Small foci of discirculation in the cerebral hemispheres description. Discirculatory changes how to treat

The human body is not eternal and with age it develops various pathological processes. The most dangerous among them are focal changes in the substance of the brain of a discirculatory nature. They occur as a result of impaired cerebral blood flow. Such a pathological process manifests itself in a number of ways and is characterized by a progressive course. It will no longer be possible to return the lost nerve cells to life, but it is possible to slow down the course of the disease or even prevent its development.

What to do with a focal change in the substance of the brain should tell the doctor, but the patient himself can suspect the presence of pathology. The disease often has a postischemic origin. It is characterized by a violation of blood flow in one of the sections of the hemisphere (hemisphere). It is difficult for some people to understand what it is, therefore, for convenience, the development of changes in the brain substance was divided into 3 stages:

First stage. At this stage, signs of focal lesions in the substance of the brain do not appear. The patient may feel only slight weakness, dizziness and apathy. Occasionally, sleep is disturbed and headaches bother. Foci of vascular genesis are just emerging and there are small disruptions in the blood flow;
Second phase. As the pathology develops, the course of the disease worsens. This manifests itself in the form of a migraine, a decrease in mental abilities, ringing in the ears, outbursts of emotions and a disorder in coordination of movements;
Third stage. If the disease has reached this stage, then focal changes have irreversible consequences. Most of the neurons die and the patient's muscle tone rapidly decreases. Over time, symptoms of dementia (dementia) appear, the sense organs cease to perform their functions, and the person completely loses control over his movements.

Subcortical lesions in the white matter, localized under the cerebral cortex, may not appear at all for a long time. Diagnosis of such failures is mostly accidental.

Changes in the white matter of the frontal lobes are manifested much more actively and mainly in the form of a decrease in mental abilities.

At-risk groups

If there are no signs of the disease, it is advisable to find out what risk groups this disease has. According to statistics, focal lesions often occur in the presence of such pathologies:

Atherosclerosis;
High pressure;
VVD (vegetovascular dystonia);
Diabetes;
Pathology of the heart muscle;
Constant stress;
Sedentary work;
Abuse of bad habits;
Overweight.

Damage to the white matter of the brain of vascular origin may appear as a result of age-related changes. Usually there are small single foci in people after 60 years.

Dystrophic nature of damage

In addition to damage caused by vascular genesis, there are other types of disease, for example, single focal changes in the substance of the brain of a dystrophic nature. This type of pathology occurs due to lack of nutrition. The reasons for this phenomenon are as follows:

Weakened blood supply;
Osteochondrosis of the cervical region in the acute stage;
oncological diseases;
Head injury.

Damage to the substance of the brain of a dystrophic nature usually manifests itself due to a lack of nutrition of the brain tissues. The patient has the following symptoms:

Decreased brain activity;
dementia;
Headache;
Weakening of muscle tissue (paresis);
Paralysis of certain muscle groups;
Dizziness.

Diagnostics

In most people, with age, focal changes in the substance appear due to tissue degeneration or due to disruptions in the blood flow. You can see them using magnetic resonance imaging (MRI):

Changes in the cerebral cortex. Such a focus occurs mainly due to blockage or clamping of the vertebral artery. This is usually associated with congenital anomalies or the development of atherosclerosis. In rare cases, along with the appearance of a focus in the cerebral cortex, a vertebral hernia occurs;
Multiple focal changes. Their presence usually indicates a pre-stroke condition. In some cases, they can prevent dementia, epilepsy and other pathological processes associated with vascular atrophy. If such changes are detected, a course of therapy should be started urgently to prevent irreversible consequences;
microfocal changes. Such damage is found in virtually every person after 50-55 years. You can see them with the use of a contrast agent only if they have a pathological nature of occurrence. Small-focal changes are not particularly evident, but as they develop, they can cause a stroke;
Changes in the white matter of the frontal and parietal lobes subcortically and periventricularly. This type of damage occurs due to constantly elevated pressure, especially if a person has had a hypertensive crisis. Sometimes small single foci are congenital. The danger arises from the growth of lesions in the white matter of the frontal and parietal lobes subcortically. In such a situation, the symptoms gradually progress.

If a person is at risk, then an MRI of the GM (brain) should be done once a year. Otherwise, it is advisable to do such an examination every 2-3 years for prevention. If MRI shows a high echogenicity of the focus of disculatory genesis, then this may indicate the presence of an oncological disease in the brain.

Methods of dealing with pathology

Gradually affecting human brain tissue, the disease can cause irreversible consequences. To prevent changes in the white matter of the brain of a vascular nature, it will be necessary to stop the emerging symptoms and improve blood flow with the help of medications and physiotherapy. Treatment should be comprehensive, which means you will have to change your lifestyle. To do this, you will have to follow these rules:

Active lifestyle. The patient should move more and play sports. After eating, it is advisable to go for a walk and do the same before going to bed. Water treatments, skiing and running are good. Treatment with an active lifestyle improves the general condition, and also strengthens the cardiovascular system;
Properly formulated diet. For successful treatment, you will have to give up alcoholic beverages and reduce the consumption of sweets, conservation, as well as smoked and fried foods. You can replace them with boiled food or steaming. Instead of purchased sweets, you can cook a homemade pie or eat fruit;
Avoidance of stress. Constant mental stress is one of the causes of many diseases, so it is advisable to relax more and not overwork;
Healthy sleep. A person should sleep at least 6-8 hours a day. In the presence of pathology, it is desirable to increase the sleep time by 1-2 hours;
Annual survey. If a change in the white matter of the brain is diagnosed, then the patient should undergo an MRI 2 times a year. It is imperative to follow all the recommendations of the doctor and take the necessary tests on time.

Treatment of focal changes usually consists of lifestyle changes and the elimination of the cause of their development. It is desirable to detect the problem immediately in order to be able to slow it down. For this, a complete examination should be carried out annually.

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Focal brain lesions can be caused by trauma, infectious disease, vascular atrophy, and many other factors. Often, degenerative changes are accompanied by problems associated with a violation of the normal functions of life and coordination of human movement.

MRI in focal brain lesions helps to identify the problem in the early stages, coordinate drug therapy. If necessary, based on the results of the examination, minimally invasive surgery can be prescribed.

Signs of focal lesions

All violations of the activity of the brain are reflected in the natural daily functions of human life. The location of the lesion affects the functioning of the internal organs and the muscular system.

Changes in vascular genesis can lead to mental disorders, cause high blood pressure, stroke, and other unpleasant consequences. On the other hand, subcortical foci may not have clinical manifestations and be asymptomatic.

One of the clear signs of the presence of a focal lesion is:

Hypertension - lack of oxygen supply to the brain caused by vascular degeneration leads to the fact that the brain speeds up and increases blood circulation.
epileptic seizures.
Mental disorders - occur in the pathology of the subarachnoid spaces, accompanied by hemorrhage. At the same time, congestion in the fundus may be observed. A characteristic feature of the pathology is the rapid formation of darkening, bursting of blood vessels and retinal rupture, which makes it possible to determine the probable site of a focal lesion.
Strokes - clearly defined focal changes in the brain of a vascular nature on MRI allow you to establish a pre-stroke state and prescribe appropriate therapy.
Pain syndrome - chronic headaches, migraine may indicate the need for a general examination of the patient. Ignoring symptoms can lead to disability or death.
Involuntary muscle contractions.

Signs of single focal changes in the substance of the brain of a dyscirculatory nature on magnetic resonance imaging mean that the patient has certain deviations in the functioning of the vascular system. Most often it is associated with hypertension. The attending physician will provide the diagnosis and explanation of the results of the study.

Carrying out diagnostics of changes

The picture of focal changes in the substance of the brain of a dystrophic nature is observed, according to various sources, from 50 to 80% of all people as they age. Ischemia, as a result of which the normal blood supply stops, causes a provoking change in the soft tissues. Resonance tomography helps to identify the causes of disorders and conduct a differential analysis of the disease.

Small focal changes that do not cause concern at first can eventually cause a stroke. In addition, foci of increased echogenicity of vascular origin may indicate an oncological cause of disorders.

Timely identification of the problem helps to prescribe the most effective therapy. The focus of discirculatory genesis, clearly visible on MRI, may indicate the following pathologies:

In the cerebral hemispheres - indicates the following possible causes: blocking the blood flow of the right vertebral artery through a congenital anomaly or atherosclerotic plaque. The condition may be accompanied by a hernia of the cervical spine.
In the white matter of the frontal lobe - the causes of changes can be ordinary hypertension, especially after a crisis. Some anomalies and single small foci in the substance are congenital and pose a threat to normal life. Fears are caused by a tendency to increase the area of the lesion, as well as accompanying changes with impaired motor functions.
Multiple focal changes in the substance of the brain indicate the presence of serious deviations in the genesis. It can be caused both by a state before a stroke, and senile dementia, epilepsy and many other diseases, the development of which is accompanied by vascular atrophy.
If the conclusion of the MRI indicates the diagnosis: "signs of multifocal brain damage of a vascular nature" - this is a reason for certain concerns. The attending physician will be required to establish the cause of the changes and determine the methods of conservative and restorative therapy.
On the other hand, microfocal changes occur in almost every patient after 50 years. Foci are visible in the angiography mode, if the cause is a violation in the genesis.

If a focus of a dystrophic nature is detected, the therapist will definitely prescribe the collection of a general history of the patient. In the absence of additional reasons for concern, it will be recommended to regularly monitor trends in the development of pathology. Substances may be prescribed to stimulate circulation.

Changes in the substance of the brain of a dyscirculatory-dystrophic nature indicate more serious problems. Pressure and lack of circulation can be caused by trauma or other causes.

Signs of small-focal brain damage with vascular etiology of moderate expansion can cause the diagnosis of encephalopathy, congenital and acquired. Some medications can only exacerbate the problem. Therefore, the therapist will check the relationship between medication and ischemia.

Any pathological and degenerative changes should be well studied and verified. The cause of the focal lesion was determined, and according to the results of MRI, prevention or treatment of the detected disease was prescribed.

Topics directly related to diseases of the brain are the most serious medical issues. In particular, this concerns circulatory disorders in the vascular system of the brain and spinal cord.

blood circulation is a physiological mechanism that is aimed at maintaining a constant level of blood circulation during various changes in systemic blood flow and which compensates for changes in the chemistry of the environment or blood surrounding the vessels.

Violation of the blood supply to any area of the brain usually leads to brain damage, while its severity is determined by the level of decrease in cerebral blood flow. The area of the brain in which the level of blood flow becomes less than 10 ml / 100 g per minute is irreversibly damaged, and destructive changes in the brain tissues develop instantly - within 5-10 minutes.

There are many different reasons leading to a violation of the brain. The severity and localization of changes in the brain tissues, the area of blood supply to the damaged vessel, the mechanisms that give rise to circulatory disorders, the individual characteristics of the patient - all these changes in the brain tissues are called morphological signs of the disease. They are determined by MRI. Carefully considering these morphological features, among them one can single out cerebrovascular accidents of diffuse and focal character.

Focal changes in the substance of the brain are diseases that reveal lesions not of the entire brain, but only of a part or individual parts. Such diseases include cerebral infarction, hemorrhagic stroke, intrathecal hemorrhages. The very nature of the disease can be of different types: postischemic, dystrophic and dyscirculatory are distinguished. It is the latter that will be discussed.

Focal changes in the substance of the brain of a dyscirculatory nature - this is the name of diseases that are closely associated with chronic and slowly progressive disorders of cerebral and spinal circulation. Such diseases are quite difficult. Usually they are accompanied by dizziness, headaches, noise in the head and ears, sleep disturbances, decreased performance.

Focal changes of a dyscirculatory nature in the initial stages are quite difficult to detect. This is due to the fact that the condition does not have pronounced symptoms: as a rule, there are only scattered microsymptoms. Such focal changes in the substance of the brain are usually accompanied by the following diseases: atherosclerosis, arterial hypertension, neurosis, and vasomotor dystonia.

In other words, in simpler terms, focal lesions of the brain substance of a dyscirculatory nature are lesions of individual parts of the brain due to impaired blood supply and impaired blood circulation.

When conducting CT (MR) studies in the substance of the brain, it is possible to detect foci of a dystrophic nature (like gliosis), atrophic nature (like a cerebrospinal fluid cyst), as well as calcifications. In chronic tissue ischemia, some other characteristic changes can also be detected, for example, periventricular leukoaraiosis (a change in the structure and density of the substance around the ventricles), often with the presence of small cysts in the basal ganglia, as well as in the outer and inner capsule of the brain. Quite often also signs (replacement character) come to light.

Causes and Predisposing Factors of Changes in the Brain

Focal changes include pathological processes that occur in a specific area of the brain. In the brain tissues, modifications of a different nature occur (scars, cysts, necrosis). The most often focal changes of a dystrophic nature are found:

In the elderly. Thus, the probability of detecting dystrophic foci significantly increases with age. Pathological changes in intra- and extracranial vessels, narrowing of the vascular lumen and brain ischemia provoked by these factors play a role here.
In persons with diabetes mellitus. With this pathology, angiopathy often occurs, manifested by changes in the vascular wall, impaired vascular permeability, and impaired vascular patency. Against this background, strokes often also occur.
In people with other angiopathy, anomalies in the development of the vascular bed of the brain (for example, an open circle of Willis), thrombosis (violations of the lumen of another etiology) of extra- and intracranial arteries.
In persons with exacerbation of cervical osteochondrosis. With a disease, the brain ceases to receive oxygen in sufficient quantities. As a result of oxygen starvation, areas of ischemia appear.
Those who have suffered a trauma of the skull, brain. Restructuring of the brain substance in the focus of contusion after injury can lead to the appearance of a focus of gliosis, cysts or calcification.
In persons exposed to long-term intoxication (exo- or endogenous). So, the first group can include people who abuse alcohol, take toxic substances (or are exposed to them in production, for example, workers in paint production shops). To the second - people with long-term current diseases (infectious, inflammatory).
In patients with oncological processes of the brain, dystrophic foci are found during examination.

Methods for detecting dystrophic foci in the brain

The main methods for detecting dystrophic (and other) parenchymal lesions in the brain are CT and MRI. In this case, the following changes can be identified:

Foci of the type of gliosis.
Cystic areas due to atrophy (and trauma).
Calcifications (as an example, due to hematoma impregnation with calcium salts).
Periventricular leukoaraiosis. Although not directly related to focal changes, it is a significant marker of chronic ischemia.

On the CT scan at the level of the third ventricle and the posterior horns of the lateral ventricles, blue arrows indicate areas of a cystic nature (the result of necrosis of the brain substance in the past): a small one in the area of the right thalamus and a larger one in the occipital lobe on the right. There is also a change in the density of the substance of the brain around the posterior horn of the right lateral ventricle. The Sylviian fissures are enlarged, which indicates hydrocephalus (atrophic, replacement).

On the CT scan at the level of the bodies of the lateral ventricles, blue arrows indicate cystic (atrophic) areas in the parietal and occipital lobes on the right (consequences of a stroke). There are also signs of chronic cerebral ischemia, more pronounced on the right (periventricular leukoaraiosis).

CT scan of the head at the level of the 4th ventricle, cerebellar peduncles: in the left hemisphere of the cerebellum (at the base, near the left cerebellar peduncle) there is an atrophic area (consequences of a stroke). Pay attention to how the external cerebrospinal fluid spaces of the brain are expanded.

Blue arrows on the CT scan indicate areas of periventricular leukoaraiosis (around the anterior and posterior horns of both lateral ventricles). The red arrow also indicates "fresh" (on the right in the occipital lobe).

The presence of dystrophic focal changes in the brain in many cases is a consequence of chronic ischemia and is often combined with atrophic (replacement) hydrocephalus, especially in people who take alcohol for a long time, are exposed to intoxications of a different nature, have had a stroke or a head injury.

On the scan (CT) of the head, there are signs of replacement hydrocephalus (due to necrosis of the brain parenchyma), with the presence of multiple foci of an atrophic nature on the left side - in the occipital lobe (1), in the parietal lobe (2) and on the right side - in the region of the head of the lenticular nucleus , periventricular to the body of the ventricle (3). The diameter of the lateral ventricles is expanded (marked with an arrow). Around the horns of the lateral ventricles there is a hypodense (low density on CT) zone.

Results

Dystrophic focal changes can be detected by CT and MRI in the brain of any person. Their detection may indicate a past pathology (traumatic, ischemic). If the foci are small in size and localized in the peripheral parts of the brain or in the white matter, basal ganglia, the prognosis for the patient's future life is favorable. But focal changes in the stem localization, on the legs of the brain, the thalamus are more unfavorable and may be the cause of the appearance of neurological symptoms.

Sooner or later, all people grow old, and the body ages along with them. It primarily affects the heart, brain and spinal cord. If the heart ceases to properly cope with its task - pumping blood - then over time this will affect the state of the brain, the cells of which will not receive enough nutrients to sustain life.

According to various sources, from 50 to 70% of the elderly (over 60 years) suffer from a similar disease.

Symptoms of dystrophy of the substance of the brain

Any disease is better to prevent than to treat later, and for this you need to know its external manifestations (signs) and symptoms.

First stage. In the first couple, a person feels a little tired, lethargic, dizzy and does not sleep well. This is due to poor blood circulation in the brain. The degree of significance grows along with the development of vascular diseases: cholesterol deposition, hypotension, etc.
Second stage. At the second stage, the so-called “center of the disease” appears in the brain, the damage to the substance of the brain deepens due to poor blood circulation. Cells do not receive sufficient nutrition and gradually die off. The beginning of this stage is indicated by memory impairment, loss of coordination, noise or “shooting” in the ears, and severe headaches.
Third stage. Due to the discircular nature of the course of the last stage, the focus of the disease moves even deeper, the affected vessels bring too little blood to the brain. The patient shows signs of dementia, lack of coordination of movements (not always), dysfunction of the sense organs is possible: loss of vision, hearing, shaking hands, etc.

It is possible to establish the exact change in the substance of the brain using MRI.

In the absence of treatment, over time, diseases such as:

. The most common form of degeneration of the nervous system.
Pick's disease. A rare progressive disease of the nervous system, manifested from 50-60 years.
Huntington's disease. Genetic disease of the nervous system. developing from 30-50 years.
Cardiocerebral syndrome (impairment of the basic functions of the brain due to cardiac pathology).

Reasons for change

As already mentioned, the main cause of the manifestation of the disease is vascular damage that inevitably arise with age. But for some, these lesions are minimal: small cholesterol deposits, for example, - while for someone they develop into pathology. So, diseases lead to a change in the substance of the brain of a dystrophic nature:

Ischemia. This disease is mainly characterized by a violation of the blood circulation of the brain.
Cervical osteochondrosis.
Tumor (or).
Severe head injury. In this case, age does not matter.

Risk group

Any disease has a risk group, people who are in it should be extremely careful. If a person has similar diseases, then he is in the primary risk group, if only predispositions, then in the secondary:

Suffering from diseases of the cardiovascular system: hypotension, hypertension, hypertension, dystonia.
Patients with diathesis, diabetes mellitus or stomach ulcers.
Those who are overweight or have an unhealthy eating habit.
Being in a state of chronic depression (stress) or leading a sedentary lifestyle.
People over 55-60 years old, regardless of gender.
Those suffering from rheumatism.

For people of the main risk group, first of all, it is necessary to cure the underlying disease, followed by the recovery of the brain. Particular attention should be paid to patients with hypertension and all its manifestations.

How to overcome?

Despite the complexity of the disease and the problems with its diagnosis, each person can avoid such a fate by helping his body fight the signs of old age or the consequences of a serious injury. To do this, follow simple rules.

Firstly, lead an active lifestyle. Walk or jog for at least two hours a day. Walk in the fresh air: in the forest, in the park, go out of town, etc. Play outdoor games that correspond to physical abilities: basketball, pioneer ball, volleyball, tennis or table tennis, etc. The more movement, the more actively the heart works, and the vessels become stronger.

Secondly, proper nutrition. Eliminate or minimize the consumption of alcohol, excessively sweet and salty foods and fried foods. This does not mean that you have to keep yourself on the strictest diet! If you want meat, then you don’t need to fry it or drip sausage, it’s better to boil it. Same thing with potatoes. Instead of cakes and pastries, you can treat yourself to homemade apple and strawberry pies from time to time. All harmful dishes and products can be replaced with their equivalents.

Third, avoid stressful situations and overwork. The mental state of a person directly affects his health. Do not overwork yourself, rest, if you are tired, sleep at least 8 hours a day. Do not overwork yourself with physical activity.

Fourth, Get medical check-ups 1-2 times a year to control the state of the body. Especially if you are already undergoing treatment!

It is best not to try to help your body with “home methods”: drink medicines on your own, inject injections, etc. Follow the instructions of the doctor, go through the procedures that he will prescribe. Sometimes, to determine the accuracy of the diagnosis, it is necessary to undergo many procedures, taking tests is a normal situation.

A responsible doctor will never prescribe medication unless he is sure of the accuracy of the diagnosis.