Treatment of cerebrovascular accident. Transient cerebrovascular accident

Cerebral circulation is the blood circulation in the vascular system of the spinal cord and brain. A pathological process that causes a violation of cerebral circulation can also affect the cerebral and main arteries (brachiocephalic trunk, aorta, external and internal vertebral, carotid, subclavian, spinal, radicular arteries and their branches), jugular and cerebral veins, venous sinuses. Pathology in nature can be different: embolism, thrombosis, looping and kinks, aneurysms of the vessels of the spinal cord and brain, narrowing of the lumen.

Signs of cerebrovascular accident

Morphological signs of violation of proper blood circulation in the brain are divided into diffuse and focal. Diffuse signs include small organized and fresh foci of necrosis of brain tissue, small-focal multiple changes in the medulla, small cysts and hemorrhages, gliomesodermal scars; to focal - cerebral infarction, hemorrhagic stroke, intrathecal hemorrhages.

By the nature of cerebral circulation disorders are divided into acute (subthecal hemorrhages, transient, strokes), initial stages and chronic disorders of the spinal and cerebral circulation (dyscirculatory encephalopathy and myelopathy).

Symptoms of cerebrovascular accident

Initially, the disease may be asymptomatic. But in the absence of proper treatment, the disorders progress rapidly. The symptoms of cerebrovascular accident are as follows:

Headache. This is the very first symptom of circulatory disorders in the brain. If headaches become systematic, you should immediately consult a doctor.

Dizziness. A doctor should be consulted immediately if dizziness occurs more than three times a month.

Pain in the eyes. Pain in the eyes with circulatory disorders in the brain tends to increase during the movement of the eyeballs. Most often, such pain occurs at the end of the working day, when the eyes are tired from stress throughout the day.

Nausea and vomiting. A doctor should be consulted if nausea and vomiting are observed along with headache, dizziness and eye pain.

Seizures. Seizures can be of various types. As a rule, they occur quite rarely.

Congestion, ringing and noise in the ears. When blood circulation is disturbed in the brain, a feeling arises as if water has got into the ears.

Numbness. Those with cerebrovascular accidents may experience numbness in their arms, legs, or other parts of the body. Numbness does not occur as usual, after a long stay in an uncomfortable position, but just like that. This is a direct consequence of a violation of normal blood circulation in the brain.

Acute cerebrovascular accident

Acute circulatory disorders in the brain can be persistent (cerebral stroke) and transient.

A transient disorder of cerebral circulation occurs due to a hypertensive crisis, cerebral angiospasm, cerebral atherosclerosis, arrhythmias, heart failure, and collapse. Symptoms of transient cerebrovascular accident can occur for a few minutes or all day.

Treatment of cerebrovascular accident

Treatment of cerebrovascular disorders consists in normalizing cerebral blood flow in tissues, stimulating metabolism in neurons, treating major cardiovascular diseases, and protecting brain neurons from hypoxia factors.

Prevention of cerebrovascular accidents

Prevention of circulatory disorders in the brain is quite simple. To avoid violations, you must:

Do not smoke or use psychotropic substances;

To live an active lifestyle;

Reduce salt intake;

Control and maintain normal body weight;

Control the level of glucose, the content of lipoproteins and triglycerides in the blood;

Treat existing diseases of the cardiovascular system.

Video from YouTube on the topic of the article:

cerebral circulation- blood circulation in the vascular system of the brain and spinal cord.

The process that causes disorders of cerebral circulation can affect the main and cerebral arteries (aorta, brachiocephalic trunk, common, internal and external carotid, subclavian, vertebral, basilar, spinal, radicular arteries and their branches), cerebral veins and venous sinuses, jugular veins. The nature of the pathology of the cerebral vessels is different: thrombosis, embolism, narrowing of the lumen, kinks and looping, aneurysms of the vessels of the brain and spinal cord.

The severity and localization of morphological changes in the brain tissue in patients with cerebral circulation disorders are determined by the underlying disease, the blood supply pool of the affected vessel, the mechanisms of development of this circulatory disorder, the age and individual characteristics of the patient.

Morphological signs of cerebrovascular accident can be focal and diffuse. Focal include hemorrhagic stroke, intrathecal hemorrhage, cerebral infarction; to diffuse - multiple small-focal changes in the substance of the brain of different nature and different prescription, small hemorrhages, small fresh and organizing foci of necrosis of the brain tissue, gliomesodermal scars and small cysts.

Clinically, with cerebral circulation disorders, there may be subjective sensations (headache, dizziness, paresthesia, etc.) without objective neurological symptoms; organic microsymptoms without clear symptoms of loss of CNS function; focal symptoms: movement disorders - paresis or paralysis, extrapyramidal disorders, hyperkinesis, coordination disorders, sensitivity disorders, pain; violations of the functions of the sense organs, focal violations of the higher functions of the cerebral cortex - aphasia, agraphia, alexia, etc .; changes in intelligence, memory, emotional-volitional sphere; epileptic seizures; psychopathological symptoms.

According to the nature of cerebrovascular accidents, initial manifestations of insufficient blood supply to the brain, acute cerebrovascular accidents (transient disorders, intrathecal hemorrhages, strokes), chronic slowly progressive disorders of cerebral and spinal circulation (dyscirculatory encephalopathy and myelopathy) are distinguished.

Clinical symptoms of the initial manifestations of insufficiency of blood supply to the brain are appearing, especially after intense mental and physical work, staying in a stuffy room, headache, dizziness, noise in the head, decreased performance, sleep disturbance. Focal neurological symptoms in such patients, as a rule, are absent or are represented by diffuse microsymptoms. To diagnose the initial manifestations of insufficient blood supply to the brain, it is necessary to identify objective signs of atherosclerosis, arterial hypertension, vasomotor dystonia and exclude other somatic pathologies, as well as neurosis.

Acute cerebrovascular accidents include transient cerebrovascular accidents and strokes.

Transient disorders of cerebral circulation are manifested by focal or cerebral symptoms (or a combination thereof), lasting less than 1 day. Most often they are observed in atherosclerosis of cerebral vessels, hypertension and arterial hypertension.

There are transient ischemic attacks and hypertensive cerebral crises.

Transient ischemic attacks are characterized by the appearance of focal neurological symptoms (weakness and numbness of the extremities, speech difficulty, impaired statics, diplopia, etc.) against the background of mild or absent cerebral symptoms.

For hypertensive cerebral crises, on the contrary, the predominance of cerebral symptoms (headache, dizziness, nausea or vomiting) over focal ones, which sometimes may be absent, is characteristic. Acute cerebrovascular accident, in which focal neurological symptoms persist for more than 1 day, is considered a stroke.

Acute disorders of venous circulation in the brain also include venous hemorrhages, thrombosis of the cerebral veins and venous sinuses.

Chronic disorders of cerebral circulation (dyscirculatory encephalopathy and myelopathy) are the result of progressive circulatory failure caused by various vascular diseases.

With dyscirculatory encephalopathy, diffuse organic symptoms are detected, usually in combination with memory impairment, headaches, non-systemic dizziness, irritability, etc. There are 3 stages of dyscirculatory encephalopathy.

For stage I, in addition to diffuse, unsharply pronounced persistent organic symptoms (asymmetry of cranial innervation, light oral reflexes, inaccuracies in coordination, etc.), the presence of a syndrome similar to the asthenic form of neurasthenia is characteristic (memory impairment, fatigue, absent-mindedness, difficulty switching from one activity to another). another, dull headaches, non-systemic dizziness, poor sleep, irritability, tearfulness, depressed mood). The intellect does not suffer.

Stage II is characterized by a progressive deterioration of memory (including professional), a decrease in working capacity, personality changes (viscosity of thought, a narrowing of the circle of interests, apathy, often verbosity, irritability, quarrelsomeness, etc.), and a decrease in intelligence. Daytime sleepiness is typical with poor night sleep. Organic symptoms are more pronounced (mild dysarthria, reflexes of oral automatism and other pathological reflexes, bradykinesia, tremor, changes in muscle tone, coordination and sensory disorders).
Stage III is characterized by both aggravation of mental disorders (up to dementia) and the development of neurological syndromes associated with a predominant lesion of a certain area of ​​the brain. It can be pseudobulbar palsy, parkinsonism, cerebellar ataxia, pyramidal insufficiency. Frequent stroke-like worsening of the condition, characterized by the appearance of new focal symptoms and an increase in previously existing signs of cerebrovascular insufficiency.

Dyscirculatory myelopathy also has a progressive course, in which three stages can be conventionally distinguished. Stage I (compensated) is characterized by the appearance of moderate fatigue of the muscles of the limbs, less often by weakness of the limbs. Subsequently, in stage II (subcompensated), weakness in the limbs progressively increases, sensitivity disorders appear in the segmental and conduction type, changes in the reflex sphere. In stage III, paresis or paralysis, severe sensory disturbances, and pelvic disorders develop.

The nature of focal syndromes depends on the localization of pathological foci along the length and diameter of the spinal cord. Possible clinical syndromes are polio, pyramidal, syringomyelic, amyotrophic lateral sclerosis, posterocolumnar, transverse spinal cord lesions.

Chronic venous circulation disorders include venous congestion, causing venous encephalopathy and myelopathy. It is a consequence of cardiac or pulmonary heart failure, compression of extracranial veins in the neck, etc. Difficulties in venous outflow from the cranial cavity and spinal canal can be compensated for a long time; with decompensation, headaches, convulsive seizures, cerebellar symptoms, and dysfunction of the cranial nerves are possible. Venous encephalopathy is characterized by a variety of clinical manifestations. Hypertension (pseudotumor) syndrome, disseminated small-focal brain damage syndrome, asthenic syndrome can be observed. Venous encephalopathy also includes bettolepsy (cough epilepsy), which develops in diseases that lead to venous congestion in the brain. Venous myelopathy is a particular variant of dyscirculatory myelopathy and does not differ significantly from the latter clinically.

Symptoms of circulatory disorders in the vessels of the brain

In the early stages, the disease is asymptomatic. However, it progresses rapidly and gradually its symptoms completely incapacitate a person, work capacity is seriously impaired, a person loses the joy of life and cannot fully live.

So, the symptoms of cerebrovascular accident include:

Headache is a major wake-up call, but people often ignore it, believing that pain is caused by fatigue, weather, or other causes.
pain in the eyes - its peculiarity lies in the fact that it noticeably increases during the movement of the eyeballs, especially in the evening
dizziness - when such a phenomenon is noted regularly, it should by no means be ignored
nausea and vomiting - usually this symptom occurs in parallel with the above
ear congestion
ringing or noise in the ears
convulsions - this symptom is less common than others, but still occurs
numbness - in violation of blood circulation in the vessels of the brain, it occurs absolutely for no reason
tension of the head muscles, especially pronounced in the occipital
weakness in the body
fainting
skin blanching
decrease in heart rate

There are also various disorders of consciousness, such as:

Alterations in perception, such as feeling overwhelmed
memory impairment - a person remembers his past perfectly, but often forgets about plans, about where everything is
distraction
rapid fatigue and, as a result, a decrease in working capacity
irascibility, slight excitability, tearfulness
constant drowsiness or vice versa insomnia

Causes of cerebrovascular disorders

The causes of this disease are very diverse. Usually they are associated with other abnormalities in the work of the cardiovascular system, for example, with vascular atherosclerosis or hypertension. Atherosclerosis is a blockage of blood vessels with cholesterol plaques, so it is simply necessary to monitor the concentration of cholesterol in the blood. And for this you should monitor your daily diet.

Chronic fatigue also often causes circulatory disorders in our brain. Unfortunately, people often do not realize the seriousness of their condition and reach terrible consequences. But chronic fatigue syndrome can lead not only to circulatory failure, but also to disruption of the endocrine system, central nervous system and gastrointestinal tract.

Various traumatic brain injuries can also cause disorders. It can be an injury of any severity. Injuries with intracranial hemorrhage are especially dangerous. It is quite natural that the stronger this hemorrhage, the more serious consequences it can lead to.

The problem of a modern person is a regular sitting in front of a computer monitor in an uncomfortable position. As a result of this, the muscles of the neck and back are greatly overstrained and blood circulation in the vessels, including the vessels of the brain, is disturbed. Excessive exercise can also be harmful.

Circulatory problems are also closely related to diseases of the spine, especially its cervical region. Be careful if you are diagnosed with scoliosis or osteochondrosis.

The main cause of cerebral hemorrhage is high blood pressure. With its sharp rise, a rupture of the vessel may occur, resulting in the release of blood into the substance of the brain and the development of an intracerebral hematoma.

A more rare cause of hemorrhage is a ruptured aneurysm. An arterial aneurysm, usually related to congenital pathology, is a saccular protrusion on the vessel wall. The walls of such a protrusion do not have such a powerful muscular and elastic frame as the walls of a normal vessel have. Therefore, sometimes only a relatively small jump in pressure, which is observed in quite healthy people during physical exertion or emotional stress, is enough for the wall of the aneurysm to burst.

Along with saccular aneurysms, other congenital anomalies of the vascular system are sometimes observed, creating a threat of sudden hemorrhage.
In cases where an aneurysm is located in the walls of vessels located on the surface of the brain, its rupture leads to the development of not intracerebral, but subarachnoid (subarachnoid) hemorrhage, located under the arachnoid membrane surrounding the brain. Subarachnoid hemorrhage does not directly lead to the development of focal neurological symptoms (paresis, speech disorders, etc.), but with it general cerebral symptoms are expressed: a sudden sharp ("dagger") headache, often followed by loss of consciousness.

A cerebral infarction usually develops as a result of blockage of one of the cerebral vessels or a large (main) vessel of the head, through which blood flows to the brain.

There are four main vessels: the right and left internal carotid arteries, supplying most of the right and left hemispheres of the brain, and the right and left vertebral arteries, which then merge into the main artery and supply blood to the brainstem, cerebellum and occipital lobes of the cerebral hemispheres.

The causes of blockage of the main and cerebral arteries may be different. So, during an inflammatory process on the heart valves (with the formation of infiltrates or with the formation of a parietal thrombus in the heart), pieces of a thrombus or infiltrate can come off and with the blood flow come to the cerebral vessel, the caliber of which is smaller than the size of the piece (embolus), and as a result clog the vessel. Particles of a decaying atherosclerotic plaque on the walls of one of the main arteries of the head can also become emboli.

This is one of the mechanisms for the development of cerebral infarction - embolic.
Another mechanism for the development of a heart attack is thrombotic: the gradual development of a blood clot (blood clot) at the location of an atherosclerotic plaque on the vessel wall. Atherosclerotic plaque filling the lumen of the vessel leads to a slowdown in blood flow, which contributes to the development of a blood clot. The uneven surface of the plaque favors the adhesion (aggregation) of platelets and other blood elements in this place, which is the main frame of the resulting thrombus.

As a rule, some local factors for the formation of a blood clot are often not enough. The development of thrombosis is facilitated by factors such as a general slowdown in blood flow (therefore, thrombosis of the cerebral vessels, as opposed to embolism and hemorrhage, usually develops at night, during sleep), increased blood clotting, increased aggregation (gluing) properties of platelets and red blood cells.

What is blood clotting, everyone knows from experience. A person accidentally cuts a finger, blood begins to flow from it, but gradually a blood clot (thrombus) forms at the site of the cut and the bleeding stops.
Blood clotting is a necessary biological factor contributing to our survival. But both reduced and increased clotting threatens our health and even our very lives.

Increased coagulability leads to the development of thrombosis, reduced - to bleeding with the slightest cuts and bruises. Hemophilia, a disease accompanied by reduced blood clotting and having a hereditary character, suffered from many members of the reigning families of Europe, including the son of the last Russian emperor, Tsarevich Alexei.

Violation of normal blood flow can also be the result of a spasm (strong compression) of the vessel, which occurs as a result of a sharp contraction of the muscle layer of the vascular wall. A few decades ago, spasm was given great importance in the development of cerebrovascular accidents. Currently, cerebral infarctions are mainly associated with spasm of cerebral vessels, which sometimes develop several days after a subarachnoid hemorrhage.

With frequent rises in blood pressure, changes can develop in the walls of small vessels that feed the deep structures of the brain. These changes lead to narrowing, and often to the closure of these vessels. Sometimes, after another sharp rise in blood pressure (hypertensive crisis), a small infarct develops in the circulation of such a vessel (called in the scientific literature "lacunar" infarction).

In some cases, cerebral infarction can develop without complete blockage of the vessel. This is the so-called hemodynamic stroke. Imagine a hose that you use to water your garden. The hose is clogged with silt, but the electric motor, lowered into the pond, works well, and there is enough water jet for normal watering. But a slight bend in the hose or a deterioration in the operation of the motor is enough, instead of a powerful jet, a narrow stream of water begins to flow out of the hose, which is clearly not enough to water the ground well.

The same can occur under certain conditions with the blood flow in the brain. For this, the presence of two factors is sufficient: a sharp narrowing of the lumen of the main or cerebral vessel by an atherosclerotic plaque filling it or as a result of its inflection plus a drop in blood pressure due to a deterioration (often temporary) of the heart.

The mechanism of transient disorders of cerebral circulation (transient ischemic attacks) is in many respects similar to the mechanism of development of cerebral infarction. Only compensating mechanisms for transient cerebrovascular accidents work quickly, and the developed symptoms disappear within a few minutes (or hours). But one should not hope that compensation mechanisms will always cope so well with the violation that has arisen. Therefore, it is so important to know the causes of cerebrovascular accident, which makes it possible to develop methods for preventing (preventing) repeated disasters.

Treatment of cerebrovascular accident

Various diseases of the cardiovascular system are the most common ailments among the population of the planet. A violation of cerebral circulation in general is an extremely dangerous thing. The brain is the most important organ of our body. Its poor functioning leads not only to physical abnormalities, but also to a violation of consciousness.

The treatment of this disease includes not only taking medications, but also a complete change in your lifestyle. As mentioned above, cholesterol plaques contribute to the development of circulatory disorders in the vessels of the brain. So, it is necessary to take measures to prevent an increase in the level of cholesterol in the blood. And the main measures include proper nutrition. First of all, do the following:

Limit your salt intake as much as possible
give up alcoholic beverages
if you have extra pounds - you urgently need to get rid of them, because they create an extra load on your blood vessels, and this is simply unacceptable with this disease
In some people, blood vessels, including capillaries, are fragile. These people often bleed gums, nosebleeds are not uncommon. How to get rid of this scourge?

Dissolve a teaspoon of well-peeled (food) and finely ground sea salt in a glass of water at room temperature. Cool saline solution draw in through the nostrils and hold your breath for about 3-4 seconds. Repeat the procedure every morning for 10-12 days, and nosebleeds will stop.

This method also helps well: prepare a saturated saline solution (five tablespoons of coarse sea salt in a glass of warm water). Make two swabs out of cotton, soak them in the prepared solution and insert them into your nose. Lie with your head thrown back for 20 minutes. It is also useful to rinse your mouth with the same solution: the gums will stop hurting and bleeding.

Take two tablespoons of dry mustard, two pods of crushed hot pepper, a tablespoon of sea salt. Mix all ingredients and add two glasses of vodka. Leave the mixture in a dark place for 10 days. With the resulting tincture, actively rub your feet at night. After rubbing, put on woolen socks and go to bed.

Treatment of age-related changes in the circulatory system in the elderly

Age-related changes in the vessels and heart to a large extent limit the adaptive capacity and create prerequisites for the development of diseases.

Changes in the vessels. The structure of the vascular wall changes with age in each person. The muscle layer of each vessel gradually atrophies and decreases, its elasticity is lost and sclerotic seals of the inner wall appear. This greatly limits the ability of blood vessels to expand and narrow, which is already a pathology. First of all, large arterial trunks, especially the aorta, suffer. In elderly and old people, the number of active capillaries per unit area is significantly reduced. Tissues and organs cease to receive the amount of nutrients and oxygen they need, and this leads to their starvation and the development of various diseases.

With age, in each person, small vessels are more and more “clogged” with lime deposits and peripheral vascular resistance increases. This leads to some increase in blood pressure. But the development of hypertension is largely hampered by the fact that with a decrease in the tone of the muscle wall of large vessels, the lumen of the venous bed expands. This leads to a decrease in cardiac output (minute volume is the amount of blood ejected by the heart per minute) and to an active redistribution of peripheral circulation. The coronary and cardiac circulations are usually almost unaffected by the decrease in cardiac output, while the renal and hepatic circulations are greatly reduced.

Decreased contractility of the heart muscle. The older a person becomes, the more muscle fibers of the heart muscle atrophy. The so-called "senile heart" develops. There is a progressive sclerosis of the myocardium, and in place of the atrophied muscle fibers of the heart tissue, fibers of non-working connective tissue develop. The strength of heart contractions gradually decreases, metabolic processes are more and more disturbed, which creates conditions for energy-dynamic insufficiency of the heart in conditions of intense activity.

In addition, in old age, conditioned and unconditioned reflexes of the regulation of blood circulation appear, and the inertness of vascular reactions is increasingly revealed. Studies have shown that with aging, the effects on the cardiovascular system of various brain structures change. In turn, the feedback also changes - the reflexes coming from the baroreceptors of large vessels are weakened. This leads to dysregulation of blood pressure.

As a result of all of the above reasons, with age, the physical performance of the heart decreases. This leads to a limitation of the range of reserve capabilities of the body and a decrease in the efficiency of its work.

Points of influence in circulatory disorders

With weak blood flow and blockage of blood vessels, the index finger and thumb of one hand should grab the middle finger of the other hand. Acupressure is carried out by pressing with medium force with the thumbnail on the point, which is located under the nail bed. Massage should be done on both hands, devoting 1 minute to it.

Points of influence for thirst. If you feel thirsty, you should act on a calming point. The peculiarity of this BAP is that so far it has not been possible to determine other points associated with the mucous membrane in the human body. The point is located at a distance of about 1 cm from the tip of the tongue. The massage consists in the form of a light biting of this point with the front teeth (incisors) with a rhythm of 20 times in 1 minute.

Points of influence in sleep disorders. With insomnia, acupressure of the lower part of the auricle should be performed. Massage should be carried out with the index and thumb, clasping the earlobe on both sides. The biologically active point is located in the middle of the lobe. Sleep will come faster (yuli massage is carried out more often on the right side than on the left.

Drawing. Points of influence for influenza, runny nose, catarrh of the upper respiratory tract

Acupressure does not replace the necessary medical treatment, especially if surgery is urgently needed (for example, with appendicitis, its purulent stage).

Not even a significant, but often repeated change in blood pressure leads to the development of cerebral ischemia, and the affected areas try to continue to perform their functions. A chronic violation of the blood supply to the brain develops - encephalopathy of the discirculatory type.

It does not progress quickly, due to insufficient blood circulation, while small foci of necrosis develop in the brain tissues, which will inevitably lead to loss of brain function. Symptoms of cerebrovascular accident are treated by traditional medicine methods, the goal of treatment is to restore blood supply deficiency, alleviate the symptoms of hypertension.

The lack of blood supply to the brain tissues causes metabolic, and after them, destructive changes in brain cells. Years of the course of the disease, even with proper treatment, aggravate it both in the quality and quantity of the affected cells.

When the disease is at the very beginning of its development, the main symptoms are cerebrosthenic:

• increased fatigue;
• the predominance of emotional instability;
• anxiety from sleep disturbances;
• suffering from frequent headaches;
• memory loss.

Symptoms of cerebrovascular accident are treated with injections, droppers, that is, by such methods when the medicine penetrates directly into the bloodstream and starts working in the body faster.

Non-children's children's problems

Circulatory disorders in the brain in children are much less common than in adult patients. Children do not have age-related deformations of blood vessels, the outflow of blood from the brain is not disturbed. If circulatory disorders do occur, their causes are quite different from the factors that cause NMC in adults.

Among the causes of circulatory disorders in children, the most common are:

• blood diseases;
• vascular injury;
• cardiac pathology;
• vasculitis;
• symptoms of arterial hypertension;
• vasomotor type dystonia;
• disease of the endocrine system;
• hypertension;
• atherosclerosis of the vessels of the child's brain.

Different factors prevail in different age periods of growth of children. Treatment of symptoms of cerebrovascular accident in children depends on their age and physiological factors.

The 1st year of life shows that the main factor of NMC is anomalies in the formation of cerebrospinal fluid. Preschoolers and schoolchildren give such causes of NMC as blood and heart diseases.

Manifestation of signs and symptoms

Most vascular disorders are based on hypoxia - a lack of oxygen. Neurons are unusually sensitive to the decrease in oxygen supply. Even a five-minute cessation of blood supply to the brain can lead to irreparable consequences.

The development of hypoxia leads to a violation:

• brain functions,
• functions of the center responsible for the movement of blood vessels,
• regulation of vascular tone.

When the hypoxia of brain cells is at a reversible level, transient ischemia develops. If irreversible changes have occurred, then a cerebral infarction occurs, which is expressed in white or red softening of the tissues. As long as cerebrovascular accidents are at a transient level, their symptoms are treated, amenable to medication, restoration of motor and facial functions.

NMC manifests itself in acute and chronic nature, includes the passage of crises or strokes. Reversible disorders usually show vascular crises, but it should be noted that they are strong signals of strokes.

Clinical symptoms common to all vascular diseases:

• briefly lost and confused consciousness;
• the symmetry of the face is broken;
• nystagmus appears;
• speech becomes confused, little understood;
• epileptic seizures occur.

Vegetative signs appear:

• increased sweating with cold hands and feet;
• blanching or flushing of the skin;
• changes in heart rate and respiratory rhythm;
• blurred vision;
• nausea;
• instability in movements and in a static state.

If there are at least a few of the above symptoms, the doctor prescribes an examination in which the following have a special diagnostic value:

• development over several years of vascular diseases - hypertension, diabetes;
• appropriate presentation of complaints by the patient;
• indicators of research by a medical psychologist, here the MMSE scale is most often used, which reveals mental abilities;
• duplex scanning, which provides information about the localization of the affected vessels, the presence of malformations, the development of venous-type encephalopathy;
• MRI indicators - the most informative examination in modern medicine, detecting the smallest lesions;
• blood tests - clinical, for sugar;
• blood test for lipidogram, coagulogram.

Therapeutic measures

The treatment is aimed at stabilizing blood flow in the brain tissues, at stimulating neuronal metabolism. At the same time, the underlying disease of a vascular nature is actively treated, which, in the sum of the complexes, gives neurons effective protection against oxygen starvation.

An important direction of treatment is taking antihypertensive drugs, the same courses effectively prevent the formation of all kinds of blood circulation disorders in the brain. Non-drug methods of prevention and treatment in adults of symptoms of cerebrovascular accident are lowering blood pressure, reducing the amount of salt in the diet, getting rid of excess weight, and a calm lifestyle.

The drugs of the glycoside group normalize the work of blood vessels: Korglikon, Digoxin. Their reception must be combined with potassium complexes, diuretics. Doctors pay special attention to the normalization of blood pressure.

A sharp increase in pressure is removed by Eufillin, Dibazol. The decrease in blood pressure is corrected by vasotonic drugs, glucocorticosteroid hormones. To prevent cerebral edema, in a critical state of the patient, it is necessary to take dehydrated drugs - Lasix, Mannitol.

An ischemic stroke is a serious symptom of cerebrovascular accident, with the reasons clarified, the doctor prescribes targeted treatment:

• taking drugs that dilate blood vessels - Complamin, No-shpy;
• exposure to anticoagulants - Heparin, Warfarin;
• regular intake of antiplatelet agents - Curantyl, Plavix.

At the stage of recovery after active drug therapy, traditional physiotherapy procedures are carried out to resolve the issue of rehabilitation of lost functions. Here in the first place are physiotherapy, massage, exercise therapy. Doctors do not deny complex rehabilitation treatment and traditional medicine, they recommend old recipes tested for centuries.

To help doctors - grandmother's recipes

In addition to medications, which the therapist selects individually for each patient, a constant intake of light antihypertensive herbs in the minimum dosage is prescribed. This is done in order to constantly maintain the norm of blood pressure.

Symptoms of cerebrovascular accident are treated with folk remedies. Phytotherapeutists recommend drinking an infusion of hawthorn with wild rose every day: in a thermos, pour boiling water over 11 large rose hips, and 7 hawthorn berries. Insist night. Drink ¼ cup before meals. Dried hawthorn flowers are also used, brewed like tea so that the drink does not taste bitter.

Valerian extract also belongs to herbal preparations. Phytotherapeutists do not recommend drinking complex fees, so that the patient knows exactly the effect of each medicinal plant in order to exclude an allergic reaction to herbs.

• 3 equal parts of motherwort herb, cudweed herb, hawthorn flowers,
• 1 part chamomile flowers.

A mixture of dry herbs is made, and 1 tbsp is brewed with boiling water. l. mixture in 1 cup boiling water for 8 hours. Then the finished infusion is filtered, divided into 2 equal parts, drink 2 r. per day 1 hour after eating.

From folk remedies, vitamin and sedative herbal teas, climatotherapy, aromatherapy, hirudotherapy, oxygen and pine baths, wound up in fresh or sea water, depending on the location of the resort area, are shown. For aromatherapy, you can create all the conditions at home, in a pharmacy you can buy an aroma lamp, choose the right aroma for yourself personally, and enjoy folk treatment in the comfort of your home, not forgetting a cup of herbal tea.

Transient cerebrovascular accident (TICH)- short-term acute cerebral ischemia, accompanied by transient cerebral and focal symptoms, completely disappearing within no more than 24 hours from the onset of the attack. Clinical manifestations are varied, depending on the type and topic of PNMK. Diagnosis is carried out retrospectively and includes neurological, ophthalmological and cardiological examinations, the study of cerebral blood supply (Ultrasound, duplex scanning, MRA), radiography and CT of the spine. Treatment of PNMK is aimed at normalizing cerebral blood supply and metabolism, preventing relapses and preventing the occurrence of stroke. With hemodynamically significant occlusion of large arteries, surgical treatment by angiosurgeons is possible.

PNMK treatment

In mild cases, when PNMK lasts no more than an hour, therapy is carried out in an outpatient setting. For more severe manifestations or repeated PNMK, treatment is indicated in a neurological hospital. The main objectives in the treatment of PNMK are the improvement of cerebral circulation and the restoration of adequate metabolism of cerebral tissues.

Medications are prescribed that improve blood rheology (pentoxifylline, dextran). 3-5 daily intravenous drip injections are recommended for the course of treatment. Then a long-term intake of acetylsalicylic acid is prescribed. For patients with PNMK who have contraindications to taking salicylates (for example, in the presence of gastric ulcer), Bromocamphor is recommended. Of the neurometabolites, piracetam, porcine cerebral hydrolyzate, gamma-aminobutyric acid, vitamins gr. IN.

Normalization of blood pressure numbers is important. For this purpose, intravenous or intramuscular administration of dibazol, papaverine, intramuscular administration of magnesium sulfate, drotaverine are carried out. With systemic dizziness and severe vegetative symptoms, belladonna alkaloids, phenobarbital, belladonna extract, diazepam, and chlorpromazine are prescribed. Sedative therapy with valerian, trioxazine, tazepam, or elenium is recommended for 1-2 weeks from the moment of MI.

Diagnosed stenosis of the carotid artery exceeding 70% of its lumen is an indication for surgical treatment. On an individual basis, the choice of the most appropriate surgical tactics is carried out - eversion or classical carotid endarterectomy, stenting, prosthetics, carotid-subclavian bypass. Also, according to indications, stenting or prosthetics of the vertebral artery is performed.

Forecast and prevention of PNMK

In terms of the complete elimination of the neurological deficit that has arisen, PNMK has a favorable prognosis. Unfavorable is the typical repeatability for PNMK. The frequency of relapses can reach up to several times a year. Each subsequent episode of MIMC increases the likelihood of ischemic stroke. The prognosis is most favorable for PNMK in the basin of the internal auditory artery. With localization of disorders in the carotid basin, the prognosis is worse than with LIMC of the vertebrobasilar region. Typically, these patients have a stroke within 1 year.

The basis for the prevention of PNMK is a healthy lifestyle, excluding factors that adversely affect the state of blood vessels - smoking, taking large doses of alcohol, excessive consumption of animal fats. Preventive measures include control of blood pressure, blood sugar, lipid spectrum; adequate treatment of arterial hypertension, diabetes mellitus, vascular diseases. Secondary prevention of PNMK consists in regular observation by a neurologist with the passage of repeated courses of vascular therapy.

Disorders of the arterial circulation of the brain: forms, signs, treatment

In recent years, the percentage of mortality from pathological lesions of the cerebral vessels has significantly increased, which were previously associated with aging and were diagnosed only in elderly people (after 60 years). Today, the symptoms of cerebrovascular accident have rejuvenated. And people under the age of 40 often die from a stroke. Therefore, it is important to know the causes and mechanism of their development, so that diagnostic and therapeutic measures give the most effective result.

What is cerebrovascular accident (MK)

The vessels of the brain have a peculiar, perfect structure that ideally regulates blood flow, ensuring the stability of blood circulation. They are designed in such a way that with an increase in blood flow to the coronary vessels by about 10 times during physical activity, the amount of circulating blood in the brain, with an increase in mental activity, remains at the same level. That is, there is a redistribution of blood flow. Part of the blood from parts of the brain with a lower load is redirected to areas with enhanced brain activity.

However, this perfect process of blood circulation is disturbed if the amount of blood entering the brain does not satisfy its need for it. It should be noted that its redistribution among brain regions is necessary not only for its normal functionality. It also occurs when various pathologies occur, for example, (narrowing) or obturation (closure). As a result of impaired self-regulation, there is a slowdown in the speed of blood movement in certain parts of the brain and them.

Types of violations of MC

There are the following categories of blood flow disorders in the brain:

1. Acute (strokes) that occur suddenly with a long course, and transient, the main symptoms of which (visual impairment, loss of speech, etc.) last no more than a day.
2. Chronic, caused. They are divided into two types: origin and caused.

Acute disorders of cerebral circulation (ACC)

Acute cerebrovascular accident causes persistent disorders of brain activity. It is of two types: and (it is also called a cerebral infarction).

hemorrhagic

Etiology

Hemorrhage (hemorrhagic disturbance of blood flow) can be caused by various arterial hypertension, congenital, etc.

Pathogenesis

As a result of an increase in blood pressure, the plasma and proteins contained in it are released, which leads to plasma impregnation of the walls of blood vessels, causing their destruction. A peculiar hyaline-like specific substance (a protein resembling cartilage in its structure) is deposited on the vascular walls, which leads to the development of hyalinosis. Vessels resemble glass tubes, lose their elasticity and ability to hold blood pressure. In addition, the permeability of the vascular wall increases and blood can freely pass through it, soaking the nerve fibers (diapedetic bleeding). The result of such a transformation can be the formation of microaneurysms and rupture of the vessel with hemorrhage and blood entering the white medulla. Thus, hemorrhage occurs as a result of:

• Plasma impregnation of the walls of the vessels of the white medulla or visual tubercles;
• diapedetic bleeding;
• formation of microaneurysms.

Hemorrhage in the acute period is characterized by the development of hematomas during wedging and deformation of the brain stem into the tentorial foramen. At the same time, the brain swells, extensive edema develops. There are secondary hemorrhages, smaller ones.

Clinical manifestations

Usually occurs during the day, during a period of physical activity. Suddenly, the head starts to hurt badly, there are nauseating urges. Consciousness is confused, a person breathes often and with a whistle, occurs, accompanied by hemiplegia (unilateral paralysis of the limbs) or hemiparesis (weakening of motor functions). Lost basic reflexes. The gaze becomes motionless (paresis), anisocoria (pupils of different sizes) or divergent strabismus occurs.

Treatment

Treatment of this type of cerebrovascular accident includes intensive therapy, the main goal of which is to lower blood pressure, restore vital (automatic perception of the external world) functions, stop bleeding and eliminate cerebral edema. In this case, the following medicines are used:

1. Decreasing - ganglionic blockers ( Arfonad, Benzohexanium, Pentamine).
2. To reduce the permeability of the walls of blood vessels and increase blood clotting - Dicynon, vitamin C, Vikasol, Calcium gluconate.
3. To increase the rheology (fluidity) of blood - Trental, Vinkaton, Cavinton, Eufillin, Cinnarizine.
4. Inhibiting fibrinolytic activity - ACC(aminocaproic acid).
5. Decongestant - Lasix.
6. Sedative drugs.
7. A lumbar puncture is prescribed to reduce intracranial pressure.
8. All drugs are administered by injection.

Ischemic

Etiology

ischemic NMC due to atherosclerotic plaque

Ischemic circulatory disorders are most often caused by atherosclerosis. Its development can provoke strong excitement (stress, etc.) or excessive physical activity. It can occur during a night's sleep or immediately after waking up. Often accompanies a pre-infarction state or.

Symptoms

They may appear suddenly or increase gradually. They manifest themselves in the form of headaches, hemiparesis on the side opposite to the lesion. Disturbance of coordination of movement, as well as visual and speech disorders.

Pathogenesis

An ischemic disorder occurs when an area of ​​the brain does not receive enough blood. In this case, a focus of hypoxia arises, in which necrotic formations develop. This process is accompanied by a violation of basic brain functions.

Therapy

The treatment uses injections of drugs to restore the normal functioning of the cardiovascular system. These include: Corglicon, Strofantin, Sulfocamphocaine, Reopoliklyukin, Cardiamin. Intracranial pressure decreases Mannitol or Lasix.

Transient cerebrovascular accident

Transient cerebrovascular accident (TIMC) occurs against the background of arterial hypertension or atherosclerosis. Sometimes the cause of its development is their combination. The main symptoms of PNMK are manifested in the following:

• If the focus of the pathology is located in the basin of the carotid vessels, the patient becomes numb half of the body (on the opposite side of the focus) and part of the face around the lips, paralysis or short-term paresis of the extremities is possible. Speech is impaired, an epileptic seizure may occur.
• In case of circulatory disorders, the patient's legs and arms weaken, it is difficult for him to swallow and pronounce sounds, photopsia occurs (appearance of luminous points, sparks, etc. in the eyes) or diplopia (doubling of visible objects). He loses his bearings, he has memory lapses.
• Signs of cerebrovascular accident against the background of hypertension are manifested in the following: the head and eyeballs begin to hurt badly, the person experiences drowsiness, he has stuffy ears (as in an airplane during takeoff or landing) and nauseating urges. The face turns red, sweating increases. Unlike strokes, all these symptoms disappear within a day. For this they received the name.

PNMK is treated with antihypertensive, tonic and cardiotonic drugs. Antispasmodics are used, and. The following medications are prescribed:

Dibazol, Trental, Clonidine, Vincamine, Eufillin, Cinnarizine, Cavinton, Furasemide, beta-blockers. As tonic - alcohol tinctures of ginseng and Schisandra chinensis.

Chronic disorders of cerebral circulation

Chronic cerebrovascular accident (CIC), in contrast to acute forms, develops gradually. There are three stages of the disease:

1. In the first stage, the symptoms are vague. They are more like chronic fatigue syndrome. A person quickly gets tired, his sleep is disturbed, he often hurts and his head is spinning. He becomes short-tempered and distracted. He often changes his mood. He forgets some minor things.
2. In the second stage, chronic cerebrovascular accident is accompanied by a significant memory impairment, small motor dysfunctions develop, causing unsteady gait. There is constant noise in the head. A person does not perceive information well, with difficulty concentrating his attention on it. He is gradually degrading as a person. Becomes irritable and insecure, loses intelligence, reacts inadequately to criticism, often becomes depressed. He is constantly dizzy and has a headache. He always wants to sleep. Efficiency - reduced. He does not adapt well socially.
3. In the third stage, all symptoms intensify. Personality degradation turns into, memory suffers. Leaving the house alone, such a person will never find his way back. Motor functions are impaired. This is manifested in the tremor of the hands, stiffness of movements. Speech impairment, uncoordinated movements are noticeable.

Violation of cerebral circulation is dangerous because if treatment is not carried out in the early stages, neurons die - the main units of the brain structure, which cannot be resurrected. Therefore, early diagnosis of the disease is so important. It includes:

• Identification of vascular diseases that contribute to the development of cerebrovascular accidents.
• Making a diagnosis based on the patient's complaints.
• Conducting a neuropsychological examination on the MMSE scale. It allows you to detect cognitive impairment by testing. The absence of violations is evidenced by 30 points scored by the patient.
• Duplex scanning in order to detect lesions of cerebral vessels by atherosclerosis and other diseases.
• Magnetic resonance imaging, which allows to detect small hypodense (with pathological changes) foci in the brain.
• Clinical blood tests: complete blood count, lipid spectrum, coagulogram, glucose.

Etiology

The main causes of cerebrovascular accident are as follows:

1. Age. Basically, they occur in people who have stepped into their fifth decade.
2. genetic predisposition.
3. Traumatic brain injury.
4. Overweight. Obese people often suffer from hypercholesterolemia.
5. Physical inactivity and increased emotionality (stress, etc.).
6. Bad habits.
7. Diseases: diabetes mellitus (insulin-dependent) and atherosclerosis.
8. Hypertension. High blood pressure is the most common cause of strokes.
9. In old age, blood flow disorders in the brain can lead to:
   • shimmering ,
   • various diseases of the hematopoietic organs and blood,
   • chronic,

Treatment

In chronic disorders of blood flow in the brain all therapeutic measures are aimed at protecting the neurons of the brain from death as a result of hypoxia, stimulate metabolism at the level of neurons, normalize blood flow in brain tissues. Medicines for each patient are selected individually. They should be taken in a strictly specified dosage, constantly monitoring blood pressure.

In addition, for disorders of cerebral circulation, accompanied by manifestations of a neurological nature, antioxidants, vasodilators, drugs that increase blood microcirculation, sedatives and multivitamins are used.

Chronic cerebrovascular accident can also be treated with traditional medicine, using various fees and herbal teas. Especially useful is the infusion of hawthorn flowers and the collection, which includes chamomile, marsh cudweed and motherwort. But they should be used as an additional treatment course that enhances the main drug therapy.

Overweight people who are at risk for developing atherosclerosis due to need to pay attention to nutrition. For them, there are special diets, which you can learn about from a dietitian who monitors the organization of nutrition for patients who are being treated in a hospital at any hospital. Dietary products include everything of vegetable origin, seafood and fish. But milk products, on the contrary, should be low in fat.

If the cholesterolemia is significant, and the diet does not give the desired results, the drugs included in the group are prescribed: Liprimar, Atorvakar, Vabarin, Torvakard, Simvatin. With a large degree of narrowing of the lumen between the walls of the carotid arteries (more than 70%), a carotid (surgical operation) is required, which is performed only in specialized clinics. With stenosis less than 60%, conservative treatment is sufficient.

Rehabilitation after acute cerebrovascular accident

Drug therapy can stop the course of the disease. But she cannot return the opportunity to move. Only special gymnastic exercises can help with this. We must be prepared for the fact that this process is quite lengthy and be patient. Relatives of the patient should learn how to perform massage and therapeutic exercises, since it is they who will have to do them to him for six months or more.

Kinesiotherapy is shown as the basis for early rehabilitation after a dynamic violation of cerebral circulation in order to fully restore motor functions. It is especially necessary in the restoration of motor skills, as it contributes to the creation of a new model of the hierarchy of the nervous system for the implementation of the physiological control of the body's motor functions. The following methods are used in kinesitherapy:

1. Gymnastics "Balance", aimed at restoring coordination of movements;
2. The Feldenkrais Reflex System.
3. Vojta system, aimed at restoring motor activity by stimulating reflexes;
4. Microkenisotherapy.

Passive gymnastics "Balance" is assigned to every patient with impaired cerebral circulation, as soon as consciousness returns to him. Usually relatives help the patient to perform it. It includes kneading the fingers and toes, flexion and extension of the limbs. Exercises begin to be performed from the lower extremities, gradually moving up. The complex also includes kneading the head and cervical regions. Before starting the exercises and finishing the gymnastics should be light massaging movements. Be sure to monitor the patient's condition. Gymnastics should not cause him overwork. The patient can independently perform exercises for the eyes (squinting, rotation, fixing the gaze at one point, and some others). Gradually, with the improvement of the general condition of the patient, the load is increased. For each patient, an individual recovery method is selected, taking into account the characteristics of the course of the disease.

Photo: basic exercises of passive gymnastics

The Feldenkrais Method- This is a therapy that gently affects the human nervous system. It contributes to the complete restoration of mental abilities, physical activity and sensuality. It includes exercises that require smooth movement during execution. The patient must focus on their coordination, make each movement meaningful (consciously). This technique forces you to divert attention from the existing health problem and focus it on new achievements. As a result, the brain begins to "remember" the old stereotypes and returns to them. The patient is constantly exploring his body and its capabilities. This allows you to find quick ways to get him moving.

The methodology is based on three principles:

• All exercises should be easy to learn and remember.
• Each exercise should be performed smoothly, without muscle strain.
• Performing the exercise, a sick person should enjoy the movement.

But most importantly, you should never divide your achievements into high and low.

Additional rehabilitation measures

Breathing exercises are widely practiced, which not only normalizes blood circulation, but also relieves muscle tension arising under the influence of gymnastic and massage loads. In addition, it regulates the respiratory process after performing therapeutic exercises and gives a relaxing effect.

With disorders of cerebral circulation, the patient is prescribed bed rest for a long time. This can lead to various complications, for example, a violation of the natural ventilation of the lungs, the appearance of bedsores and contractures (mobility is limited in the joint). Prevention of bedsores is the frequent change of position of the patient. It is recommended to turn it over on the stomach. At the same time, the feet hang down, the shins are located on soft pillows, under the knees there are cotton pads lined with gauze.

1. Give the patient's body a special position. In the first days, he is transferred from one position to another by relatives caring for him. This is done every two or three hours. After stabilizing blood pressure and improving the general condition of the patient, they are taught to do it themselves. Early seating of the patient in bed (if health permits) will not allow contractures to develop.
2. Do the massage necessary to maintain normal muscle tone. The first days it includes light stroking (with increased tone) or kneading (if muscle tone is reduced) and lasts only a few minutes. In the future, massage movements are intensified. Rubbing is allowed. The duration of massage procedures also increases. By the end of the first half of the year, they can be completed within an hour.
3. Perform exercise therapy exercises, which, among other things, effectively fight synkinesis (involuntary muscle contractions).
4. Vibrostimulation of paralyzed parts of the body with an oscillation frequency of 10 to 100 Hz gives a good effect. Depending on the condition of the patient, the duration of this procedure can vary from 2 to 10 minutes. It is recommended to carry out no more than 15 procedures.

For cerebrovascular accidents, alternative methods of treatment are also used:

• Reflexology including:
  1. Treatment with smells (aromatherapy);
  2. classic version of acupuncture;
  3. acupuncture to reflex points located on the auricles (auricol therapy);
  4. acupuncture of biologically active points on the hands (su-Jack);
• Coniferous baths with the addition of sea salt;
• Oxygen baths.

Video: rehabilitation after a stroke, the program "Live healthy!"

Read more about comprehensive rehabilitation after strokes and ischemic attacks.

Consequences of NMK

Acute cerebrovascular accident has serious consequences. In 30 cases out of a hundred people who have had this disease become completely helpless.

1. He cannot eat, perform hygiene procedures, dress himself, etc. on his own. Such people have a completely impaired ability to think. They lose track of time and do not orient themselves in space at all.
2. Some people still have the ability to move. But there are many people who, after a violation of cerebral circulation, forever remain bedridden. Many of them keep a clear mind, understand what is happening around them, but are devoid of speech and cannot put into words their desires and express feelings.

Disability is a sad result of acute and in many cases chronic disorders of cerebral circulation. About 20% of acute cerebrovascular accidents are fatal.

But it is possible to protect yourself from this serious disease, regardless of which category of classification it belongs to. Although many people neglect it. This is an attentive attitude to your health and all the changes that occur in the body.

• Agree that a healthy person should not have headaches. And if you suddenly feel dizzy, it means that there is some kind of deviation in the functioning of the systems responsible for this organ.
• Elevated temperature is an indication of a malfunction in the body. But many go to work when it is 37 ° C, considering it normal.
• Does it happen for a short time? Most people rub them without asking the question: why is this happening?

Meanwhile, these are the satellites of the first minor changes in the blood flow system. Often, an acute cerebrovascular accident is preceded by a transient one. But since its symptoms disappear within a day, not every person is in a hurry to see a doctor in order to be examined and receive the necessary medical treatment.

Today, doctors have effective drugs in service -. They literally work wonders, dissolving blood clots and restoring cerebral circulation. However, there is one "but". To achieve maximum effect, they should be administered to the patient within three hours after the onset of the first symptoms of a stroke. Unfortunately, in most cases, seeking medical help is too late, when the disease has passed into a severe stage and the use of thrombolytics is no longer useful.

Video: brain blood supply and the consequences of a stroke