancreas, causing an increase in the content of toxic substances in the blood and their penetration into the brain tissue.
• Exposure of the brain to radioactive radiation.
• Development of malignant neoplasms.
• , as a result of which hypoxia develops.

With encephalopathy in the brain, the number of fully functioning neurons decreases, small foci of necrosis appear, blood stagnation develops, and swelling of the meninges and hemorrhages are observed. Pathological foci are most often localized in the white or gray matter.

Types of pathology

The identification of types of disorders is based on what vascular pathology caused the disorder. The most common encephalopathies are:

• Atherosclerotic- develops as a result of blockage of cerebral vessels with atherosclerotic plaques and the occurrence of hypoxia. The disorder is more often diagnosed in older people, but it is also possible in at a young age when called for various reasons elevated cholesterol levels. This type of encephalopathy develops over a long period of time, but in the absence timely diagnosis and treatment, can manifest itself in a sharp form, leading to serious complications.
• Hypertensive- arises as a result acute nephritis, eclampsia, sudden increases in blood pressure or hypertensive crisis, which is the most dangerous. The encephalopathy that develops during a crisis and the changes associated with it are irreversible and have an unfavorable prognosis.
• Venous- develops gradually, due to blood stagnation, after the appearance of the first symptoms, and may not cause a noticeable deterioration in well-being for several years. In case of effective treatment on early stages, the disorder is completely reversible, but in the absence of therapy it quickly progresses and leads to serious consequences.

Other forms of impairment

There are a number of less common types of encephalopathy:

• Hypoxic-ischemic- the above types of disorders can also be attributed to this form, since circulatory disorders entail the development ischemic changes brain tissue and hypoxia. Characteristic difference This type of disorder is common in children in the first month of life. May occur during fetal development or during childbirth, leading to both minor damage brain, manifested in hyperactivity and absent-mindedness, as well as serious pathologies.
• Leukoencephalopathy- the most severe version of the disorder, with which the patient can live for a maximum of two years. Acute forms usually end in death within a month. Focal white matter lesions are not treatable and have viral nature. Most often the disease is diagnosed in people old age, with weakened immunity.

To date, there is no method of treating leukoencephalopathy. This is explained by the presence of a kind of protective barrier at the approaches to the brain, through which they do not penetrate. medications aimed at eliminating the causative virus. The reason lies in the fact that the barrier allows only fat-soluble pharmaceuticals to pass through, while the drugs indicated in this case are mostly water-soluble.

Signs of the disorder

Common to different forms disorders are the following symptoms:

• Migraine-like headache and dizziness.
• Tinnitus.
• Decreased hearing and visual acuity.
• Sudden mood swings.
• Fast fatiguability.
• Psycho-emotional disorders - increased irritability, depressive states, tearfulness.
• Sleep disorders.
• Deterioration of short-term memory.
• Inability to concentrate, absent-mindedness.
• Coordination problems.
• Numbness of fingers and toes.

There are three stages of encephalopathy:

1. Compensated- the body more or less copes with developing pathology, painful symptoms are mild. A person suffers from headaches, dizziness, and a feeling of heaviness in the head. At night a person cannot sleep, and during the day, on the contrary, he suffers from drowsiness and lethargy.
2. Subcompensated- vascular pathology progresses, lesions of brain tissue become more extensive. The patient has an unsteady gait, constant tinnitus, and symptoms of diseases that caused encephalopathy.
3. Decompensation- due to increasing hypoxia, atrophic phenomena develop in the cerebral cortex, symptoms appear very clearly, therapeutic measures do not bring a noticeable effect.

How to diagnose

First of all, the doctor examines the patient, listens to his complaints and studies the medical history. To clarify the diagnosis, the following methods are used:

• Computer and magnetic resonance imaging.
• Ultrasound examination - Doppler ultrasound, duplex and.
• Electroencephalography.
• Nuclear magnetic resonance.
• Biochemical analysis of blood, cerebrospinal fluid and urine.

Treatment methods for the disorder

After vascular encephalopathy of the brain has been diagnosed, treatment is prescribed, primarily aimed at eliminating the cause of the disorder. In the future, a course of comprehensive drug therapy, lasting from one to three months. To loosen painful symptoms and improve the condition of blood vessels, the following drugs are used:

• Angioprotectors - Etamzilat, Vasobral.
• Hypolipidemic agents, normalizing increased level saturated fatty acids and reducing the likelihood of atherosclerosis - Polysponin, Miscleron.
• Vasoactive agents - Cinnarizine, Cavinton.
• Phlebotonics used for vein pathologies - Troxevasin, Aescusan.
• Nootropics - Nootropil, Piracetam.
• Vitamin and mineral complexes.

Positive effect provides physiotherapy, physiotherapy and other procedures. However, you should always remember that this is helper methods, which work only in combination with the main therapeutic course.

Vascular encephalopathy is a term derived from the Greek “encephalon”, which means brain and “pathos” - disease. Plus a designation of genesis, indicating specifically the connection with the vascular system of the brain. The basis of the emerging deviations is the mechanism of ischemic disruption of vascular activity, that is, short-term or complete violation blood flow to the brain. As a result, hypoxia occurs and neuron cells die if treatment is not provided in time. First, a focal lacuna appears, and if measures are not taken, then extensive death of nerve cells.

Types of encephalopathies

There are both congenital dyscirculatory encephalopathy and those acquired subsequently: in the perintal period, during childbirth, when exposed to harmful factors on the body - ecology, toxins, brain injuries.

Thus, there are several types of vascular encephalopathy acquired during a person’s life:

• Post-traumatic consequences if the injury was not treated properly or complications arose. Types of vascular encephalopathy, such as dyscirculatory encephalopathy, may show signs only years after injury.
• Toxic, resulting from the entry of substances toxic to the body into the blood. Moreover, toxins can be bacterial, viral, or can arise as a result of diseases of other organs - the liver, for example, with cirrhosis.
• Radiation discirculatory - occurs as a result of irradiation of brain vessels with infrared, ionizing, X-ray or other radiation. Also, if cancer was treated with radiation therapy.
• Metabolic – encephalopathy of the vascular type, which occurs when general metabolism is disturbed, diseases internal organs. Also associated with encephalopathy of hepatic and toxic origin.

The subtypes into which vascular encephalopathy is divided can be designated depending on the lesion - for example, with damaged pancreas it is called pancreatic, with kidney damage - renal or urinary, with dysfunction of glycemia - hyperglycemic or hypoglycemic, etc.

However, it is vascular encephalopathy that receives the most attention: every year more young patients are admitted for treatment, complaining of problems with brain activity. For example, with atherosclerosis, hypertension, venous dysfunction or thrombosis, a picture of vascular genesis of encephalopathy is noted, characterized as dyscirculatory.

If an acute change in metabolism, blood loss, or sudden jump AD, hypoxic vascular encephalopathy occurs. For example, in patients after resuscitation.

Mechanism of vascular encephalopathy

Signs of hypoxia most often indicate the development of vascular encephalopathy. Moreover, hypoxia can be based on many reasons. In addition to what is stated above:

1. Venous congestion.
2. Brain swelling.
3. Microscopic hemorrhage, not to mention full-blown hemorrhage.
4. Transient ischemic attack.
5. Unfinished stroke treatment or recurrent stroke.
6. Exposure to toxins, etc.

The resulting discirculatory atrophy leads not only to a decrease in the number of nerve cells, but also to the degeneration of the remaining ones. Small foci of necrosis that appear grow to the point of demyelination in the structure of the white matter of the brain.

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Symptoms of dyscirculatory encephalopathy

To prescribe treatment, it is necessary to find out at what stage of development the disease is. In particular, doctors distinguish three stages of vascular origin in encephalopathy:

I – compensated, in which the body as a whole copes with vascular disease, trying to provide for the affected brain cells. As you can understand, this cannot be done 100%, so some signs begin to appear vascular disorder– dizziness, memory problems, a person has a headache or a feeling of heaviness in the head. Often in the first stage, insomnia is tormented, which is replaced by lethargy in daytime. Together, all these symptoms cause lability of the emotional state, although patients mistakenly direct treatment on their own to relieve the symptoms themselves.

At this stage, the patient may experience instability when walking, persistent ringing in the ears, and problems appear with those organs and systems, the centers responsible for which are affected by dyscirculatory encephalopathy.

For example, when the cells responsible for the innervation of the head, arms, and legs are disrupted, numbness of the tongue occurs, absence of coughing, sneezing, swallowing reflexes, tremors, and problems with coordination.

III – decompensation of ongoing processes of vascular genesis. Since the body is no longer able to supply the brain areas with oxygen sufficiently, cortical atrophy develops rapidly, the symptoms are pronounced, and treatment does not provide complete rehabilitation. The patient may develop epilepsy, disability, fall into a coma, or it will all end in death.