Clamp the carotid artery death. Carotid artery how to press

In the region of the larynx, the artery is divided into internal and external. It is the latter that is well felt on the lateral surfaces of the neck and, with the help of its palpation, the pulse rate is determined. Also, in some cases, by pressing on the vessel, it is possible to stop blood loss for a short time in case of wounds and injuries. Therefore, each person should know how to clamp the carotid artery in order to provide first aid to the victims if necessary.

Vessel location

First, let's figure out how to grope for the carotid artery. To do this, use the index and middle fingers, which are most sensitive to the pulsation of the vessels. The area of palpation is a depression located between the anterolateral muscle and the larynx. To determine the pulse, you need to place your fingers under the lower jaw, namely in the area between the earlobe and the chin, dropping down by about 2 cm. A pulsation can be felt in the hole near the windpipe.

Stop bleeding

In the event of an injury or injury where there is damage to the blood vessels in the neck and external arterial bleeding, it is important to know how to occlude the carotid artery. This must be done quickly and at the same time very carefully, as strong pressure can cause even more harm to the victim. Of course, such measures rarely save the life of the wounded, and most often death occurs in the first minutes after an injury to an artery in the neck. In addition, unskilled first aid in such situations can be fatal.

When bleeding from the carotid artery, it is recommended to pinch it using bandages or a gauze bandage folded several times. You need to apply the tissue to the area where the pulse is usually felt, pressing down with your hand from above. A more qualified first aid approach involves the application of a tourniquet. The arm of the victim, which is opposite to the side of the wound, must be raised, bent and placed with the forearm on the cranial vault. Then apply a tourniquet around the neck and involved upper limb. With the right actions, the shoulder, acting as a splint, should touch the ear. Thus, the hand will prevent strangulation and squeezing of intact vessels on the opposite side of the neck.

Important: you can not exert strong pressure on the carotid artery, as this will increase blood pressure, slow down the heartbeat and the person will lose consciousness.

Artificially induced hypoxia

In what cases the question still arises, how to clamp the carotid artery? In some types of martial arts, a strangulation technique is used when the opponent is deprived of consciousness by pressing on the vessels that feed the brain. For a person to faint, it is enough to put pressure on the carotid artery equal to a weight of 5 kg. With the correct execution of the reception, loss of consciousness occurs in about 10 seconds. The enemy can come to his senses within a quarter of a minute. A choke hold, as such, does not pose a mortal threat. This is due to the fact that oxygen and nutrients continue to flow to the brain through the second carotid and vertebral arteries. At the same time, such a method of protection can save a life in a dangerous situation. So, knowing how to clamp the carotid artery, a relatively weak woman is able to immobilize even a large and strong man.

If you squeeze both carotid vessels on the right and left sides of the neck, this can lead to serious consequences. At the same time, the oxygen tension to the cells of the head organs falls below the critical value, metabolic and physiological processes are disturbed. Complete blockage of blood flow to the brain provokes irreversible changes that can cause death.

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The information on the site is provided for informational purposes only. In no case do not self-medicate. At the first symptoms of the disease, consult a doctor first

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Vertebral artery syndrome: symptoms and treatment

Vertebral artery syndrome (SAS) is a complex of symptoms resulting from impaired blood flow in the vertebral (or vertebral) arteries. In recent decades, this pathology has become quite widespread, which is probably due to an increase in the number of office workers and people who lead a sedentary lifestyle, spending a lot of time at the computer. If earlier the diagnosis of SPA was made mainly for the elderly, today the disease is diagnosed even in twenty-year-old patients. Since any disease is easier to prevent than to treat, it is important for everyone to know the reasons for the vertebral artery syndrome, what symptoms it manifests itself and how this pathology is diagnosed. We will talk about this, as well as about the principles of SPA treatment in our article.

Fundamentals of anatomy and physiology

Blood enters the brain through four large arteries: the left and right common carotid arteries and the left and right vertebral arteries. It is worth noting that 70-85% of the blood passes through the carotid arteries, so the violation of blood flow in them often leads to acute disorders of cerebral circulation, that is, to ischemic strokes.

The vertebral arteries provide only 15-30% of blood to the brain. Violation of blood flow in them, as a rule, does not cause acute, life-threatening problems - chronic disorders occur, which, nevertheless, significantly reduce the patient's quality of life and even lead to disability.

The vertebral artery is a paired formation originating from the subclavian artery, which in turn departs from the left - from the aorta, and to the right - from the brachiocephalic trunk. The vertebral artery goes up and slightly back, passing behind the common carotid artery, enters the opening of the transverse process of the sixth cervical vertebra, rises vertically through similar openings of all overlying vertebrae, enters the cranial cavity through the foramen magnum and follows to the brain, supplying blood to the posterior parts of the brain : cerebellum, hypothalamus, corpus callosum, midbrain, partially - temporal, parietal, occipital lobes, as well as the dura mater of the posterior cranial fossa. Before entering the cranial cavity, branches depart from the vertebral artery, carrying blood to the spinal cord and its membranes. Therefore, if the blood flow in the vertebral artery is disturbed, symptoms appear that indicate hypoxia (oxygen starvation) of the brain areas that it nourishes.

Causes and mechanisms of development of vertebral artery syndrome

Along its course, the vertebral artery contacts both the solid structures of the spinal column and the soft tissues surrounding it. Pathological changes that occur in these tissues are prerequisites for the development of SPA. In addition, congenital features and acquired diseases of the arteries themselves can become the cause.

So, there are 3 groups of causative factors of vertebral artery syndrome:

Congenital features of the structure of the artery: pathological tortuosity, anomalies of the course, kinks.
Diseases, as a result of which the lumen of the artery decreases: atherosclerosis, all kinds of arteritis (inflammation of the walls of the arteries), thrombosis and embolism.
Compression of the artery from the outside: osteochondrosis of the cervical spine, anomalies in the structure of bones, injuries, scoliosis (these are vertebrogenic, that is, associated with the spine, causes), as well as tumors of the neck tissues, their cicatricial changes, spasm of the muscles of the neck (these are non-vertebrogenic causes).

Often, SPA occurs under the influence of several causative factors at once.

It should be noted that SPA develops more often on the left, which is explained by the anatomical features of the left vertebral artery: it departs from the aortic arch, which often has atherosclerotic changes. The second leading cause, along with atherosclerosis, are degenerative-dystrophic diseases, that is, osteochondrosis. The bone canal in which the artery passes is quite narrow, and at the same time mobile. If there are osteophytes in the region of the transverse vertebrae, they compress the vessel, disrupting blood flow to the brain.

In the presence of one or more of the above reasons, the factors predisposing to the deterioration of the patient's well-being and the appearance of complaints are sharp turns or tilts of the head.

Symptoms of vertebral artery syndrome

The pathological process in SPA goes through 2 stages: functional disorders, or dystonic, and organic (ischemic).

Stage of functional disorders (dystonic)

The main symptom at this stage is a headache: constant, aggravated during head movements or with a long forced position, baking, aching or pulsating, covering the back of the head, temples and following forward to the forehead.

Also, at the dystonic stage, patients complain of dizziness of varying intensity: from a feeling of slight instability to a feeling of rapid rotation, tilt, and fall of their own body. In addition to dizziness, patients are often worried about tinnitus and hearing impairment.

Various visual disturbances can also occur: sand, sparks, flashes, darkening in the eyes, and when examining the fundus, a decrease in the tone of its vessels.

If at the dystonic stage the causative factor is not eliminated for a long time, the disease progresses, the next ischemic stage sets in.

Ischemic, or organic, stage

At this stage, the patient is diagnosed with transient disorders of cerebral circulation: transient ischemic attacks. They are sudden attacks of severe dizziness, impaired coordination of movements, nausea and vomiting, speech disorders. As mentioned above, these symptoms are often provoked by a sharp turn or tilt of the head. If, with such symptoms, the patient takes a horizontal position, there is a high probability of their regression (disappearance). After an attack, the patient feels weakness, weakness, tinnitus, sparks or flashes before his eyes, headache.

Clinical variants of the vertebral artery syndrome

drop attacks (the patient suddenly falls, his head throws back, he cannot move and stand up at the time of the attack; consciousness is not disturbed; motor function is restored within a few minutes; this condition occurs due to insufficient blood supply to the cerebellum and the caudal sections of the brain stem);
syncope vertebral syndrome, or Unterharnsteint's syndrome (with a sharp turn or tilt of the head, as well as in the case of a long stay in a forced position, the patient loses consciousness for a short time; the cause of this condition is ischemia of the region of the reticular formation of the brain);
posterior cervical sympathetic syndrome, or Bare-Lieu syndrome (its main symptom is constant intense headaches of the "helmet removal" type - localized in the occipital region and spread to the anterior sections of the head; pain intensifies after sleeping on an uncomfortable pillow, when turning or tilting head; the nature of the pain is throbbing or shooting; may be accompanied by other symptoms characteristic of SPA);
vestibulo-atactic syndrome (the main symptoms in this case are dizziness, a feeling of instability, imbalance, darkening of the eyes, nausea, vomiting, as well as disorders of the cardiovascular system (shortness of breath, pain in the heart area, and others);
basilar migraine (an attack is preceded by visual disturbances in both eyes, dizziness, unsteady gait, tinnitus and blurred speech, after which there is an intense headache in the back of the head, vomiting, and then the patient loses consciousness);
ophthalmic syndrome (complaints from the organ of vision come to the fore: pain, a feeling of sand in the eyes, lacrimation, redness of the conjunctiva; the patient sees flashes and sparks before the eyes; visual acuity decreases, which is especially noticeable when the eyes are loaded; fields partially or completely fall out vision);
cochleo-vestibular syndrome (the patient complains of a decrease in hearing acuity (the perception of whispered speech is especially difficult), tinnitus, a feeling of swaying, instability of the body or rotation of objects around the patient; the nature of the complaints changes - they directly depend on the position of the patient's body);
syndrome of autonomic disorders (the patient is concerned about the following symptoms: chills or a feeling of heat, sweating, constantly wet cold palms and feet, stabbing pains in the heart, headaches, and so on; often this syndrome does not occur on its own, but is combined with one or more others );
transient ischemic attacks, or TIA (the patient notes intermittent transient sensory or motor disorders, disorders of the organ of vision and / or speech, unsteadiness and dizziness, nausea, vomiting, double vision, difficulty swallowing).

Diagnosis of vertebral artery syndrome

Based on the patient's complaints, the doctor will determine the presence of one or more of the above syndromes and, depending on this, prescribe additional research methods:

radiography of the cervical spine;
magnetic resonance or computed tomography of the cervical spine;
duplex scanning of the vertebral arteries;
vertebral dopplerography with functional loads (flexion/extension/head rotation).

If during the additional examination the diagnosis of SPA is confirmed, the specialist will prescribe the appropriate treatment.

Treatment of vertebral artery syndrome

The effectiveness of the treatment of this condition directly depends on the timeliness of its diagnosis: the earlier the diagnosis is made, the less thorny the path to recovery will be. Comprehensive SPA treatment should be carried out simultaneously in three directions:

therapy of pathology of the cervical spine;
restoration of the lumen of the vertebral artery;
additional treatments.

First of all, the patient will be prescribed anti-inflammatory and decongestants, namely non-steroidal anti-inflammatory drugs (meloxicam, nimesulide, celecoxib), angioprotectors (diosmin) and venotonics (troxerutin).

In order to improve blood flow through the vertebral artery, agapurine, vinpocetine, cinnarizine, nicergoline, instenon and other similar drugs are used.

To improve the metabolism (metabolism) of neurons, citicoline, gliatilin, cerebrolysin, actovegin, mexidol and piracetam are used.

To improve metabolism not only in nerves, but also in other organs and tissues (vessels, muscles), the patient takes mildronate, trimetazidine or thiotriazoline.

In order to relax spasmodic striated muscles, mydocalm or tolperil will be used, vascular smooth muscles - drotaverine, better known to patients as No-shpa.

For migraine attacks, anti-migraine agents, such as sumatriptan, are used.

To improve the nutrition of nerve cells - B vitamins (Milgamma, Neurobion, Neurovitan and others).

To eliminate the mechanical factors that compress the vertebral artery, the patient may be prescribed physiotherapy (manual therapy, post-isometric muscle relaxation) or surgery.

In the recovery period, massage of the collar zone, physiotherapy exercises, acupuncture, as well as spa treatment are widely used.

Prevention of vertebral artery syndrome

The main preventive measures in this case are an active lifestyle and a healthy sleep on comfortable bedding (it is highly desirable that they belong to the orthopedic category). In the event that your work involves a long stay of the head and neck in one position (for example, it is work at a computer or an activity related to continuous writing), it is strongly recommended to take breaks in it, during which you can do gymnastics for the cervical spine. When the complaints mentioned above appear, one should not wait for their progression: the right decision would be to consult a doctor in a short time. Do not be ill!

6 COMMENTS

Great article, thanks!

Thank you! Good, informative article, written intelligibly and clearly! It would be nice to write about the connection between SPA and the development of hypertension, otherwise the pills are prescribed for symptoms, and not for the disease.

Thanks for your article! A very accessible explanation. And this is very rare.

Thank you so much for the simple and clear explanation.

Good article! But if this is really this syndrome, then not only drugs here will not solve the problem. I speak from my own experience, here only an operation gives a chance, otherwise it’s possible to “treat” to a stroke ... And not only pills did not alleviate my suffering, but only time passed, and the torment was even stronger ...

Thank you, clear, concise, accessible. God bless you

Circulatory disorders in the carotid arteries

The common carotid artery arises from the aorta on the left and the innominate artery on the right. At the level of the superior thyroid cartilage, the common carotid artery divides into internal and external. The internal carotid artery enters the skull through the canal of the carotid artery, passes through the torn foramen, bends upward, then through the sulcus caroticus (on the side of the sphenoid bone) between the layers of the dura mater, passes through the cavernous sinus, and at the external chiasma is divided into the anterior and middle cerebral arteries. The siphon of the internal carotid artery is formed by bending it upward and backward after passing through the carotid canal. The ophthalmic artery departs from the trunk of the internal carotid artery, penetrating the orbit and giving branches to the pituitary gland. The ophthalmic artery, having passed through the dura mater, forward and downward, enters the orbit and lateral to the optic nerve. It is important in the development of collateral circulation between the external and internal carotid arteries. Occasionally, collaterals develop between the ophthalmic anterior sheath arteries. An aneurysm of the ophthalmic artery causes compression of the optic nerve. Thrombosis at the site of origin of the ophthalmic artery from the internal carotid artery causes opto-hemiplegic syndrome.

With blockage of the internal carotid artery, collateral circulation is carried out either through anastomoses in the pia mater, or through gradually developing collaterals of the ophthalmic artery from the side of the external carotid artery. Of great importance for collateral circulation is the level of blood pressure, the presence and functioning of anastomoses under overload conditions.

For the first time, Willis pointed out the importance of the internal carotid artery in violation of cerebral circulation. Oppenheim described hemiplegia in carotid thrombosis. Chiari emphasized carotid thromboembolism in the development of apoplexy. Nestiano noted that a decrease in blood flow to the brain after ligation of the carotid arteries causes a decrease or perversion of the potential difference that normally exists between the cerebral cortex and the white subcortical substance. Currently, there are a large number of works devoted to the pathology of the carotid artery.

Valkenhorst found that blockage occurs predominantly at the bifurcation of the common carotid artery or at the junction of the extracranial part of the internal carotid artery to the intracranial. The main cause of true blockages is vessel thrombosis due to atherosclerosis or obliterating endarteritis.

Monitz angiographically established a filling defect in thrombosis of the internal carotid artery in a patient with recurrent hemiplegia and aphasia. Terma, Forbes and Trupp, having examined angiographically the carotid arteries (2400 cases), noted cases of blockage of the internal carotid arteries (on the right, 2 less than on the left).

Pilas and Bonnet described 21 of their own observations and analyzed 170 cases of carotid thrombosis collected in the literature. Rijshede found carotid thrombosis in 56 cases of hemiplegia, based on 22 observations (17 men and 5 women), described the clinical picture of carotid thrombosis: hemiparesis and hemihypesthesia with a predominance of weakness in the hand; first there is a feeling of weakness, confusion and blackout of consciousness, paresthesia and convulsions in the limbs, in which then paralysis develops, blurred vision. The intensity of prodromal symptoms fluctuates, since they are based on adgiospasms. With thrombosis of the left carotid artery, speech disorders are observed. On the electroencephalogram corresponding to the affected hemisphere, delta waves are noted, which are clearly expressed when taken from the temporal region.

Negri and Passerini presented data from an analysis of 73 cases of thrombosis of the internal carotid and middle cerebral arteries.

Sastrasin described 65 cases of carotid thrombosis. Hemiparesis was observed in patients, sensory disorders - in 20, aphasia - in 34, visual disturbances - in 19, loss of consciousness and convulsions - in 12, mental disorders - in 24. arteries. Webster, Gurdian, Martin studied the symptoms of blockage of the carotid artery in patients. Some of them showed partial blockage of the carotid artery on angiograms.

Jacobson and Skinhow reported cases (21 men and 6 women) of thrombosis of the internal carotid artery, verified by arteriography. The clinical picture manifested itself in various forms: tumorous (10 patients), cerebral thrombosis, cerebral apoplexy, intermittent cerebral angiospasm. Consciousness was lost only in 4 patients. Thrombus in most patients was localized near the bifurcation. Electroencephalograms showed delta waves in the temporal and temporofrontal areas. The diagnosis was based on alternating opto-hemiplegic syndrome. Local symptoms were multifocal in nature. patients were differentiated with a brain tumor. Cabizes and Zaldias described thrombosis of the internal carotid artery in a boy. There was malaise, nausea, vomiting, and right-sided hemiparesis developed, which progressed. Arteriogram and surgical examination confirmed the diagnosis of thrombosis of the internal carotid artery.

Treatment with anticoagulants and vasodilators improved after 10 and recovery after 6 months. King and Langworthy described carotid thrombosis in a 7-year-old boy after pneumonia.

Boyari and Alpers. reported data from a clinical and anatomical study of 21 cases of occlusion of the internal carotid artery. The reasons are various: arteriosclerosis embolism ligation in the treatment of aneurysm injection of a contrast agent for angiography and an unexplained cause Patients survived after occlusion from 21 to 46 months. patients there was a softening of the brain in the area of vascularization of the middle cerebral artery, in one - in the area of the anterior cerebral artery. In 3 cases no encephalomalacia was found. A pronounced hemisphere on the side of occlusion was observed in acute cases up to 12 years after a stroke. Prudey observed 56 patients with thrombosis of the internal carotid artery, 50% of them complained of headache, and high protein content in the cerebrospinal fluid.

Krauenbuhl and Weber, as well as Buscaino noted the connection of thrombosis of the internal carotid artery with Winivarter-Burger's obliterating endarteritis (brain form). The disease often proceeded in relapsing exacerbations, beginning with transient paresthesias in the extremities, short-term speech disorders, sometimes loss of consciousness, headaches with vomiting and dizziness, seizures of Jacksonian epilepsy, and short-term paresis. In the future, flaccid and then spastic hemiparesis or hemiplegia developed gradually immediately, with damage to the facial nerve, sensitivity disorders on the corresponding side of the face, sometimes with motor and sensory aphasia or dysarthria. Mostly men fell ill, at the age of 40-50 Arterial pressure was not increased. Buscaino noted a change in the psyche. The diagnosis was supported by arteriography and encephalography. Clarke and Garrison reported their own observations and analyzed 69 cases of carotid occlusion reported in the literature. One case had giant cell arteritis, the other had atherosclerosis. mental disorders and symptoms of pyramidal and extrapyramidal lesions are expressed.

Folkers described bilateral occlusion of the internal carotid artery. A 53-year-old patient suffered from intermittent deterioration in gait. Then there were retro-orbital disorders, then transient infiltration of the arteries of the retina (nodous periarteritis). After 5 years from the onset of the disease, short-term seizures with loss of consciousness appeared in the back of the head, paresis of the left limbs with Babinsky's symptom developed. Arterial pressure 190/100 mm. Soon the pain and temperature sensitivity was disturbed. The electroencephalogram showed bilateral delta waves (larger on the right). Increased protein content in the cerebrospinal fluid. Arteriography revealed a blockage of the internal carotid artery near the bifurcation on the right and left sides.

Boudin, Barbitset and Morin observed a patient with suddenly developed left-sided hemiplegia, which disappeared after a few hours, but right-sided hemiplegia with aphasia soon appeared. Angiography revealed partial thrombosis of the right internal carotid artery. Left-sided hemiplegia was explained by a reversible vascular process in the other carotid artery.

A number of authors observed the development of hemiplegia after the defeat of the carotid sinus. There is a violation of blood circulation in the anterior cerebral artery with obliteration of the internal carotid artery and insufficiency of collateral circulation in the system of the vertebral artery (Lermit). Currently, a large number of observations have accumulated, proving the possibility of developing softening in the brain as a result of damage to the extracranial vessels and especially the carotid arteries.

The cause of blockage of the carotid artery is thrombosis with obliterating endarteritis or embolism (from the pulmonary vessels, from the heart or descending aorta), thrombus (retrograde origin) or local limited damage to the atheromatously altered wall of the internal carotid artery with syphilis, trauma, causing its stenosis.

Thrombosis of the internal carotid artery occurs when a combination of adverse factors: atheromatosis of the artery, violation of the coagulating properties of the blood, increased blood pressure, sometimes trauma that causes damage to the artery wall.

Pathological changes in carotid thrombosis are manifested by narrowing of the lumen of the artery and expansion of the bulb. Inflammatory changes are detected periarterially: infiltration, clutches. A thrombus in an artery is usually organized, fibroblasts, newly formed vessels, infiltration by lymphocytes and plasmocytes are found in it (Fig. Endothelium disappears, fibrous degeneration of the muscle layer, adventitia sclerosis is observed, calcium and lipoid inclusions, xanthomatous cells are noted. Endothelial growth, tortuous (worm-like ) the course of small arterial branches, the formation of blood clots, softening and necrosis in the vascularization of the affected vessels.With a rapid course with a fatal outcome, pronounced softening in the brain has not yet developed, hypoxic changes in ganglion cells, edema, microhemorrhages and small focal perivascular necrosis are detected.

Symptoms of cerebral circulation disorders in the pathology of the main vessels are different depending on the following conditions: 1) the nature of the pathological process - thrombosis, embolism, aneurysm, stenosis; 2) localization of the lesion of the artery - in the area of the bifurcation of the carotid artery, in the area of the carotid sinus, or the origin of the ophthalmic artery, in the siphon of the internal carotid artery or near the circle of Willis; 3) the degree of obliteration or stenosis of the artery and created in connection with the conditions for the passage of blood from the aorta to the brain; 4) the possibilities of collateral circulation through the external carotid artery system in case of blockage of the internal carotid artery and 5) compensatory possibilities to equalize impaired blood circulation in the carotid system through the system of vertebral arteries through the circle of Willis; 6) acuteness of the development of the pathological process (rapid development of thrombosis, sudden blockage of the artery by an embolus, delamination of the wall with an aneurysm, gradual slow development of arterial obliteration, etc.); 7) the state of general hemodynamics in connection with the activity of the heart, the state of the aorta, the height of blood pressure and other conditions affecting cerebral blood flow; 8) the nature of the vascular disease (atherosclerosis, trauma and the course of the disease (progredient or regredient).

Carotid artery occlusions are divided into three groups:

spontaneous thrombosis;
thrombosis as a complication;
surgical occlusion.

Thrombosis of the carotid arteries occurs in men than in women, aged: in men - 70 in women - 60-80 Blockage of the internal carotid artery is more common than the external one. The left carotid artery is affected by the right, which can be explained by higher pressure in the left common carotid artery, which branches directly from the aorta. On the right, thrombosis is localized at the level of the right innominate artery. Sometimes bilateral thrombosis of the internal carotid arteries occurs.

Emboli in the carotid artery are observed at the level of the internal carotid artery or in the area of bifurcation. The cause of embolism is mitral heart disease, aortic thrombi, left atrial thrombus, etc. Since the left common carotid artery starts directly from the aorta, and the right one from the innominate artery, emboli occur in the left middle cerebral artery branches and in the right. Sometimes it is difficult to determine whether the carotid artery has been obliterated by a thrombus or occlusion as a result of an embolism (from the heart, aorta) followed by thrombosis. Distinguish embolic syndrome with acute development and thrombotic syndrome with slow progressing

course in the presence of transient dynamic circulatory disorders. Embolism causes blockade faster than thrombosis. Recognition is aided by angiography. Open angiography is appropriate, since thrombosis usually develops in the bifurcation of the carotid artery.

Carotid thrombosis occurs with atherosclerosis, which affects mainly the cervical internal carotid artery, carotid sinus and abdominal aorta. the cause of thrombosis of the carotid artery is obliterating endarteritis, syphilitic vasculitis (often the aorta and carotid arteries are affected). between the development of thrombosis of the carotid artery and its injury on the neck (gunshot wounds, on the neck and can be equal to several months and years. The main factor is damage to the artery wall, as a result, conditions are created for the development of parietal thrombosis with slow blood flow and an increase in the coagulating properties of blood. Localization and the size of the carotid artery thrombus is very variable. The segmental type is characterized by blockage of a certain segment of the artery; and the thrombus artery and the branches extending from it are passable. The thrombus can have a large spread along the length, reaching the branches of the middle cerebral artery. Along the diameter, the thrombus can cause complete obliteration of the artery, narrowing the lumen to the thickness of the needle.The more distal the thrombus is located in the carotid artery, the less opportunities to compensate for impaired blood circulation in the brain and the greater the softening foci develop.The vascularization zone of the middle cerebral artery suffers more than the anterior cerebral artery. It explains that the middle cerebral artery is the largest branch of the internal carotid artery, supplying most of the cortex, subcortical white matter and subcortical nodes. Violation of the blood supply to the pool can occur when the angioreceptors of the carotid artery are irritated by a thrombus.

A. N. Koltover objects to the position according to which, with proximal blockage of the cerebral vessel, extensive softening is formed and the more, the closer to the blockage.

The pathology of the carotid arteries plays an important role in the development of ischemic softening of the brain. Studies of the carotid and vertebral arteries in 100 patients with cerebral circulation disorders revealed pathological changes in the vessels of cases. Often there are combined lesions of the internal carotid arteries with vertebral.

In the pathology of blood circulation, pathological tortuosity and kinks of the main vessels are important. Particularly unfavorable are bends with the formation of sharp corners that contribute to the delay in blood flow. In the mechanism of cerebral circulation disorders with pronounced kinks of the main arteries, a drop in blood pressure, a decrease or cessation of blood flow with the development of an ischemia focus in the brain during sharp head turns are important. With pathological kinks of large arteries and with a combination of pathology of extracranial and intracranial vessels, conditions are created for the development of ischemic low blood pressure) or hemorrhagic high blood pressure) softening. When the carotid artery is compressed, blood flow increases in the other carotid artery. When there is a reflex expansion of the circle of Willis in response to a change in the blood supply to the hemisphere in which ischemia has developed. Increased blood flow in the internal carotid artery on the side opposite to the blockage can maintain the overall blood flow in the brain at a normal level.

With thrombosis of the carotid artery, there is a sharp narrowing of its lumen, infiltration by lymphocytes and plasma cells of its walls; sometimes the segmental nature of the lesion of the carotid artery is found. With the acute development of thrombosis of the carotid artery, softening occurs in the cerebral hemisphere with small hemorrhagic foci and edema in the vascularization of the anterior and middle cerebral arteries. The cortex, internal capsule, semioval center, subcortical nodes suffer. In chronic, slowly developing thrombosis of the carotid arteries, small cysts appear in the white subcortical substance, the cortex, mainly the frontal lobe, subcortical nodes, and newly formed vessels appear.

To recognize carotid thrombosis, arteriography (carotid, temporal), carotid oscillography (weakening of the pulsation on the side of the blockage), palpation of the artery through the side wall of the pharynx, digital compression of the unaffected artery, and ophthalmodynamics are used. It is necessary to conduct bilateral arteriograms of the carotid arteries, especially hemiplegia develops again. The arteriogram shows that the artery is not filled, there is no pulsation of the artery. Compression of the internal carotid artery is an important factor in the diagnosis of internal carotid thrombosis. On the electroencephalogram in the stage of flickering of symptoms, slow waves are noted. With superficial (cortical) foci, delta waves appear, with thrombosis of the carotid artery - slow waves in the frontal, central and temporal regions. When turning the head towards the clogged artery, pathological phenomena on the electroencephalogram increase.

There is also a sharp decrease in the bioelectrical activity of the brain, deformation of the alpha rhythm, a significant severity of the beta rhythm, the prevalence of frequent rhythms, low-voltage slow waves in the opposite and high-frequency oscillations in the collateral hemisphere.

Pneumoencephalography sometimes revealed internal communicating dropsy of the cerebral ventricles. X-ray may show calcification of the thrombosed area of the carotid artery.

With thrombosis of the internal carotid artery, there is often a prodrome in the flickering of symptoms. There are four forms: acute, subacute, often recurrent, and chronic. The acute form (apoplexy) is characterized by a sudden onset with a sharp headache, coma, decreased vision on the side of thrombosis and hemiplegia on the opposite side. In the subacute form, thrombosis develops within a day or several hours, sometimes paralysis does not occur simultaneously. In the relapsing form, attacks of transient ischemia are characteristic, manifested by the same type of transient symptoms (hemiparesis, speech disorders). In the chronic form, the development of symptoms is slowly progressive, sometimes "pseudotumorous".

Blockage of the internal carotid artery is manifested by the following symptoms: paroxysmal headache, transient visual disturbances, paresis of the limbs and speech disorder, sometimes convulsive twitches (epileptiform seizures) and mental changes: irritability, euphoria, spatial orientation disorders, memory loss, sometimes hallucinations and delirium. With thrombosis or near the outlet of the ophthalmic artery, an alternating syndrome occurs: decreased vision or blindness on the side of the blockage of the carotid artery and hemiparesis on the opposite side (opticohemiplegic syndrome) due to blockage of the internal carotid artery, impaired blood circulation in the branches of its ophthalmic artery and middle cerebral artery. When miosis is observed, a decrease in retinal pressure on the side of thrombosis. Percussion of the skull reveals tenderness on the side of the blockage. When feeling the carotid artery on the neck, there is a weakening or absence of pulsation, compacted. One of the symptoms of occlusion of the internal carotid artery is a noise in the head on the side opposite to the lesion (Fischer's symptom).

Noise allows to differentiate occlusion of the internal carotid artery from blockage of the middle cerebral artery. A murmur due to occlusion of the internal carotid artery is detected by auscultation above the eye and is systolic in time. The origin is explained by the acceleration of blood flow in the open carotid artery. When a healthy carotid artery is clamped, the noise disappears. Sometimes it is observed on the side of thrombosis. Localization of blockage of the carotid arteries affects the symptoms, treatment and prognosis: with blockage at the place of discharge from the aorta, aortic-carotid syndrome occurs, with blockage in the bifurcation of the carotid arteries, a typical thrombosis syndrome of the internal carotid artery is observed (syn-carotid syndrome is determined in fluctuations in blood pressure, attacks of tachycardia or bradycardia, etc.). With blockage at the level of the circle of Willis near the posterior communicating artery, the anterior villous artery is sometimes turned off and symptoms of damage to the subcortical nodes appear. With obliteration near the outlet of the middle or anterior cerebral arteries, a syndrome of damage to the corresponding arteries occurs. Regardless of the level and degree of occlusion of the carotid artery and the rate of blockage of the artery, cerebrovascular insufficiency develops, which can vary in degree of compensation. Ischemia and hypoxia of the brain tissue can result from the cessation of blood flow through the clogged artery and reflexively due to the blockade of the carotid sinus zone.

The following symptoms are characteristic of blockage of the internal carotid artery:

remitting symptoms of ischemia in the branches of the carotid artery;
the appearance of hemiplegia and aphasia of left-sided localization of thrombosis) after a period of transient attacks of weakness in the same limbs;
the presence of recurrent cortical lesions;
weakening of the pulse and the appearance of Horner's symptom on the side of thrombosis;
angiography data.

When the common carotid artery is blocked, blood pressure in the internal carotid artery drops. With thrombosis of the internal carotid artery, the pressure in it drops (not lower than with blockage of the common carotid artery). Sometimes there is homolateral atrophy of the optic nerve with vasoconstriction (the lesion may be an early symptom of carotid thrombosis). It is noted that the difference in diastolic pressure in both retinal arteries exceeds 10 mm Hg, this indicates a limitation or absence of blood flow in the carotid artery on the side of low pressure. Normally (in 90% of people), diastolic pressure in the retinal arteries is the same. With thrombosis of the internal carotid artery, a unilateral decrease in pressure in the central retinal arteries by 25-30% is observed. When applying a ligature to the common carotid artery, at first the arterial pressure in the retinal arteries is different, but after 4 months its alignment is noted due to the development of collateral circulation. Sometimes there is an asphygo-pyramidal syndrome: a decrease in the pulsation of the internal carotid artery on the side of paralysis, i.e., on the side opposite to thrombosis.

Transient amaurotic-hemiplegic syndrome of thrombosis of the internal carotid artery may be accompanied by convulsions and paresthesias for a short time. Bilateral blockage of the carotid arteries by a thrombus or aortography embolism) causes a syndrome of decerebrate rigidity and paralysis of four limbs. Pressing a healthy carotid artery causes dizziness, convulsions in non-paralyzed limbs, loss of consciousness. Therefore, the use of a carotid sinus compression test is dangerous.

Symptoms of blockage of the carotid artery depend on the rate of development of obstruction, the localization of the thrombus, the conditions for the development of collateral circulation, and the condition of the vertebral arteries. The intermittent development of focal symptoms depends on the intensity of spasm of the vessels of the carotid artery system (reaction to a thrombus), the mechanical conditions of the blockade of these vessels and collateral circulation. The symptomatology of carotid thrombosis is characterized by variability in the course and severity of cerebral disorders. For early diagnosis, the phenomena of cerebrovascular insufficiency are important.

Often the development of ischemic stroke is preceded by transient cerebrovascular insufficiency. Transiently arising and quickly disappearing neurological disorders with remissions of various durations manifest themselves in sensory, motor and speech disorders. Anonymous-carotid syndrome is sometimes observed. During the developing insufficiency of cerebral circulation, asymmetry of pressure on the brachial and temporal arteries is noted, angiodistonic disturbances in the study of the eye, sometimes weakening of the pulsation on the temporal and radial arteries. Intermittent cerebral disorders are combined with a violation of the activity of the heart (tachycardia, arterial hypotension), a change in temporal pressure on the side of the focus, a weakening of the pulsation of the carotid artery, sometimes with pain in the artery in the neck during palpation and turning the head, a decrease in retinal pressure on the side of the pathology of the carotid circulation.

Comparative symptoms of softening that develops gradually with thrombosis of the common and internal carotid arteries are presented in the table.

Thrombosis of the common carotid artery

Thrombosis of the internal carotid artery

Head diffuse Transient disturbances of motor and speech functions on the opposite side in combination with decreased vision on the side of the focus

No carotid pulsation and no temporal pulsation

The head is more on the side of thrombosis Short-term repeated paroxysms of weakness (paresis) or paresthesia in opposite limbs. Development of hemiplegia (hemiparesis), hemihypesthesia, aphasia in the focus on the left), hemianopsia, blindness on the side of the focus (opticohemiplegic alternating syndrome) Weakening of the pulsation of the carotid artery on the side of the focus. Sometimes hum or noise in the head (more on the affected side). Sometimes noise during auscultation of the carotid artery near the lower jaw. Reduced pressure in the central retinal artery on the side of the focus. Increased pressure in the temporal artery (absence of anisovasotonia). Rare Horner's syndrome

Motor disorders in case of blockage of the carotid artery occur in the limbs on the side opposite to the focus. Initially, they are transient, then flaccid and then spastic hemiparesis may develop. With left-sided localization, aphasia is observed (motor predominates), sometimes there is epilepsy. Often there is a change in the psyche: memory loss, criticism, orientation, sometimes excitement, delirium, often depression, depression, indifference.

Characterized by a dynamic change in pressure in the carotid and temporal arteries and retinal pressure. With thrombosis of the carotid artery, the pulsation of the temporal artery may stop. Fradke and Petrovich described asphygopyramidal syndrome: the absence of a pulse on the branches of the carotid artery on the side of thrombosis. When the carotid artery is compressed on the healthy side, the pressure in the central retinal artery decreases, and after the test with compression, the pulsation in “flashes” of the optic nerve papilla increases. On the side of the blockage of the carotid artery, its compression does not affect the pulsation of the retinal artery. On average, retinal pressure on the side of thrombosis is reduced by 20-25%. Sometimes there is atrophy of the optic nerve.

In acute development, thrombosis of the internal carotid artery is differentiated with hemorrhage or embolism in the brain. With a recurrent course at a young age, obliterating thromboangiitis, sometimes multiple sclerosis, is often assumed. The gradual development of a focal brain lesion with a transient symptom indicating the localization of the pathological process in the same area makes it possible to differentiate with a brain tumor. Diagnosis is especially difficult in the presence of hydrocephalus and the development of psychopathological symptoms.

The course is usually progressive. It was noted that from the moment of occurrence of large foci of softening, attacks of decompensation occur, apparently due to a lower need for the brain in blood supply. The development of collateral circulation has a great influence on the course.

The course of carotid thrombosis has the following options:

asymptomatic course of thrombosis of the carotid artery, which is found on the section manifested by signs of cerebrovascular accident clinically and pathomorphologically;
chronic favorable course of thrombosis of the carotid artery with transient cerebral disorders and a slow increase in chronic cerebrovascular insufficiency;
subacute course with relapsing disorders of cerebral circulation, gradual obliteration of the carotid artery and recanalization of the thrombus;
acute course with sudden blockage of the carotid artery by a thrombus or embolus, severe cerebrovascular accident with an unfavorable outcome;
a progressive rapid course with sequential blockage of the carotid artery by a thrombus that increases in length - sometimes with penetration into the middle or anterior cerebral artery.

With an aneurysm of the common carotid artery, when listening, there is a “pulsating” noise on the artery, when palpated, a slight bulge is sometimes found in the supraclavicular region, often a scar on (traumatic aneurysm). Paresis of the extremities on the side opposite to the focus, with aneurysm of the common carotid artery, rarely occurs due to the development of collateral circulation. Transient phenomena from the brain are characteristic: noise in the head, headache. These phenomena are caused by reflex neurodynamic changes in the distal branches of the common carotid artery.

Sometimes there are several aneurysms of the internal carotid artery (in the outer segment and intracranial section of the same artery), sometimes bilateral symmetrical aneurysms of the internal carotid arteries in the cavernous sinuses.

Post-traumatic aneurysms of the carotid sinus occur some time after injury. There is a headache, blindness on the side of the aneurysm, and nosebleeds. A ligature of the common and internal carotid arteries on the side of the aneurysm can stop nosebleeds.

Intradurally located aneurysms of the internal carotid artery cause intrasellar disorders. They are characterized by severe headache attacks, visual impairment (sometimes unilateral amaurosis), absence of symptoms of brain compression, mild endocrine disorders, crescent-shaped calcifications on the X-ray, and sometimes the expansion of the Turkish saddle. Simultaneous ligation of the internal carotid artery improves collateral circulation.

With an aneurysm of the internal carotid artery, Foix's syndrome is observed (damage to the oculomotor, abducens and trochlear nerves and neuralgia of the first branch of the trigeminal nerve) in combination with miosis. Sometimes ophthalmoplegia is combined with Horner's syndrome on the side of the aneurysm of the internal carotid artery and hemiparesis with hemianesthesia on the opposite side. The appearance of Horner's syndrome on the side of the aneurysm or thrombosis of the carotid artery is explained by damage to the sympathetic fibers.

Congenital aneurysms of the common carotid artery are determined by angiography. An expansion of the common carotid artery is found, at the level of the bifurcation. An aneurysm can cause peripheral facial palsy and contralateral hand palsy.

Rupture of an aneurysm of the internal carotid artery causes severe frontotemporal pain, anxiety attacks, optic neuritis, decreased visual acuity, and acute retrobulbar neuropathy.

Rudimentary supra-sphenoid aneurysms of the internal carotid artery exiting the cavernous sinus and dividing into the anterior and middle cerebral arteries) cause ischemic softening syndrome in the areas of vascularization of the middle or anterior cerebral arteries, sometimes they are asymptomatic or are accompanied by phenomena of transient cerebrovascular insufficiency. Clipping of the aneurysm neck on the intracranial segment of the internal carotid artery is a good result.

Aneurysms that form at the junction of the internal carotid artery with the posterior communicating artery cause noise in the head, in the trigeminal nerve region, and dyscirculatory cerebral disorders with hemiparesis.

The prognosis for circulatory disorders in the carotid artery worsens with poor collateral circulation and the impossibility of surgical intervention due to the state of cardiovascular activity and the age of the patient.

Treatment of blockage of the carotid artery can be conservative and surgical. Apply the blockade of the stellate node, resection of the cervical sympathetic nodes, sometimes thrombectomy, removal of plaques that cause stenosis. With an aneurysm of the carotid artery, the most radical method of treatment is the removal of the aneurysm; sometimes limited to the imposition of a ligature on the carotid artery proximal to the aneurysm.

Knowing where the carotid artery is located can help in a critical situation and even save a person's life. The fact is that a pulse is well felt on the carotid artery, and if it is absent, artificial respiration will be required.

The Role of the Vessel

Arteries are blood vessels that carry blood from the heart to the organs. Their difference from veins is in the reverse process, that is, veins supply blood to the heart.

The common carotid artery transports blood from the heart muscle to the brain and other peripheral organs of the human head. The artery is quite wide. This is due to the need to transport sufficient levels of oxygen to enrich the brain tissues and the presence of a stable but intense blood flow.

The carotid artery is quite "gentle". Clamping it can lead to a sudden loss of consciousness. Those who have ever worn a tightly tightened tie or sweater with a high and narrow collar noticed a peculiar feeling of discomfort. Such discomfort is caused by compression of the carotid artery.

Before answering the question about the location of the carotid artery, you need to make a reservation that there are two of them. One is on the right side of the neck, and the other is on the left. The artery that runs along the left side is somewhat longer than the artery that runs along the right, since the first originates at the brachiocephalic trunk, and the second - in the aortic arch.

To feel the pulse of the carotid artery in the neck, you need to find a point under the cheekbone in the hole, on the right or left side of the Adam's apple. In heavily muscled people, detecting the pulse in this way may take a little longer than in the average person, since muscles can close the artery.

Determining the presence of a pulse in the neck is considered optimal in a critical situation. The fact is that not all people feel a pulsation on the wrist.

External carotid artery

The carotid artery in humans consists of several parts and is therefore considered a paired organ. Normal blood flow for the brain is 55 ml / 100 g of tissue, and the need for oxygen is 3.7 ml / min / 100 g. This volume of blood supply is provided by normal arteries with normal intima and undisturbed vascular lumen. The external artery is located above the larynx towards the front of the head and is its anterior component.

In the place where the Adam's apple, or "Adam's apple", is located, the carotid artery is divided into 2 branches. One goes to the back of the head, and the other to the front. The one at the back supplies blood to the brain. The second part that goes to the front is the blood supplier of the eyes and face. Both parts branch and pass through all the tissues in the head area, saturating them with blood, and the blood with oxygen.

The external carotid artery itself is divided into 4 components. It consists of the following departments:

front;
rear;
medial;
end branches.

The terminal branches, as they decrease towards the edges, form a large network of capillaries that extend into the oral cavity and into the eyeballs. Everyone can verify the presence of capillaries. At the moment of embarrassment, stressful situations, laughter or in hot weather, the face is covered with a blush. This reddening of the face is the result of the work of blood vessels. In some people, this process is less pronounced than in others. The reason for this may be the color of the skin, the thickness of the fatty layer and other features of the epidermis.

internal carotid artery

The internal carotid artery is the posterior part of the main artery. Directly, its main task is to deliver blood to the brain, which will enrich the cells with oxygen, which is necessary for the normal functioning of the latter. Rising along the neck, the artery enters the skull at the temple.

Under the influence of external stimuli, such as those listed earlier (stress, hot weather, etc.), blood flow increases in the internal carotid artery. With a short preservation of this state, a person experiences a surge of strength and emotional upsurge. In the case when the intensity of blood circulation is kept above the norm for a long time, the reverse process begins to occur. This condition is due to an excess of oxygen in the brain. It should be understood that insufficient oxygen supply, as well as its oversupply, are equally harmful to humans.

The internal carotid artery is subdivided into the following parts:

cervical;
rocky;
cavernous;
cerebral.

Laterally from it is the internal jugular vein, v. jugularis interna. On its way to the base of the skull, the internal carotid artery passes along the lateral side of the pharynx (cervical part, pars cervicalis) medially from the parotid gland, separated from it by the stylohyoid and stylo-pharyngeal muscles.

The internal carotid artery divides into several smaller arteries, which also divide into even smaller ones, and so on. Thus, a large and complex blood highway arises, which provides the brain cells with oxygen.

In the cranial cavity, small branches depart from the cerebral part of the internal carotid artery to the pituitary gland: the superior pituitary artery (a. hypophysialis superior) and the clivus branch (r. clivi), which supplies the dura mater of the brain in this area.

Crushing hazard

Due to the fact that the carotid artery performs one of the most important functions in the body, its damage is dangerous to health. Bleeding from it can lead to death in 2.5-3 minutes if it is not stopped in time and the victim is not taken to the appropriate medical facility, where he will be provided with professional medical care. It should be understood that with such serious injuries, even doctors can not always help.

Since oxygen is delivered to the brain through the artery, it is easy to guess what will happen if you press on the carotid artery. The person will feel sleepy, which is a symptom of oxygen starvation.

Longer pressure on the carotid artery can put a person to sleep.

The duration of the loss of consciousness will depend on the time of squeezing. You can not press hard and hold your fingers on your neck for a long time. Due to the fact that the supply of oxygen to the brain stops, a person may remain disabled or not survive at all. Therefore, if it becomes necessary to check the pulse on the neck, light pressure is applied with the index and middle fingers. To find and determine the presence of a pulse, you can use any finger except the thumb, since it has its own pulse.

If it is necessary not only to check the presence of a pulse, but also to count the number of beats, then the measurement technique must be carried out correctly, depending on the side of the neck on which the data measurement process will take place. Measurement on the right side should be done with the right hand. If you measure the pulse of the left, then you can immediately clamp the 2nd artery, which will affect the results.

The carotid arteries in the neck are one of those that can be fatal if damaged. For this reason, it is categorically not recommended to conduct tests, whether a person will lose consciousness if an artery in the neck is compressed, or not.

Content

The human circulatory system is a complex mechanism consisting of a four-chamber muscle pump and many channels. Vessels that supply organs with blood are called arteries. These include the common carotid artery, which transports blood from the heart to the brain. The normal functioning of the body is impossible without the effective circulation of blood flow, since it carries the most important trace elements and oxygen.

What is the carotid artery

As already mentioned, this type of artery is a vessel designed to feed the head and neck. The carotid vein has a wide shape, necessary to carry a large amount of oxygen, create an intense and continuous blood flow. Thanks to the artery, the tissues of the brain, visual apparatus, face and other peripheral organs are enriched, due to which their work occurs.

Where is

Often people have a question: how to find the carotid artery in the neck? For the answer, you need to turn to the basics of the anatomy of the human body. The common carotid artery originates in the chest, then passes along the neck to the skull, ending at the base of the brain. The longer right branch departs from the brachiocephalic trunk, the left branch from the aorta. In the cervical region, the trunks run along the anterior covering of the vertebral processes, and between them is the esophageal tube and trachea.

Structure

On the outside of the common SA is the jugular vein, and among them in the groove is the vagus nerve: this is how the neurovascular bundle is formed. The absence of branches is observed along the vertical course of the channel, but the thyroid cartilage bifurcates the carotid artery into the internal and external. The peculiarity of the vessel is the presence of an extension (carotid sinus) with an adjacent nodule (carotid glomus). The external carotid canal consists of several groups of blood vessels:

thyroid;
language;
pharyngeal;
front;
occipital;
ear back.

The location of the branch of the internal carotid artery is considered intracranial, since it enters the cranium through a separate opening in the temporal bone. The area of connection of the vessel with the basal artery through the anastomosis is called the circle of Willis. Segments of the internal carotid artery transport blood to the visual organ, the anterior and posterior parts of the brain, and the cervical vertebrae. This vein consists of seven vessels:

connective;
cavernous;
cervical;
eye;
wedge-shaped;
rocky;
torn hole sector.

How many carotid arteries does a person have

There is a misconception that a person has one carotid artery: in fact, there are two. They are located on both sides of the neck and are the most important sources of blood circulation. Next to these vessels are two additional vertebral arteries, which are significantly inferior to carotid ones in terms of the volume of fluid they move. To feel the pulse, you need to find a point in the recess under the cheekbone on one side of the Adam's apple.

Functions

In addition to moving the blood flow, the carotid arteries solve other, no less significant, tasks. The carotid sinus is supplied with nerve cells, the receptors of which perform the following functions:

monitor internal vascular pressure;
respond to changes in the chemical composition of the blood;
give signals about the presence of oxygen supplied with erythrocytes;
participate in the regulation of the activity of the heart muscle;
control the pulse;
maintain blood pressure.

What happens if you press on the carotid artery

It is strictly forbidden to determine from one's own experience the consequences of pressing the carotid artery. If you press this vessel for a short time, loss of consciousness occurs. This state lasts about five minutes, and when the blood circulation resumes, the person awakens. Experiments with a longer time of force exposure can provoke severe dystrophic processes, because the lack of oxygen is detrimental to brain cells.

Diseases

The external carotid thread does not directly supply blood to the brain. The non-stop opening of the anastomoses, even with the insufficiency of the circle of Willis, is explained by the good blood supply of this branch. Pathologies are mainly characteristic of the internal channel, although otolaryngologists, plastic and neurosurgeons in practice face violations of the external basin. These include:

congenital facial, cervical hemangiomas;
malformation;
arteriovenous fistula.

Chronic ailments, such as atherosclerosis, syphilis, muscular fibrous dysplasia, cause serious changes in the internal trunk. Possible causes of diseases of the carotid bloodstream are:

inflammation;
the presence of a plaque;
blockage of an artery;
formation of cracks in the canal wall (dissection);
proliferation or delamination of the vessel membrane.

The result of negative processes is the narrowing of the carotid artery. The brain begins to receive less nutrients, oxygen, then there is a clinical development of cell hypoxia, ischemic stroke, thrombosis. Against this background, the following diseases of SA are distinguished:

pathological arterial branching;
trifurcation, which means division into three sprouts;
aneurysm;
thrombus in the carotid artery.

Atherosclerosis

The normal appearance of the arterial wall implies smoothness and elasticity. The formation of plaques contributes to a decrease in the lumen of the trunk. The growth of deposits leads to a pronounced narrowing of the vessel. Carrying out diagnostics, doctors diagnose the patient: atherosclerosis of the carotid arteries. This condition belongs to a number of serious diseases that provoke a stroke, atrophy of brain tissue, and therefore requires immediate treatment. You can determine the presence of plaques in the carotid blood thread by the following symptoms:

a sharp increase in cholesterol levels;
frequent headaches;
fainting;
vision problems;
rapid pulse;
strong tinnitus;
numbness of the limbs;
convulsions, confusion;
speech disorder.

carotid syndrome

An ailment characterized by spasm of the vascular walls is recognized by medicine as carotid artery syndrome. Its occurrence is associated with the accumulation of a cholesterol layer along the edges of the channel, the division of the shell into several layers, and stenosis. Less commonly, the origin of the disease is caused by a genetic predisposition, hereditary factors, injuries.

Stratification of the inner surface of the artery becomes the root cause of ischemic stroke in people of different ages. Patients over fifty are at risk, but recent studies by scientists show that the percentage of strokes in young people is increasing. Prevention of the development of SA syndrome involves the rejection of bad habits, maintaining an active lifestyle.

Aneurysm

Expansion of the arterial zone with local thinning of the coating is called an aneurysm. The condition is preceded by inflammatory reactions, muscle atrophy, sometimes the disease is congenital. It is formed in the intracranial zones of the internal carotid branch and looks like a sac. The worst consequence of such an education is a rupture, leading to death.

An aneurysm should not be confused with carotid chemodectoma, which is a benign tumor. According to statistics, 5% of cases turn into cancer. The path of development originates in the area of bifurcation, continuing to move under the jaw. During his life, the trouble does not manifest itself in any way, therefore it is diagnosed by pathologists.

Treatment of diseases

It is possible to suggest the pathology of the artery by clinical symptoms, but the diagnosis is made only by doctors after an appropriate examination. To study the body, methods using modern technologies are used:

dopplerographic observation;
angiography;
computed tomography.

The treatment regimen for the disease depends on the stage, size, and general condition. For example, in the initial course of thrombosis, a small aneurysm, anticoagulants and thrombolytics are prescribed. The expansion of the arterial canal is carried out using novocaine isolation or removal of neighboring sympathetic clusters. Severe narrowing, clogging and thrombosis of the carotid artery requires surgical intervention. An operation on a carotid vessel is performed by stenting or removing the damaged area and replacing it with an artificial part.

Probably, many have heard that there is such a carotid artery, and if you click on it, the person will turn off. Is it true? And why is the impact on the notorious artery so dangerous?

What is the carotid artery?

In fact, we have as many as two carotid arteries. One of them is located on the right side of the neck, the other - on the left. The one on the left is slightly longer, it starts at the aortic arch, and the right one at the brachiocephalic trunk.

The general function of the carotid artery is to transport blood from the heart muscle to the brain and other peripheral organs that are located in the head region. It is thanks to her that our brain is constantly supplied with oxygen. Compression of the carotid artery (for example, by a tight collar or tie) can cause a noticeable feeling of discomfort.

The outer part of the carotid artery runs above the larynx towards the front of the head. In the region of the "Adam's apple" it is divided into two branches, one of which supplies blood to the brain, and the second - to the face and eyes. The terminal branches form a network of capillaries, due to which, in certain life situations, our eyeballs can turn red, and the skin of the face can turn red.

The inside of the carotid artery directly delivers oxygen-rich blood to the brain cells. It enters the skull in the region of the temple.

Under the influence of stress, hot weather and other external factors, blood flow in the internal artery may increase. In this case, we experience a surge of strength and emotional upsurge. But if the intensity of blood flow exceeds the norm for a long time, the process of decline will begin and the person will fall into a state of weakness.

In the region of the carotid artery, it is easy to feel the pulse. To do this, you need to find a point located in the hole under the cheekbone, on the right or left side of the Adam's apple. If a person has a highly developed musculature, this may take longer, as the carotid artery may be closed by muscles. Usually this method is resorted to if they cannot find a pulse on the wrist.

What can not be done with the carotid artery?

You can not strongly squeeze the carotid artery. If you just press it, the person will feel drowsy, because oxygen starvation will come. If you press the carotid artery for a long time, the object will fall asleep (that's why the artery is called carotid). Or rather, he will lose consciousness.

Pressing too hard while holding the fingers on the neck for a long time can lead to the fact that the supply of oxygen to the brain will completely stop. As a result, a person will either remain disabled or die altogether. Bleeding from the carotid artery in 2-3 minutes is fatal if professional medical care is not provided to the victim in time. Yes, and doctors with such injuries may be powerless.

How to check the pulse in the carotid artery?

If it becomes necessary to check the pulse in the neck, do not press hard on the carotid artery, but lightly press it with your index and middle fingers. To count the number of strokes, the impact must be carried out with the hand that corresponds to the given side of the carotid artery. So, if you count the pulse on the right side of the neck, use your right hand. If on the left, then on the left. If you measure the pulse on the right side with your left hand, you can pinch both parts of the artery, which will affect both the results and the patient's condition.

ARTIFICIALLY CAUSED HYPOXIA = VOLUNTARY CHANGING?!

ATTENTION, THE METHOD OF ARTIFICIALLY CAUSED HYPOXIA CAN BE DANGEROUS!

Recently, I have often been asked about artificially induced hypoxia, its effects and possibilities of application.

The general topic of hypoxia, that is, the temporary restriction of oxygen supply to tissues, is not new. People have been using the effects of artificially induced hypoxia for a long time. For example, yogis use it during meditation to reduce the activity of tissue respiration and slow down biochemical reactions. They achieve hypoxia by willpower, reducing the depth and frequency of respiratory excursions to the sensations they need, as well as slowing down the frequency and strength of heart contractions, while the brain of yogis begins to work in a state of altered consciousness, where various kinds of hallucinations are possible. Being in captivity of these illusions, yogis, as a rule, live outside of society: outside of work, outside of family, outside of society.

Athletes use the effect of hypoxia by training in high altitude conditions, where there is a high degree of air rarefaction with a low oxygen content.

English university students have used hypoxia to increase their ability to remember, especially before exams, by activating their brain cells with a short-term oxygen deficit. They used a paper bag placed over their head to limit the oxygen supply to the blood, and inhaled air that had already been in the lungs and contained more carbon dioxide than oxygen. The lack of oxygen irritates the brain cells, causing them to work harder.

Doctors also use hypoxia, using breathing exercises for therapeutic and prophylactic purposes, but, unfortunately, they do this extremely rarely.

Today, the methods of Strelnikova and Buteyko are almost forgotten, but they are physiological and effective, and each of these methods should be in the arsenal of physical exercises of any healthy (!) Person, as well as in patients with diseases where these methods are indicated.

Their alternate use leads to the normalization of many body functions, working as a powerful preventive factor. Why do these two methods not find such a wide response among the population? I think due to insufficient information and lack of habit to maintain their health.

But there is another method of artificial hypoxia, which I will dwell on in detail, since it is this method that interests my colleagues.

For the first time I saw it performed by a masseur from Yakutia. The reception consisted in clamping the soft tissues of the neck with the shoulder and forearm, and with them the carotid arteries.

I have experienced the effect of this technique on myself. At first, I felt a slight discomfort, a rush of blood to my head, a darkening in my eyes, after which I lost consciousness. I woke up in a state of "suspension" and general weakness.

The second time I experienced this technique on myself a couple of years later, with the difference that the carotid arteries were pinched with the fingers of the hand. My feelings were no different from those described earlier.

Let's deal with this type of hypoxia so that there is no doubt about the physiological nature of this effect.

Let's start with anatomy. The tissues and organs of the head receive arterial blood through the carotid and vertebral arteries. Each carotid artery at the level of the hyoid bone bifurcates into two branches.

The external artery supplies blood to the front of the head.

The internal carotid and vertebral arteries (in pairs on each side) supply blood directly to the brain. These two arteries form at the base of the brain, the so-called circle of Valisius, uniting the left-sided and right-sided arteries into one system.

Everyone knows the fact that with the slightest decrease in blood flow to the brain, its cells cease to function normally.

For an absolutely healthy person, a short-term, brought to a faint (otherwise it cannot be called), the reaction of the body may not affect health in any way. Another thing is if there are changes in the vessels of the head, the existence of which we may not know, and which, if adverse conditions arise, will lead to an undesirable outcome.

Clamping of the carotid arteries with fingers, which is actively promoted by some "innovators", seems to me an action that is not safe and not justified.

Let's turn to an article written by doctors from the city of Izhevsk (given with some abbreviations). Maybe the people who “give life” to this method will be able to convince me?

Experience in the application of the method of induced hypoxia in the treatment of syndromes of vertebrobasilar insufficiency.

Lyubimova N.E., Mokrushina T.M., Solovieva N.G. Izhevsk

“In search of new effective methods of treatment in the practice of treating patients with a neurological profile, in particular, patients with vertebro-basilar vascular insufficiency syndromes, we became interested in the method of induced hypoxia, described many years ago in ancient medical manuals ...”.

“The technique consists in clamping the patient’s external carotid artery on one or both sides with the thumb, middle and index fingers of the experimenter’s hand (!) Until the appearance of darkening in the eyes, a feeling of “failure”, a state of syncope. In some cases, this is accompanied by a burning sensation, numbness in the limbs, a feeling of warmth, heat in them.

The syndrome of vertebrobasilar vascular insufficiency is associated primarily with the pathology of the vertebral arteries (providing blood to the occipital parts of the brain) and threatens the main (basilar) artery located at the base of the skull. The internal branch of the common carotid artery, which the authors focus on) ensures the supply of arterial blood to the central parts of the brain, connecting with the basilar artery.

It is not at all clear why doctors from Izhevsk are interested in this particular syndrome? As they write, the external carotid artery is clamped, the zone of subsequent distribution of which is only the front part of the head and it has nothing to do with the basilar artery. Are doctors wishful thinking, or have they forgotten the basics of anatomy?

“For 1.5 years, we have been using the method of induced hypoxia in 158 middle-aged patients (up to 50 years old) and mainly with initial, not grossly expressed manifestations of chronic cerebrovascular insufficiency in the vertebrobasilar system, confirmed by REG data, and in 12 -ti cases by the method of ultrasonic dopplerography (UDG).

The reliability of what was written is questionable, since in the presence of chronic (long-term) insufficiency of cerebral circulation "in the vertebrobasilar system" there can be no initial phenomena. These phenomena appear already at the first signs of disturbance in the vessels of the brain!

“Attention was drawn to the presence of interhemispheric vascular asymmetry on the REG of these patients and a decrease in the amplitude of pulse blood filling in the system of vertebral arteries. UDG revealed stenosis in varying degrees (congenital or atherosclerotic genesis) of the extracranial branches of the external carotid artery in 11 patients.

For the information of readers, I will answer the questions: what are the “extracranial branches of the external carotid artery”, and why are they mentioned in the article? Extracranial arteries are small in size, extending from the external carotid artery (outside the skull), feeding the surface tissues of the head.

I give a diagram (from the same source) of the location of the external branch of the carotid artery, so that the role of this artery in the blood supply to the head is clear.

This diagram shows how the external carotid artery feeds only the superficial part of the head, not communicating in any way with either the vertebral artery, or, even more so, with the basilar (main) one, which lies at the base of the brain. Therefore, the impact on it by clamping, even if you try very hard, in no way affects either the vertebral artery or the basilar artery.

“The procedure began with manual treatment of the cervico-occipital zones, relieving tension from the anterior scalene and long muscles until the pain disappears from the so-called “trigger” zones. Drug therapy in this group of patients was minimal, including light vasodilator and exchange therapy.

After the cessation of exposure to the artery, the patient was insured against falling and the reaction to the effect was observed.

This description of the preparatory measures is already closer to the treatment of vertebro-basilar insufficiency, however, again, the scalene muscles have nothing to do with the vertebral arteries and the basilar.

“After a period of syncope, 2/3 of the patients had convulsive twitching in the upper limbs, sometimes with a clonic component, blanching of the skin, dilated pupils. According to the severity and localization of convulsive paraclysms, in a number of cases it was assumed that hypoxic processes were most likely to be localized in one or another part of the brain.

The picture is colorful! In fact, this is what happens. This speaks of only one thing - the manifestation of a state of shock into which the brain plunges due to hypoxia.

Please note that this happens to the vast majority of those experimented (I use the terminology of the authors of the article)!

And then the authors of the article write about the localization of seizures emanating from brain regions, without specifying from which ones specifically. If doctors pointed to these areas, it would be possible to determine in which of the pools of arteries such changes in the state of the body occur.

The question involuntarily arises: do the doctors themselves know about the localization of zones that affect the motor activity of a person, his vegetative reactions. If they knew, then it would no longer be about the external carotid artery. I got the impression that they mixed up something with something.

The blanching of the skin and the dilation of the pupils, which the authors indicate, once again confirm the presence of a collision of two processes: inhibition and excitation, which are so characteristic of stress. I didn't add anything "on my own" here. This is a classic of neurology, which is impossible not to know.

“After a minute, when the patient fully recovered, the REG study was again conducted. According to our specialists, in 49 patients, the amplitude of pulse blood filling immediately increased to 30-40% of the initial level in the area with its decrease, the interhemispheric asymmetry of blood filling of the cerebral vessels was leveled, and their tone increased.

There is nothing surprising in the occurrence of a transient (quickly passing) reaction of the vessels and the brain itself to stress. However, the reader, probably, drew attention to the fact that each patient underwent preparatory measures in the form of "manual processing", and medications were used to reduce blood pressure. The authors point to small dosages of the drugs they prescribe, forgetting that it is precisely such small doses that often have a stronger effect than the standard ones.

A similar example is the administration of strong diuretics, which most often result in the opposite effect, in the form of blocking the excretory function of the kidneys, while small doses always give the desired diuretic effect.

The fact that changes in the REG were noted immediately after the procedure only indicates the reaction of the body to the amount of exposure, and not that the cause of the pathology of the cerebral vessels was eliminated.

And one more important detail. In experiments with hypoxia, there is no so-called "control" group of patients who underwent everything except hypoxia. Without this, the information presented "falls short" of scientific justification.

“Unexpected was the occurrence of procedure dependence syndrome in all of the study patients. They were looking forward to the treatment session, insisting on more frequent treatment.”

Dependence on hypoxia is explained by the fact that the brain, being an endocrine gland, secretes a number of hormones into the blood that can cause a whole range of sensations, including joy, pleasure, euphoria, sexual emotions, etc. Bringing the brain into a stressful state of acute hypoxia, can cause the release of large amounts of hormones.

Naturally, when it comes to such emotional manifestations as not being addicted, especially for those people who are not satisfied or deprived of life.

I recall the description of the "fun" performed in the cadet corps, when, with the consent of all parties, four guys, holding one, pinched his face with a pillow. Lack of air led to cerebral hypoxia (complete) and convulsions, during which all the sphincters in the body of the volunteer opened, and orgasm occurred. Seeing the ejection of sperm, the guys began to assist the subject in restoring breathing. Apparently, the acuity of sensations, the near-death rush of adrenaline and other emotions made young people want to repeat the grotesque procedure again and again.

However, everything would be fine if it concerned only this emotional affect, because not everyone has this dependence. Everything is much more serious.

"We believe that the complex use of the method of induced hypoxia in the treatment of patients with symptoms of acute and chronic cerebrovascular insufficiency, especially in the vertebrobasilar basin, opens up good prospects for improving the effectiveness of treatment for this group of patients."

This statement is in no way consistent with what was said earlier: “... they used the technique of induced hypoxia with initial, not roughly expressed manifestations ...”

Really, acute insufficiency of cerebral circulation is no longer considered an extremely serious condition of the patient?

This is not an author's typo or typo, this is some kind of absurdity. Can you imagine what will happen if a person who has received this technique decides to suffocate a patient with acute cerebral insufficiency (sorry, of course, caused by cerebral hypoxia)?!

“Nevertheless, we want to warn colleagues that despite the seeming optimism of method a, it is fraught with the danger of formidable complications that can develop with incorrect, unprofessional conduct of the method, with incomplete examination of the patient, which leads to diagnostic errors and a biased assessment of the condition. patient. Among the most formidable complications include the occurrence of acute transient ischemic attacks with the occurrence of focal neurological symptoms.

In this regard, the procedure of induced hypoxia should be carried out by an experienced neurologist who has a good understanding of the anatomical and physiological features of cerebral circulation (!), who has an idea of the neurophysiological mechanisms that occur in the body in response to emerging hypoxia and who is able to quickly and efficiently provide effective assistance to the patient in in the event of unexpected complications.

Here, as they say, comments are superfluous, but I would like to ask: what resuscitation means should a person have if, God forbid, he decides to conduct this reception? And if there is no such EXPERIENCED NEUROLOGIST nearby? What to do in cases where there is a neurologist, but he is not competent in the vascular pathology of the brain?

Personally, I resolutely refuse such an impact on the vessels of a sick (!) Person.

The above diagram shows this formidable danger, which doctors warn about - occlusion of the internal carotid artery at the site of bifurcation (bifurcation).

You can see what Doppler researchers see - vascular plaque formation on the internal carotid artery, reducing the lumen of the vessel.

However, the doctors kept silent not only about this, but also about some other things that they themselves should have known about, and point to them in their article. For example, the so-called hypersensitive carotid sinus syndrome. Pressing on this sinus can cause negative symptoms similar to those described in the article.

There are also a number of reasons that cause vertebrobasilar insufficiency:

The defeat of the vertebral artery from its pathological tortuosity or from deformation as a result of atherosclerotic lesions of the arterial walls.

Dissection of the walls of the vertebral artery as a result of a neck injury and even from rough medical manipulations during manual therapy.

Anomalies in the cervical spine, in the form of an additional cervical rib.

Acute or chronic overexertion of the neck muscles.

- "Subclavian artery steal syndrome", the pathological process of which affects the vertebral and internal arteries.

A.A. Skoromets, Professor of the Department of Neurology and Neurosurgery of the Medical Academy. I. Pavlova wrote that in the overwhelming majority of cases, the internal carotid artery is subjected to stenosis (narrowing of the lumen), and this place of narrowing is clearly visible in the diagram. This is an organic process of vessel damage, accompanying atherosclerosis of cerebral vessels. It is not difficult to guess what will happen if a persistent reflex spasm occurs during the clamping of the artery. One feels like saying: "Forgive them, Lord, for they do not know what they are doing." It is bad when people who have not received medical knowledge do it, and even worse when doctors do it.

The article of doctors from Izhevsk not only did not convince me, but also disappointed me with the lack of a professional approach and illogicality.

Artificially reviving this ancient method, what are the goals of the authors? Interested in something new, which we are so greedy for?

If this technique requires modern diagnostic equipment for a preliminary examination of the patient, would it not be more logical to treat with modern methods, and not those that Yakut shamans may have used in ancient times? Naturally, in this case there will be no need for either resuscitation or a resuscitator.

Today, there are effective and safe methods and techniques for the treatment of vascular pathologies, known to my students, colleagues and followers.

In conclusion, let me ask a question to everyone who has read this work: do you want to become an experimenter's client?

I read the article, drew attention to the words “Today, the methods of Strelnikova and Buteyko are almost forgotten, but they are physiological. » Dr. Levashov Igor Borisovich claims that these methods are contrary to the natural breathing of a person and are NOT physiological. Where is the truth? It's just that such contradictions make the whole material questionable.

Unfortunately, I do not know what the statements of Dr. I. B. Levashov are based on, and you did not cite them in your post either.

The rules of this site say that if an opponent puts forward his version, theory, opinion, etc., different from the one I set out in articles and posts, then he must back it up not only with general words, but also provide an evidence base, otherwise it will be empty ranting .

This develops the topic, allows you to get to the bottom of those truths that few people know about, benefiting me, my colleagues and those who are simply interested in alternative medicine, not to mention the one who opened this topic on the forum.

It is not clear what material you have doubts about? In the materials of Buteyko and Strelnikova or in the material from I.B. Levashov?

Since, judging by your words, these materials are opposite in meaning, it is obvious that some of them are right and some are not. Therefore, it is necessary to get acquainted not only with the statements of Levashov, but also to know what Buteyko and Strelnikova claimed.

When you cite the statements of I. B. Levashov, and also indicate whose materials are in doubt, I will try to give exhaustive answers. Having familiarized yourself with them, you will thereby resolve your dilemma in search of the truth.

I will have to provide links to the video of Levashov's seminar I.B. (don't take it as an advertisement, it's just that his words about it are literally heard there - the Buteyko system is not physiological) video Breathing of the body, part 1, the first fragment, starting from 69 minutes 55 seconds. Does it make sense here to retell the entire “Body Breathing System” that he tells?

If, as you write, "his words sound" there, then why not put them in writing. I don't think there are that many. Moreover, we are talking only about the Buteyko system.

Remember, I asked you to read what Buteyko offered and why. Therefore, Levashov must clearly express the idea, that is, make the main emphasis, what is wrong with the practice of Buteyko. And Strelnikova - let her rest for now, since she was not discussed in your last post.

And yet, most importantly, words are words, and arguments are facts, that is, evidence. Without evidence of the word - only an assumption. They can be? Of course! Nobody excludes this. It is the right of everyone to have them. But then, that's the way it should be said - I guess, etc. It will be fair and decent.

We are awaiting developments with interest. This is His Majesty - the Forum, an arena for opinions and pores.

Literally words from Levashov's lecture: ". and, accordingly, all respiratory systems, according to Buteyko, Strelnikova and others, all this is just an elementary misunderstanding of the laws. this is a complete misunderstanding - why, the body is not accustomed to it, why force the body, i.e. the Buteyko system itself is not physiological, neither in terms of reflexes, nor in terms of what should happen. "

According to the theory of Breathing, the body's main task is not to interfere with the passage of the respiratory wave. If there are obstacles on this path, then a violation of the passage of the respiratory wave will lead to disturbances throughout the body (since it is impossible to consider body systems separately - this is a single mechanism). Ideally, the breathing rhythm should match the craniosacral rhythm (8-12). The main muscle, the "conductor", is the diaphragm.

Taken from the Buteyko clinic website:

“The action of the Buteyko method is based on a gradual decrease in the depth of breathing to the norm (? - what is the norm?)

The Buteyko method is a volitional elimination of deep breathing (VLHD)

K.P. Buteyko was the first in medicine to use breath reduction as the main method of treating a number of diseases, the development of which is associated with hyperventilation of the lungs, CO2 deficiency, cellular and tissue hypoxia (oxygen deficiency).

The therapeutic principle of the Buteyko method - a gradual decrease in the depth of breathing to the norm - allows you to eliminate CO2 and oxygen deficiency, normalize respiratory homeostasis (now this term is practically not used - homeodynamics is used) and eliminate compensatory reactions of the body's functional systems (bronchospasm, vasospasm, normalize cholesterol and others) without drugs and other treatments. Recovery is the result of the elimination of compensatory reactions of the functional systems of the body.

Three principles of breathing according to Buteyko: shallow breathing, nasal breathing and relaxation. It turns out that "volitional influence" is a non-physiological movement (we act AGAINST the body). It is rather psychotechnics, of which there are many. And as examples show, "treatment according to the Buteyko method" leads to the relief or disappearance of symptoms (like many psychotechnics), but not to a somatic cure (for example, signs of allergic inflammation in the bronchi remain).

Now back to breathing:

Respiration is not only the supply of oxygen and the removal of carbon dioxide, but is a set of processes consisting of several stages.

The value of pulmonary ventilation is determined by the depth of breathing and the frequency of respiratory movements. The quantitative characteristic of pulmonary ventilation is the minute volume of respiration. The volume of air in the lungs and respiratory tract depends on the constitutional, anthropological and age characteristics of a person, the properties of the lung tissue, the surface tension of the alveoli, and the force developed by the respiratory muscles. Gas exchange depends on many factors and is regulated by the respiratory center in accordance with metabolic needs. The respiratory center controls two important functions - motor (generation of the respiratory rhythm and its pattern) and homeostatic (maintains stable values of gases in the blood and extracellular fluid of the brain, as well as adaptation). Spontaneous activity of neurons of the respiratory center begins to manifest itself at the end of fetal development. Breath control is a complex process carried out by many neural structures. Two types of neurons are involved in the regulation process - those responsible for involuntary and voluntary breathing. The lungs also perform other functions: the metabolism of certain substances takes place here, the deposition of blood and the filtration and removal of harmful substances from the bloodstream. The volumes of interest in the study of lung function are tidal volume, anatomically and physiologically dead spaces. Different parts of the lungs are ventilated differently (in healthy people). The factors limiting the transfer of gases are diffusion and perfusion. The volume of the lungs is one of the important factors affecting the resistance of the vessels of the small circle. Under normal conditions, vascular resistance and the distribution of pulmonary blood flow depend mainly on passive factors, however, with a decrease in P-O2 in the alveolar air, a very interesting active reaction is observed - contraction of the smooth muscles of the walls of the alterioles in the hypoxic zone. Other active reactions of pulmonary vessels were also found - this is how they narrow at low blood pH. Accordingly, for effective gas exchange, ventilation and blood flow must be matched.

How to act to clamp the carotid artery

The carotid artery is one of the most important blood channels that feeds the brain, organs of vision and some other intracranial structures.

It branches off from the thoracic aorta and runs to the neck, where it diverges into two separate vessels (right and left). In the region of the larynx, the artery is divided into internal and external. It is the latter that is well felt on the lateral surfaces of the neck and, with the help of its palpation, the pulse rate is determined. Also, in some cases, by pressing on the vessel, it is possible to stop blood loss for a short time in case of wounds and injuries. Therefore, each person should know how to clamp the carotid artery in order to provide first aid to the victims if necessary.

Vessel location

Stop bleeding

Important: you can not exert strong pressure on the carotid artery, as this will increase blood pressure, slow down the heartbeat and the person will lose consciousness.

Artificially induced hypoxia

Syndrome of vertebral arteries

Headache, dizziness, tinnitus, flies before the eyes ... These are nothing more than signs of the vertebral artery syndrome - a disease in which the blood circulation of the posterolateral parts of the brain suffers.

It is necessary to treat the pathology, as it can lead to the early development of ischemic stroke.

Therapeutic measures should be comprehensive.

What it is?

This is a combination of symptoms that occur when the lumen of the above vessel decreases and the compression effect on the surrounding nerve plexus.

In order to understand how the syndrome develops, consider the topographic anatomy of the vertebral vessels.

There are two subclavian arteries in total.

They depart from the subclavian arteries on each side, go to the 6th cervical vertebra, enter the canal formed by the transverse processes of the cervical vertebrae, go in it to the foramen magnum.

With bone pathology of this department, these vessels almost always suffer.

In the cranial cavity, they merge together, forming the basilar artery, which feeds the following structures:

brain stem;
cerebellum;
departments of the temporal lobes;
cranial nerves;
inner ear.

They account for only 15-30% of blood flow (the rest is provided by the carotid arteries).

When they are damaged, symptoms of damage to all those structures that they supply blood appear.

The vertebral artery is divided into the following segments (they are indicated on ultrasound by Roman numerals):

I - from its separation from the subclavian artery to the entrance to the bone canal;
II - from 6 to 2 vertebrae;
III - from the place of exit from the 6th vertebra to the entrance to the cranial cavity. It is here that the bends of the artery are located, that is, this place is dangerous because blood clots and atherosclerotic plaques can accumulate in it, blocking the blood flow;
IV - from the moment the artery enters the cranial cavity to the confluence of two vertebral arteries.

Most of the vertebral artery runs in the movable canal from the vertebrae and their processes.

In the same canal, the sympathetic nerve (Frank's nerve) passes, which braids the artery from all sides.

At the level of the I-II cervical vertebrae, the artery remains covered only by soft tissues (mainly the lower oblique muscle of the abdomen).

Main symptoms

The disease begins with the fact that a person has severe headaches.

They are associated with a forced uncomfortable position of the head during the daytime or during sleep, cooling or neck injury.

The pain is also called "cervical migraine" - it has the following characteristics:

extends from neck through occiput to temples;
changes depending on the movements of the head (in some of its positions it can completely disappear);
pain is felt when probing the vertebrae of the cervical region;
the character can be anything: pulsating, shooting, bursting, tightening;
the duration of the attack can be any: from minutes to several hours;
accompanied by other symptoms described below.

Dizziness

It most often occurs after sleep, especially if a person rested on a high pillow, but it can develop during the day, lasting from several minutes to hours.

Accompanied by visual impairment, hearing, tinnitus. Some patients characterize their sensations as "the head has gone somewhere."

With this symptom, the Shants collar serves as a method of differential diagnosis: if wearing it eliminates dizziness, then we are talking about vertebral artery syndrome.

Noise in ears

With this syndrome, most people note exactly the noise in both ears.

If it makes noise in only one ear, then it almost always occurs - on the side of the lesion, less often - on the reverse side.

This symptom appears at different times, has a different severity, which depends on the state of the labyrinth of the inner ear and those structures that are directly related to it.

The period of remission is characterized by a weak and low-frequency noise in the ear, before the onset of an attack, it intensifies, becomes higher. If the syndrome was caused by osteochondrosis of the cervical region, then such noise often occurs at night, in the early morning hours.

The nature of the noise changes when the head is turned.

Numbness

There may be numbness of the face (especially around the mouth), neck, one or both upper limbs.

This is due to a violation of the blood supply to certain areas.

Fainting

If the syndrome was caused by stenosis of one or two vertebral arteries, loss of consciousness is due to overextension of the head for a long time.

The cause of this condition is vertebrobasilar insufficiency.

Before such a faint, one of the following symptoms usually appears:

dizziness;
instability;
facial numbness;
speech disorder;
transient blindness in one eye.

Nausea

In most cases, nausea and vomiting are symptoms of the disease.

In this case, this symptom is not associated with an increase in intracranial pressure.

Depression

It does not occur immediately, it is caused not only by a violation of the normal blood supply to the brain, but also by moral reasons, when a person is tired of frequent attacks of headache, dizziness, constant tinnitus.

Signs of the syndrome in cervical osteochondrosis

Due to degenerative changes in the intervertebral discs, the vertebrae move relative to each other.

As a result, the lumen of the vertebral artery decreases, and the sympathetic plexus (Frank's nerve) is also involved.

This causes the development of such symptoms:

dizziness;
headache, which usually has a throbbing or burning character, extends from the occiput to the brow or temple. Such pain is usually localized in one half of the head, it increases when turning the head and neck;
noise in both ears;
hearing loss;
fog before the eyes;
nausea, vomiting;
fluctuations in blood pressure in any direction;
feeling of heartbeat;
there may be pain in the shoulder and arm on one side;
Pain in the eyes.

Does manual therapy help with cervical osteochondrosis? Read here.

Causes

There are two main groups of reasons:

Vertebrogenic syndrome of the vertebral artery

This is one that is associated with pathologies of the spine.

So, in children, the disease can often be caused by anomalies in the development of the vertebrae, as well as injuries of the cervical spine. In adults, the syndrome develops with spinal injuries, spasm of the cervical muscles, as well as with its degenerative lesions (with Bechterew's disease, osteochondrosis) and some types of tumors.

A prerequisite for the development of the syndrome of vertebral arteries of a vertebrogenic nature are the anatomical features of the bone canal, in which the indicated artery passes.

Non-vertebrogenic causes (not associated with spinal pathologies)

These reasons fall into three groups:

occlusive pathologies of arteries: arteritis, thrombosis, their atherosclerotic lesion, embolism;
deformation of the vessels: their kinks, pathological tortuosity, anomalies in the course of the arteries;
compression of the vertebral arteries from the outside - spasmodic muscles, abnormally developed cervical ribs, scars (for example, after catheterization of blood vessels or operations on the neck).

In a child, the syndrome develops due to such reasons:

abnormal course of the arteries;
congenital pathological tortuosity of blood vessels;
trauma, including birth;
muscle spasm due to hypothermia or torticollis - congenital or acquired, arising from various causes.

What is the danger of the syndrome?

If the disease is not treated or inadequate therapy is used, the following complications may develop:

Violation of the blood supply to a larger or smaller area of the brain. Initially, this causes only transient neurological disorders: for example, speech becomes slurred periodically and for a short time, or an arm or leg is “taken away”. This symptomatology, lasting up to a day, is called a transient ischemic attack. If these symptoms are ignored, the following complication develops.
Stroke. In this case, it is usually ischemic in nature. It arises due to the fact that one of the vertebral arteries is blocked from the outside or from the inside so much that this blood becomes insufficient for the normal functioning of the part of the brain that it should provide nutrition.
Physiological compensation of impaired blood supply to the brain by increasing perfusion pressure. For this, the main stage of compensation will be high blood pressure. This leads to the development of adverse effects not only on the brain, but also on the heart muscle, and on the organ of vision.

A person who quite often experiences dizziness, falls with preserved consciousness, impaired coordination and balance, loses his ability to work and even the ability to self-service.

The vertebral artery syndrome does not always cause a stroke, but disability due to insufficient blood supply to the brain occurs quite often.

Diagnostics

Suspecting vertebral artery syndrome is a task not only for a neuropathologist, but also for a general practitioner.

Based on the description of the symptoms, as well as the data of the examination (tension of the occipital muscles, pain when pressing on the processes of the cervical vertebrae and scalp), the doctor questions this diagnosis and directs it to an instrumental study.

It is carried out using several basic methods:

Doppler ultrasound. It looks and is performed like a conventional ultrasound, it allows you to evaluate the anatomy, patency, speed and nature of blood flow in the arteries. It is this study that is fundamental to the diagnosis.
MRI of the brain. Allows you to assess the state of the blood supply to the brain, identify areas of leukomalacia, ischemic foci, posthypoxic cysts - that is, those complications that could lead to a violation of trophism.
X-ray of the cervical spine. Helps to identify the bone causes of the disease.

How to treat vertebral artery syndrome?

Therapy of the disease should be complex.

Only in this way can the effect be achieved.

Wearing a Shants collar with this pathology is mandatory.

Medical treatment

It includes taking the following medications:

Anti-inflammatory therapy. Tablets "Celebrex", "Ibuprom", "Nimesulide" are designed to reduce pain, eliminate inflammation, which almost always accompanies this pathology.
Improvement of venous outflow. The optimal drug is "L-lysine", but it is administered only by intravenous drip. Diosmin and troxerutin preparations are also used.
Improving the patency of arterial vessels: "Agapurin", "Trental".
Neuroprotective therapy: Somazina, Gliatillin, Sermion.
Antihypoxic drugs: "Actovegin", "Mexidol".
Nootropics: "Piracetam", "Lucetam", "Thiocetam".
With dizziness: "Betahistine", "Betaserc".

Exercise therapy and exercises

A set of exercises should be selected individually by the doctor, since excessive activity can only harm, as well as physical inactivity.

So, the following movements can be applied:

The assistant puts a hand on the forehead, the patient should put pressure on it. At first, the backpressure should be small, but it increases with time.
Counterpressure by the assistant's hand is applied to the back of the head.
Light and careful head turns to the sides with a gradual increase in amplitude.
Back pressure on the sides of the head. Initially, such exercises are performed in the supine position of the patient, then in a sitting position. The force of pressure should increase.
Shrug.
Nodding.
Head tilts to the side.

Video: the benefits of yoga

Massage

It is prescribed starting from the subacute period of the disease.

Its main goal is to relax tense neck muscles, which will help reduce compression (squeezing) of the vertebral arteries.

Unprofessional performance of massage techniques can lead to the development of very serious and life-threatening complications: pulmonary embolism, complete clamping of the vessels of the neck with the development of syncope, or even a stroke.

Operation

In case of ineffectiveness of medical and physiotherapeutic treatment, as well as when the arteries are compressed by osteophytes, tumors, surgical treatment is indispensable.

Such operations are carried out in the conditions of neurosurgical departments: osteophytes, pathological bone and non-bone formations are removed.

A separate type of operation can also be performed - periarterial sympathectomy.

Treatment at home

Therapy includes the implementation of a set of exercises and drugs prescribed by a doctor.

There are no effective folk methods of treating this pathology.

Treatment during pregnancy

It includes the following techniques:

wearing a Shants collar;
osteopathy;
therapeutic gymnastics, including NISHI exercises;
autogravity therapy - traction, which should be used only by qualified specialists;
manual therapy;
massage;
physiotherapeutic methods of treatment: magnetotherapy, phonophoresis with hydrocortisone, diadynamic currents.

Acupuncture or electrophoresis, as well as taking any drugs, is contraindicated during pregnancy.

Why does the head hurt in the back of the head? Read here.

What are the symptoms of a dislocated cervical vertebrae? Information here.

Prevention

Preventive measures are as follows:

Perform exercises for the neck and shoulder girdle every hour: raise and lower the shoulders, gently move the head in different directions, perform counter-pressure exercises with your own palm. This is especially important for those who work in a sitting position.
Sleep on an orthopedic pillow in any position, but not on your stomach, and not in a position with your head thrown back.
Take neck and collar zone massage courses once a year - six months.
Treatment in sanatoriums specializing in neurological diseases.

It is important to remember that vertebral artery syndrome and alcohol are incompatible things.

With this syndrome, the blood supply to a part of the brain is already disrupted, and alcoholic beverages will further enhance the brain steal syndrome.

Syndrome and the army

Whether they take to the army with this disease depends on how much the patency of the artery is impaired, how much the brain suffers as a result:

if in pathology only headaches are noted, and the patency of the artery can be restored with medication, then the young man can be taken into the army;
with dizziness, convulsive seizures, if there have already been transient ischemic attacks, they put “Not fit” in the column on military duty.

Thus, vertebral artery syndrome is a polyetiological pathology that has a certain combination of symptoms.

Her treatment should be comprehensive.

Some therapies are general for any cause of the disease, while others must deal directly with its etiology.

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Clamp the carotid artery death. Carotid artery how to press

Vessel location

Stop bleeding

Artificially induced hypoxia

Categories

new entries

Vertebral artery syndrome: symptoms and treatment

Fundamentals of anatomy and physiology

Causes and mechanisms of development of vertebral artery syndrome

Symptoms of vertebral artery syndrome

Stage of functional disorders (dystonic)

Ischemic, or organic, stage

Clinical variants of the vertebral artery syndrome

Diagnosis of vertebral artery syndrome

Treatment of vertebral artery syndrome

Prevention of vertebral artery syndrome

6 COMMENTS

Circulatory disorders in the carotid arteries

The Role of the Vessel

External carotid artery

internal carotid artery

Crushing hazard

What is the carotid artery

Where is

Structure

How many carotid arteries does a person have

Functions

What happens if you press on the carotid artery

Diseases

Atherosclerosis

carotid syndrome

Aneurysm

Treatment of diseases

What is the carotid artery?

What can not be done with the carotid artery?

How to check the pulse in the carotid artery?

How to act to clamp the carotid artery

Vessel location

Stop bleeding

Artificially induced hypoxia

Syndrome of vertebral arteries

What it is?

Main symptoms

Dizziness

Noise in ears

Numbness

Fainting

Nausea

Depression

Signs of the syndrome in cervical osteochondrosis

Causes

What is the danger of the syndrome?

Diagnostics

How to treat vertebral artery syndrome?

Medical treatment

Exercise therapy and exercises

Video: the benefits of yoga

Massage

Operation

Treatment at home

Treatment during pregnancy

Prevention

Syndrome and the army