How to eat with cerebral microangiopathy of the brain. Forms and characteristics of cerebral microangiopathy

Microangiopathy is a pathological condition that affects capillaries, small vessels responsible for metabolic processes. Basically, this condition is concomitant with certain diseases, such as diabetes, infections and tumors. Varieties of this condition include disease of the renal capillaries and retinal vessels.

The term microangiopathy itself comes from the words “micro” - small, “angio” - vessel and “pathia” - pathology. In other words, microangiopathy is a disease that affects small vessels and capillaries. Microangiopathy of the brain begins from circulatory failure in the brain, which has a chronic form. Oxygen and glucose are responsible for normal cerebral blood flow. With microangiopathy, you can notice a long-term lack of these substances, this leads to disruption of the structure and functioning of small vessels in the brain, and as a result, damage to the white matter.

Conventionally, this condition can be divided into two types:

with expansion of venules and thickening of capillary walls;
with thickening of the walls of arteries of a hyaline nature.

Experts refer to microangiopathy as precisely that condition that is characterized by changes in the capillaries.

Causes of the disease

In the vascular system, microangiopathy develops against the background of other diseases. This could be oncology, diabetes, infections, liver disease, or hemolysis - a condition in which red blood cells are destroyed and hemoglobin is separated from them. Basically, this condition is attributed to the consequences of such diseases and conditions of the body:

thrombosis - disruption of normal blood flow as a result of the formation of blood clots that interfere with blood flow;
necrosis – death of cells and tissues of the body;
hyalinosis - deposition of hyaline in the tissues of the body - one of the types of protein dystrophy;
fibrinoid swelling - increased vascular permeability and, as a consequence, irreversible destruction of connective tissue.

Most often, when talking about microangiopathy, they mean a complication of long-term diabetes mellitus. This condition affects the capillaries of the kidneys (nephropathy), nerves (polyneuropathy) and eyes (retinopathy). The following changes occur in the vessels: the basement membrane of the capillaries thickens, thrombus formation occurs in the microvasculature, proliferation of the perithelium and endothelium, hyalinosis of the walls of the arterioles, capillary aneurysms appear, venules expand and undergo thrombosis.

The causes of angiopathy are metabolic disorders, the main role of which is played by the following:

glycosylation of proteins and, as a result, tissue hypoxia associated with excess glycosylated hemoglobin;
endothelial dysfunction, decreased production of nitric oxide, antithrombin, prostacyclin, increased endothelin and thromboxane content. As a result, blood vessels spasm and platelet aggregation increases;
protein synthesis decreases;
the renin-angiotensin system is activated;
the oxidation of glucose by sorbitol is enhanced;
lipid peroxidation is activated;

Increased secretion of growth factors by the endothelium is associated with excess synthesis of glycoproteins, collagen and an increase in the thickness of the basement membrane of capillaries.
Microangiopathy can also be caused by rubella, measles, trauma, intoxication of the body, smoking, addiction to alcohol, hard work that weakens the body, high blood pressure, and old age.

How does the disease manifest itself?

Microangiopathy of the brain has a number of symptoms: the patient increasingly notices memory disorders, clouding of consciousness, weakness for no reason and headaches often appear. This occurs as a result of impaired blood circulation in the capillaries in the brain area. As a result of damage to the walls of small vessels, lipid oxidation processes are activated in them, free radicals appear, which have a destructive effect on brain cells.

Since the development of symptoms occurs very slowly, the patient cannot always react in time and go to the doctor. At first, weakness appears, the person quickly gets tired of his usual work. A characteristic symptom of this disease is frequent headaches, which are almost impossible to relieve with conventional painkillers. Over time, sleep is disturbed: at night the patient suffers from insomnia, and during the day drowsiness appears.

With the further development of the disease, absent-mindedness appears, the patient becomes forgetful and inattentive. Characterized by rigidity of thinking and weak ability to fixate. These symptoms are accompanied by focal symptoms. This may include an unsteady gait, other coordination disorders, convergence disorder, different pupil diameters, and other pathological reflexes.

Also symptoms of microangiopathy are: deterioration of visual function, aneurysms in the eyes, frequent nosebleeds, stomach bleeding, pain when walking in the calf area, discomfort in the legs at rest, flaking of the skin of the feet, dry skin, blood clots in the urine.

Diagnostics

The nuclear magnetic resonance method has proven itself well in the diagnosis of cerebral microangiopathy. This method allows you to study the brain tissue itself, as well as the vascular network. With this disease, signs of arterial hypoplasia are visible. The foci of infarctions (the so-called silent ones), which are caused by vascular occlusion, as well as microscopic hemorrhages and cerebral hypoperfusion, are clearly visualized.

Cerebral microangiopathy is defined by modern specialists as discirculatory encephalopathy. When examining the brain using MRI, the following signs of this disease are obvious: cerebral atrophy, microscopic hemorrhages, leukoaraiosis, lacunar infarctions, expansion of perivascular spaces.

To identify abnormalities in blood vessels, narrowing of the lumen or blockage, Doppler ultrasound is used. Also, to get a general picture of the disease, a blood test is done, which can be used to determine changes in its rheological properties, changes in the shape of blood cells, cholesterol levels, and other important indicators.

Treatment

Treatment of cerebral microangiopathy is carried out comprehensively. First of all, the doctor must select medications suitable for the patient to normalize blood pressure. To eliminate signs of oxygen deficiency in brain tissue, antihypoxants are taken, for example, Emoxipin. Correction of lipid levels plays an important role. The drugs used to lower lipid levels are statins, bile acid sequestrants, and fibrates. Among them, the most common are Atorvastatin, Rosuvastatin, Simvastatin.

To improve brain nutrition, nootropics are used: Piracetam, Cerebrolysin, Nootropil, Encephabol. With the help of nicotinic acid preparations, blood circulation is improved: Picammilone, Xanthinol nicotinate.

The prognosis of the disease worsens if the patient has hypertension, in which case the symptoms progress quite quickly. Age is also important: in older people the disease progresses faster.

It is asked often because this phenomenon accompanies many serious diseases. With this pathology, small-caliber blood vessels are damaged in any part of the body, for example, retinal vessels or renal capillaries may be affected.

Damage to blood vessels

The occurrence of microangiopathy is influenced by the presence of an underlying chronic disease, such as diabetes mellitus, some infectious diseases, liver diseases, hemolysis and many others. In addition to the above conditions, this symptom complex occurs as a consequence of necrotic changes in the tissues and cells of organs. The same is true for thrombotic processes in the vessels, when blood clots form that interfere with normal blood flow. Microangiopathy syndrome occurs due to protein dystrophy, in which hyaline is deposited in the tissues, and with fibrinoid swelling of the tissues, when the permeability of capillaries increases and the connective tissue is sufficiently disorganized deep.

Clinical manifestations of microangiopathy

The symptoms of this pathological process appear depending on what the underlying disease is and how it is characterized. In addition, the external influence of certain factors on the body and morphological changes in organs and tissues introduce certain aspects into the manifestations of microangiopathy.

The main symptoms include damage to the integrity of the wall of blood capillaries, functional changes in the blood coagulation system, that is, disturbances in hemostasis.

Insufficient kidney function often occurs, since their main work is in the capillaries, which are damaged here. When blood clotting is impaired, the symptom of purpura occurs, which is characterized by damage to red blood cells - red blood cells.

Etiological factors

Factors contributing to the occurrence of the disease are the following:

hereditary-genetic factor, which is characterized by a decrease in the tone of the vascular wall;
some diseases that damage the blood and its plasma;
serious poisoning of the body;
mechanical injuries.

In addition to the above, many doctors suggest that alcoholism and smoking, the presence of diabetes, a decrease in immune status due to certain hazards at work, and age-related changes can be a provocative element in this pathology.

Clinical forms

In clinical practice, it is customary to divide microangiopathy into 2 forms: cerebral microangiopathy, or cerebral, and diabetic.

The cerebral form is characterized by damage to small vessels of the brain, disruption of normal cerebral circulation occurs, and occurs against the background of atherosclerosis and constant high blood pressure.

The cerebral form is divided into 2 types: with the first, the walls of the blood arteries thicken in a hyaline nature, and with the second, the walls of the capillaries thicken. Both types are the result of long-term impaired blood supply to the brain and can lead to dangerous damage to the white matter, where the clusters of nerve fibers that form the wiring pathway are located. Under such circumstances, a so-called lacunar infarction, or in other words, a cerebral stroke, may occur against the background of a closed one branch of the cerebral vessels. It is also possible to develop encephalopathy, which causes diffuse tissue damage.

In diabetes mellitus, microangiopathy is one of the symptoms of the disease. Due to the latter, tissue hypoxia develops, that is, a condition in which the use of supplied oxygen by organ tissues is impaired. Microangiopathy develops due to increased glucose in the blood, as the walls of small vessels that are close to the tissues are damaged.

The clinical signs of microangiopathy depend entirely on the location of the injury. This process is a dangerous manifestation of diabetes. The further the disease progresses, the more the lumen of the blood vessels narrows, and oxygen starvation of the body tissues intensifies. The general condition of the patient deteriorates sharply.

The irreversibility of the process of narrowing of the vascular walls is the result of damaged vascular membranes, proliferative changes in the endothelial layer, thickening of the membranes themselves and the accumulation of mucopolysaccharide substances on the arterial wall. This is followed by an increase in osmotic pressure associated with the increased amount of fructose and water intake. All this leads to the formation of edema. Clinically they manifest themselves as diabetic nephropathy (impaired kidney function), diabetic angioretinopathy (retinal vessels are affected), .

Diagnostic and therapeutic measures

Ultrasound diagnostics of blood vessels

To detect this vascular pathology, it is necessary to conduct a number of studies. These include ultrasound diagnostics of blood vessels, ultrasound examination of the fundus, magnetic resonance imaging, X-ray examination, computed tomography and MSCT. If any pathological or suspicious areas are identified, the specialist gives an opinion and refers to the appropriate doctor.

The choice of treatment tactics depends on where the process is located and what it is associated with. Treatment is based on therapy of the main, or causative, disease.

So, for diabetes mellitus, the endocrinologist selects the required dose of insulin, prescribes a more strict diet and recommends a certain work and rest regime. If the cause is arterial hypertension, the cardiologist prescribes medications that lower blood pressure, statins, a diet enriched with fiber, and physical therapy exercises.

Nicotinic acid preparations, nootropic drugs, complexes of vitamins and microelements help with cerebral changes.

Cryosurgery

Then the doctor, depending on the patient’s condition, prescribes medications that improve microcirculation. If laboratory tests do not reveal the presence of inflammatory processes, then physiotherapy and physical therapy, various massages, and a swimming pool are added to the treatment.

If irreversible occlusion (closing of the lumen) of the vessel occurs, then surgery intervenes in the treatment. The operation helps restore patency of the artery, which promotes normal blood flow. For these purposes, surgeons prefer laser coagulation and cryosurgery methods.

To date, it is not possible to completely cure such patients; it is only possible to improve the quality of life of patients and slow down the process of gliosis.

Video

What is it? The human body is designed in such a way that oxygen and nutrients are required for the normal functioning of all organs and systems. All this is delivered to the tissues along with blood through small and large vessels. The largest number of metabolic processes occurs in the brain; it is this organ that is characterized by the most developed network of blood vessels.

For some reason, changes occur in small vessels, leading to blockage of their lumens. This condition is called microangiopathy.

This pathological process can develop in any organ, but its cerebral form is considered the most dangerous. Normal functioning of brain tissue is impossible without the supply of oxygen and glucose. With microangiopathy, there is a pronounced deficiency of these substances, which contributes to the appearance of signs of hypoxia. Impaired patency of small vessels leads to a decrease in the volume of blood flowing to brain cells or a complete stop of blood supply. As a result, areas of gliosis are formed, where adhesions are formed from rapidly dividing glial cells. In the later stages, this condition becomes life-threatening.

Causes of microangiopathy

It takes quite a long time for foci of gliosis to develop and completely block the lumens of blood vessels, so we can consider that the disease is characterized by slow development. The following factors contribute to the launch of the pathological process:

alcoholism and smoking;
traumatic brain injuries;
diseases of the circulatory system leading to increased blood clotting;
chronic infections;
endocrine disorders, especially diabetes;
dysfunction of the liver and kidneys;
oncological diseases;
genetic abnormalities in the structure of vascular walls;
old age;
exhaustion of the body.

Damage to small vessels can occur due to tissue necrosis, protein deficiency, increased permeability of vascular walls, and disruption of the integrity of the protective membranes of blood vessels. Ischemic microangiopathy develops when the lumens of blood vessels are blocked by blood clots. The disease is divided into 4 types. The amyloid cerebral form occurs when protein is deposited on the walls of blood vessels. Typical for older people. The lenticulostriate type, on the contrary, most often affects children. Experts consider this condition to be normal, but the child must be under the constant supervision of the attending physician.

Diabetic microangiopathy develops in a decompensated form of diabetes mellitus. Symptoms of the disease are increasing. The hypertensive type is typical for patients who have suffered from arterial hypertension for a long time. Any form of the disease is characterized by the production of increased amounts of glycoproteins and collagen, which leads to thickening of the capillary walls. This helps to reduce the rate of metabolic processes, stop the nutrition of tissues in certain areas of the brain, and form foci of gliosis.

Clinical picture of the disease

The main signs of microangiopathy are headaches, memory impairment, general weakness and clouding of consciousness.

The appearance of such symptoms is associated with impaired blood circulation in small vessels, which causes the production of substances that destroy brain tissue. Due to the slow development of microangiopathy, the patient is unaware of the presence of the disease for a long time. Therefore, doctors most often encounter advanced forms of pathology. In the early stages, a person begins to quickly get tired when doing usual work. This symptom is accompanied by a severe headache that cannot be relieved with standard painkillers.

Over time, an astheno-neurotic syndrome develops, characterized by frequent mood swings, insomnia, chronic fatigue, and decreased performance. The disease often leads to the formation of depressive disorders. In the later stages of microangiopathy, a person becomes forgetful, absent-minded, and intellectual abilities also suffer. The nature of the accompanying symptoms depends on the location of the lesions. This may be a lack of coordination of movement, decreased visual acuity, or a change in the size of the pupils. Vegetative polyneuritis syndrome may develop, in which thermoregulation is disrupted and there is no response to pain.

Microangiopathy is accompanied by a blood clotting disorder, which is why in the later stages of the disease, nasal and gastrointestinal bleeding, hematuria and subcutaneous hemorrhages often occur. The most dangerous condition is considered to be hemorrhage in the brain tissue.

Diagnosis and treatment of the disease

Before making a final diagnosis, it is necessary to exclude other diseases that have similar symptoms.

The examination begins with collecting anamnesis and conducting laboratory tests: general and biochemical blood tests, determination of its lipid composition, coagulogram. Dopplerography allows you to assess the condition of blood vessels, identify the presence of blood clots and other abnormalities. Electroencephalography is used to detect disorders in the brain. An ophthalmological examination reveals changes in the condition of the fundus. Microangiopathy of the brain is an indication for MRI and CT. These diagnostic procedures make it possible to study the degree of pathological changes in brain tissue and vessel walls, to detect foci of gliosis and dilation of large arteries. They are also used to detect hemorrhagic stroke.

Treatment of the disease involves an integrated approach; conservative therapy is aimed at eliminating the cause of microangiopathy and relieving its main symptoms. For diabetes mellitus, medications are prescribed to normalize blood glucose levels. It is necessary to take medications that help lower blood pressure and keep it within normal limits. Antihypoxants are prescribed in the presence of severe signs of oxygen starvation.

MRI

The course of treatment includes the use of drugs that lower lipid levels, improve blood supply to brain tissue, and strengthen the walls of blood vessels. Antiplatelet agents and antioxidants are also prescribed. Drug treatment can be combined with physiotherapeutic procedures, acupuncture, special exercises, massage and swimming. Complex treatment helps to improve the general condition of the body, increase conductivity in the affected areas of the brain, and eliminate the symptoms of the disease.

Advanced forms of the disease are treated surgically. Self-medication for microangiopathy of the brain is strictly prohibited. Selection of types and dosages of drugs is possible only on the basis of test results. This disease is considered dangerous to human health and life. If left untreated, it can lead to disability and death. Early diagnosis of pathological changes in cerebral vessels and detection of foci of gliosis allows one to avoid the development of severe complications. Full recovery from microangiopathy does not occur, but it is quite possible to stop the development of the disease. It is necessary to take all medications prescribed by your doctor, follow all his recommendations, undergo regular examinations and treat chronic diseases.

Shoshina Vera Nikolaevna

Therapist, education: Northern Medical University. Work experience 10 years.

Articles written

All internal organs and tissues of the human body are unable to function without nutrients and oxygen, which are carried by the circulatory system. If there are disturbances in the functioning of blood vessels, the entire body suffers.

Microangiopathy of the brain is a common pathology of capillaries and small vessels that supply vital organs. This disease of the cardiovascular system is dangerous because in the early stages of development it has practically no pronounced symptoms. Microangiopathies (late diagnosed) of the brain often develop into chronic forms, lead to various complications and are difficult to treat.

Definition of the concept

Microangiopathy of the brain is a disease that affects the walls of the capillaries, leading to disruption of their patency, as a result of which the blood supply to the tissues of the head deteriorates. The disease leads to the fact that healthy neurons in the brain are replaced by focal formations (), and scar connective tissue appears at the site of the lesion. Pathological changes in small vessels cause dangerous consequences and can lead to the death of the patient.

Brain microangiopathy development syndrome is a chronic disease that occurs due to unfavorable factors affecting human health, including:

genetic predisposition (problems with elasticity and tone);
bad habits (cigarettes, alcohol);
poor blood clotting;
cardiovascular pathologies;
infectious and viral lesions of the body (rubella or measles suffered in childhood);
diseases of the endocrine system (diabetes mellitus);
oncological neoplasms;
work in hazardous production;
age factor.

Microangiopathy is most often a complication against the background of other ailments of the human body, provoked by the listed factors.

According to the international classification of diseases, the term “microangiopathy” has legal grounds only if there is a description of the type of lesion and its form, for example: peripheral cerebral microangiopathy.

Main reasons

In addition to the influence of external factors on the development of the disease, there are several internal mechanisms occurring in the circulatory system. They are the causes of pathology:

Formation of blood clots, leading to blockage of blood vessels.

Necrosis.

Degenerative changes in small vessels, turning into.

Hyalinosis.

A disorder of protein metabolism in the body, characterized by the deposition of protein (hyalin) on the vascular surface. The process leads to the gradual destruction of the internal walls of blood vessels.

Fibrosis.

Pathological changes in blood vessels, leading to increased permeability of the walls and their deformation.

Vasospasm occurring due to the development of endothelial dysfunction.

What are the different forms of microangiopathy?

When diagnosing the disease, doctors distinguish between several forms, which have certain manifestations and symptoms.

Cerebral microangiopathy of the brain.

This pathology is mainly diagnosed in older people. The age factor and concomitant pathologies such as: disease, lead to the accumulation of a substance called “glycoprotein” on the walls of capillaries. Under the influence of which small vessels are gradually destroyed. The pathological condition is difficult to diagnose and treat. Over time, the disease develops into, and later into, chronic disease.

Diabetic microangiopathy syndrome.

Patients suffering from diabetes mellitus are susceptible to this pathological condition. Poor circulation in the patient’s brain is one of the complications of the disease.

Hypertensive form.

The disease occurs in patients diagnosed with hypertension. Persistent hypertension leads to disruption of blood flow through the circulatory system.

Lenticulostriate form.

The pathological condition is diagnosed in newborns and young children. Pathology refers to a special development of the vascular system that poorly supplies blood to the subcortical brain structures; it is not considered a disease. A child with a striatal form of pathology needs constant supervision by a neurologist.

Diagnostic methods used

To diagnose a pathological condition, the doctor collects a complete medical history of the patient, paying close attention to the following complaints:

severe headache that does not go away after taking painkillers;
disturbances of vestibular functions;
astheno-neurotic syndrome (characteristic features: bad mood, irritability, depression, constant fatigue, intermittent sleep);
reduced performance;
disorders of skin sensitivity in certain areas;
the appearance of bruises on the body;
nosebleeds.

Such problems are typical for many diseases, so additional examinations are prescribed to the patient:

biochemical blood test;
clinical blood test;
blood clotting test;

To diagnose the disease, procedures are used that can detect the localization of pathology and examine the condition of the patient’s vascular system.

The MRI procedure is considered the safest and most informative today.

The procedure allows you to detect focal vascular lesions, determine their size and location.

A visit to an ophthalmologist to examine the condition of the vessels in the fundus is mandatory.

Treatment of the disease

To treat the pathological condition, an integrated approach is used; the patient is prescribed the following medications:

medications that normalize blood pressure levels;
agents that increase the presence of oxygen in brain tissues (antihypoxants);
drugs that lower blood lipid levels;
medications that restore blood flow in the body;
, improving the nutrition of brain tissue.

The doctor develops a special diet rich in fiber for the patient. The patient is recommended physical therapy (a set of therapeutic exercises).

A good help in treating the disease is:

visiting the swimming pool;
body massage;
acupuncture;
physiotherapy.

Surgery is performed in extreme cases. Indications for surgery are: inability to restore vascular patency with the help of medications, impaired blood circulation.

An alternative method of treating pathology of the diabetic type is hirudotherapy (treatment with leeches). This non-traditional treatment method has been known since ancient times. Today, it is successfully used to cure a whole list of diseases.

Medical leech has the following effect on the vascular system:

thrombolytic (blood thinning);
regenerating (restoring the walls of blood vessels);
analgesic (relieving pain);
hypotensive (lowering blood pressure).

The therapeutic effect of applying leeches has a long-lasting effect, has virtually no contraindications, is effective and safe.

The active substances contained in the saliva of a medicinal leech have a general effect on the patient’s body, normalize blood circulation and metabolic processes, reduce glucose levels, and improve microcirculation of capillaries. Patients with vascular pathology are recommended to undergo 2 courses of hirudotherapy per year.

Possible consequences and prognosis

Capillary pathology is a serious disease that requires complex therapy. In its absence, the patient's condition may worsen. Possible consequences of incorrect or untimely treatment are:

the patient's disability;
death of the patient.

Late visit to the doctor can lead to the development of:

stroke;
heart attack;
ischemia;
loss of vision;
renal failure.

Early diagnosis of the pathological condition, the location of the lesions and the degree of various changes in the vascular walls makes it possible to minimize the consequences of the disease.

It is impossible to completely eliminate the symptoms of the disease, but adequate treatment can slow down the course and avoid complications.

Prevention measures

Patients with diagnosed pathology should take preventive measures to help avoid the development of complications:

regularly visit your doctor and perform all medical procedures;
follow a diet;
give up bad habits (cigarettes, alcohol);
monitor blood pressure and blood glucose levels;
go in for sports, spend more time in the fresh air.

Microangiopathy of the brain is a lesion of small-diameter blood vessels. As a result of reduced blood flow, there is a deficiency of oxygen and glucose, which are necessary for the normal functioning of neurons and other cells. Gradually progressing symptoms cause changes in the patient's lifestyle. Degenerative processes in brain tissue are irreversible, so treatment of cerebral microangiopathy should begin as early as possible.

How the disease develops

The main link in the pathogenesis of microangiopathy is a change in the rheological properties of blood (tendency to increased thrombus formation) and the structure of the wall of cerebral vessels. This condition may be due to physiological reasons or a disease that occurs with metabolic disorders. From the anatomy course we know that the brain is fed through the central arteries, which enter at the base of the organ from the neck. They then branch into small vessels that penetrate the cells in the white matter. Therefore, disruption of microcirculation mechanisms leads to complex damage to the body.

The constituent components of nervous tissue are neurons and neuroglia. Neurons are cells with a specific structure. Their processes form fibers through which nerve impulses are transmitted. The role of a kind of intercellular fluid is played by neuroglia, which perform a protective function and maintain the necessary conditions for the creation and further spread of excitation. Cerebral microangiopathy causes oxygen starvation, which leads to neuronal death.

Their place is taken by neuroglia. This process is called gliosis. Although these cells normally make up about 40% of the tissue of the nervous system, they are inferior to neurons in terms of ensuring adequate impulse conduction. Therefore, the formation of gliosis foci impairs brain function.

Causes of the disease

First of all, microangiopathy of the brain is caused by age-related changes in the walls of blood vessels. This disease gives rise to a syndrome common in older people called dyscirculatory encephalopathy (DEP). Subsequently, chronic ischemic disease develops due to persistent disturbances in the blood supply to the white matter of the brain. The following reasons can trigger the onset of microangiopathy at an early age:

atherosclerosis, the formation of plaques on the inner surface of the vessel wall contributes to the narrowing of their lumen and platelet aggregation;
acute or chronic kidney pathology, these organs are involved in the synthesis of renin, a component of the renin-angiotensin system that regulates blood pressure;
diabetes mellitus, hypothyroidism;
congenital anatomical features of the structure of the circulatory network;
hemolysis due to intoxication with alcohol or other chemical toxins;
traumatic brain injuries;
vegetative-vascular dystonia syndrome;
hypertension of any origin.

People with bad habits are at risk of developing foci of necrosis (infarction) in the brain due to microangiopathy. The tone of blood vessels and the structure of their walls are negatively affected by smoking, frequent consumption of alcoholic beverages, lack of vitamins A, C, E, group B, and microelements (potassium, magnesium, iron). Chronic nervous overstrain contributes to cerebral circulation disorders. People who lead an unhealthy lifestyle or suffer from one of these diseases are advised to regularly visit a GP. Timely initiation of treatment improves the prognosis of cerebral microangiopathy.

Symptoms

Signs of microangiopathy are varied and develop in several stages. Their severity depends on the degree of vascular damage in the brain and the peripheral circulatory system. Concomitant diseases also influence the manifestations of pathology. Microangiopathy syndrome is characterized by the presence of the following symptoms:

neurological symptoms, such as headaches, dizziness, tinnitus, fatigue, forgetfulness, sleep disturbances;
weakness of the lower extremities, manifested in changes in gait, pain in the calf muscles;
imbalance;
blurred vision, change in pupil size;
nosebleeds for no apparent reason.

Manifestations of kidney pathology include pain in the lumbar region, swelling, and in severe cases, the presence of blood in the urine. The condition of the skin, usually of the lower extremities, also changes. They note its dryness, flaking, and sometimes itching. In addition, clinical signs depend on the location of the gliosis focus. When various structures of the brain are damaged, tactile sensitivity, hearing, perception of taste, sense of smell, etc. may be dulled.

Vascular involvement is assumed at the stage of collecting anamnesis and interviewing the patient about complaints and symptoms. However, foci of gliosis and necrosis can be identified using a diagnostic method such as tomography, preferably magnetic resonance imaging (MRI). The identified changes indicate the severity of the disease. Sometimes a diagnosis of macroangiopathy is made, which means damage to large vessels.

Clinical blood tests are prescribed to identify markers of latent forms of diabetes. In this regard, testing for glycosylated hemoglobin is important. Normally, its concentration in adults and children does not exceed 6.5% (in the last months of pregnancy this figure is higher). A urine test will show kidney pathology. This is evidenced by the appearance of protein, bacteria, and leukocytes.

Therapy

If the cause of the disease is precisely established, treatment of microangiopathy is aimed at eliminating it. The prognosis of the pathology largely depends on preventing further progression of vascular damage. In clinical practice, drugs to improve cerebral circulation have found widespread use. This:

Pentoxifylline (Vazonit) is prescribed both orally and intravenously. But it is recommended to start treatment with tablets at a dosage of 600 mg twice a day;
Cinnarizine (Nimodipine, Diltiazem) relaxes the vascular wall by reducing the calcium content in its cells. The drugs are taken 25–50 mg three times a day;
Halidor, the benefits of the drug include stimulation of blood flow in the vessels of the brain affected by ischemia. Prescribe 100 mg (one tablet) three times a day;
Nicergoline acts on receptors in the vascular wall, lowering blood pressure. The dosage for intramuscular administration is from 4 to 8 mg per day, for oral administration - 10 mg three times a day.

Neurometabolic therapy increases the effectiveness of these drugs. Nootropics and adaptogens are prescribed (Piracetam, Nootropil, Citicoline, etc.). Treatment is carried out starting from the diagnostic process and throughout the patient’s life. The course is repeated 2–3 times a year for 1–2 months. To reduce the symptoms of cerebral microangiopathy in the white matter of the brain, it is necessary to adhere to a certain diet.

From the menu you need to remove foods that contribute to the progression of atherosclerosis. These are fatty meats, fish, fried foods, lard. Meat consumption should be limited to 1 - 2 days a week; fasting days can be arranged. Doctors strongly recommend giving up smoking and alcohol. A sedentary lifestyle should be gradually replaced by physical activity. However, intense sports (especially with bending) are contraindicated; walking and jogging at a slow pace are more suitable.

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