Symptoms and treatment of vascular encephalopathy. Treatment of vascular encephalopathy of the brain

Many have heard about vascular encephalopathy of the brain, what it is to a person without a medical education is not completely clear. SE is a brain disease associated with ischemia, i.e. with temporary or permanent bleeding of the organ due to the pathology of the vascular system.

The consequence of ischemia is, which leads to the death of neurons. initial stage characterized by a partial (focal) lesion of some parts of the brain. If the patient is not diagnosed in time, and treatment is not started, this will lead to death. a large number nerve cells.

What are the types of SE

Vascular or venous is congenital and acquired due to any external influences. On this basis, the second type is divided into the following categories:

• Post-traumatic. Purchased upon receipt various kinds injuries. It is observed in the event that a timely appointment has not been made. qualified help. However, this type of disease does not necessarily appear immediately after the injury. The consequences of its receipt may affect in a few years. This type of encephalopathy is the most common cause of epilepsy.
• Toxic. It occurs when toxic substances penetrate into the blood, the nature of which can be of any nature: both from those received from the outside, and resulting from diseases of other internal organs of a person.
• Beam. This type diseases are acquired due to exposure to radioactive radiation (X-ray, infrared, etc.). May be due to treatment oncological diseases through radiation therapy.
• Metabolic. This variety vascular encephalopathy observed in violation of the general metabolism as a consequence of diseases of internal organs, including cancer.

There is also hypoxic encephalopathy. This type of disease occurs when abrupt changes in a human condition, for example, a hypo / hypertensive attack or. Also, vascular encephalopathy can be named depending on the location of the lesion.

Main symptoms of SE

Signs of vascular encephalopathy vary in the degree of the course of the disease.

I stage

The first or compensated stage of the disease. The brain is supplied with blood and oxygen, however, not quite enough. This stage is characterized general violations brain work:

• insomnia;
• dizziness;
• decreased attention and memory;
• weakness.

The first stage may be accompanied by a mild but constant headache. The situation is complicated by the fact that the patient does not always go to the clinic for an examination, referring to the fact that all these symptoms occur due to stress and fatigue. As a result, he decides that symptomatic treatment is the best option.

II stage

Subcompensated. At this stage, the condition of the vessels worsens significantly, and the signs of the disease become more pronounced:

• dizziness becomes permanent;
• memory lapses become pronounced;
• markedly reduced intellectual level.

During this period, there are violations of the functioning of those systems for which the affected areas of the brain are responsible.

III stage

Decompensated. The last stage, the treatment of which is ineffective. There are all signs of the disease. Extremely weak or complete absence blood supply is expressed in severe conditions patients: disability, coma. This stage ends in death.

Vascular encephalopathy is one of the causes of brain dysfunction in old age. From here, memory lapses, tremors, and strokes can occur.

Also, the disease can change a person's behavior: the mood becomes changeable, the passive state is replaced by sharp outbursts of anger, an aggressive reaction to others is possible. With SE of the brain, gait changes noticeably: steps slow down, feet do not come off the surface, and a specific shuffling appears.

Diagnostic methods

If vascular encephalopathy is suspected, whole complex research:

• Ultrasound diagnostics using Doppler. The examination is carried out in order to identify pathologies of the vascular system. Field of study - cervical region spine;
• MRI of the head and neck;
• ECG with constant control blood pressure;
• Ultrasound diagnostics of the heart;
• Rheoencephalography;
• Puncture of the spinal cord;
• Standard urine and blood tests (mandatory if a toxic variety of the disease is likely).

Various diagnostic combinations are possible. Their list depends on the severity of the patient's condition.

Puncture of the spinal cord

Ways to deal with SE

Treatment of cerebral vessels in encephalopathy consists in a therapeutic effect, including medication. The task of this process is to improve microcirculation in order to prevent oxygen starvation of the brain.

Before prescribing treatment, complete diagnostics organism. This is necessary in order to identify the cause of vascular encephalopathy. After that, appropriate procedures and medications are prescribed.

Commonly prescribed will be drugs that have a neuroprotective effect (protect and stimulate the work of neurons in conditions of lack of oxygen), namely:

• solcoseryl, actovegin, cinnarizine (improve the metabolic processes of the brain);
• diacarb, mannitol (reduces hypertension);
• eufillin (phlebotonic - a drug that promotes the outflow of venous blood);
• atorvastatin (lowers cholesterol);
• B vitamins.

In some cases, against the background of the entire treatment process, the use of various sedatives is recommended. This is necessary in order to avoid the risk of hypertensive attacks. Parallel to medical doctors prescribe physiotherapy, which is also actively carried out during the recovery period. These procedures are:

• massage courses;
• swimming;
• electrophoresis of the collar zone.

Among the population are actively practiced and folk methods treatment. However, in order to avoid allergic reactions that will only aggravate the condition, a mandatory consultation with your doctor is recommended.

Disease prevention

Venous encephalopathy is a progressive disease, and therefore neglect of its slightest manifestations can lead to irreversible consequences.

In the case when any of the above symptoms are observed, first of all, it is necessary to contact the specialists to undergo complete examination vascular network brain.

In order to minimize the risks of manifestation of this pathology, the following rules must be observed:

• control your blood pressure;
• avoid or at least reduce the impact bad habits on the body (alcohol and tobacco smoking have direct impact to the vascular system)
• monitor weight, avoid obesity;
• pass preventive measures against atherosclerosis;
• monitor the work of the heart (failures in the form of arrhythmias negatively affect the state of the vessels);
• if necessary, undergo anticoagulant and antiplatelet therapy.

Such measures will avoid not only the occurrence of venous encephalopathy, but also many other diseases characteristic of the vascular system.

Video: Treatment of encephalopathies

The content of the article:

Encephalopathy of the brain (encephalopathia, brain dystrophy) is a disease in which the cells of the main organ of the central nervous system are affected and die. nervous system person. Similar pathology organic nature is diagnosed in both adults and children. At untimely treatment illness, a person can become disabled, so you should understand the features of the disease in question.

Description and mechanism of development of the disease "encephalopathy"

This brain injury is not accompanied inflammatory process, as with the same encephalitis. Diffuse-dystrophic changes in the tissues of this main center of the human nervous system ultimately lead to a disorder of consciousness and memory in the patient.

In the clinical picture of the described pathology, there is anisocoria (eye pupils of different sizes), hyperkinesis (involuntary movements), ataxia (motor impairment in the form of a coordination disorder), nystagmus (repetitive uncontrolled eye movements), dysarthria (impaired phonetic functions) and decreased mental activity.

In some cases, a combination of a similar disease with lead meningitis can be observed, in which it is diagnosed positive reaction on the symptom of Kerning and Brudzinsky (damage meninges). In this case, the patient will also have manifestations that are characteristic of delirium tremens, progressive paralysis and schizophrenia.

The described pathology early stage its formation begins to slightly disturb the patient. Quite often, he writes it off as a migraine, fluctuations in atmospheric pressure, or overwork at work. However, such inconveniences do not cause significant discomfort, so the person does not go to the doctor and the mechanism for the development of encephalopathy is triggered:

• First period. The compensated stage, in which people develop hyperexcitability and increased irritability, is determined solely by diagnostic study. At the same time, the patient himself feels some fatigue, but does not fully feel the main symptoms of encephalopathy.
• Second period. At the subcompensated stage, the total clinical picture organic damage the brain becomes clearer. Constant headache and tinnitus are accompanied by tearfulness, lethargy and depressed mood. In some cases, there are problems with coordination of movement.
• Third period. The decompensated stage (severe degree of encephalopathy of the brain) already indicates that the disease is in a neglected state. At the same time, speech is very seriously impaired, and coordination of movements is so deformed that a person is not able to maintain any posture. In particular severe cases the victim has all the signs of dementia (dementia).

Causes of encephalopathy

Organic brain damage is an accompanying disease that can be triggered by the following factors:

1. TBI (traumatic brain injury). Quite often, a diffuse lesion of this main organ of the central nervous system is diagnosed in people who are engaged in a contact sport. Encephalopathy can also occur in those individuals who have experienced an accident, a fall from a height, or a domestic quarrel that ended in assault.
2. High blood pressure. With this problem, the risk of not only stroke increases, but also encephalopathy. If the hypertensive crisis lasts a long time and is accompanied by cerebral edema, then small foci of necrosis begin to localize in it.
3. Difficult pregnancy and childbirth. Quite often, all health problems in a newborn are attributed solely to genetic diseases. However, at the same time, they forget about the injuries that the baby can get during labor activity at his mother.
4. genetic predisposition. Outside the risk zone are those individuals who initially have protection that prevents atherosclerotic deformities from developing. Other people are less fortunate in this regard, because if they have relatives with such a disease, they can inherit it.
5. Poisoning. Long-term contact with chemicals, poisons and heavy metals usually does not go unnoticed for a person who has to deal with such hazardous materials.
6. Bad habits. A well-known fact is the assertion that with the abuse of nicotine, alcohol and drugs(if at all it is appropriate to talk about the permitted limits of this addiction), the death of brain cells occurs.
7. Hypodynamia. In most cases, this pathology affects people who lead a sedentary lifestyle. Experts insist that a person should walk 8 km a week so that he does not have health problems in the future.
8. Diabetes. In case of metabolic disorders, one of the first organs to be hit is the human brain. The affected party has significant vision loss and significant weight loss (especially in type 1 diabetes). Then there are irreversible changes in the form of death of brain cells.
9. Lack of vitamin B1 in the body. Deficiency of the so-called thiamine provokes in most cases various pathologies of the nervous system. As a result, the patient has all the symptoms that indicate the presence of encephalopathy.
10. Severe illnesses. At malignant formations and HIV infection, the body's resistance is so reduced that the death of brain cells begins to progress. In addition, radiation therapy is prescribed for cancer, which leads to radiation damage to many human organs.

Varieties of encephalopathy of the brain

Experts distinguish such varieties of this disease:

• Perinatal. It can occur even in the womb if the pregnancy becomes problematic in the third trimester (after the 28th week of fetal development). The formation of pathology in a child also provokes a traumatic brain injury during pathological childbirth. We should not forget about the genetic predisposition, which is the main risk factor for encephalopathy in a baby.
• toxic. This type of acquired disease often occurs in those people who are forced to come into contact with harmful substances. Toxic encephalopathy also occurs in lovers of strong drinks and experienced drug addicts.
• Post-traumatic. The risk group in this case are boxers, racers, rock climbers and American football players. However, no one is immune from a traumatic brain injury in an accident or at home.
• metabolic. With a serious pathology of the internal organs, disturbances occur in the human metabolism. There are hepatic, pancreatic, uremic and dysmetabolic encephalopathy.
• Radiation. It progresses imperceptibly for the affected party, because with a small dose of exposure to the body harmful factor pathology develops rather slowly.
• Discirculatory. Vascular encephalopathy is formed due to an imbalance in the blood supply to the brain. Subspecies of the voiced pathology are atherosclerotic, hypertensive and venous disorders in the work of the human body.

How does cerebral encephalopathy manifest?

It should be remembered that this disease is still a pathology in adults. Experts say that bypassing each of his decades, a person risks 5 or even 8 times more than during his youth. It is for this reason that it is necessary to consider the symptoms of cerebral encephalopathy from the point of view of age category sick.

Death of brain cells in children

1. Oppression. Depressed mood in children cannot be the norm when it has become systematic. If a son or daughter tries to retire and stop making contact, then parents definitely need to sound the alarm.
2. lethargy. With the death of brain cells, the thought process of the child is disrupted. He is simply unable to analyze causal relationships that are available for his age.
3. Speech problems. Her disorder may be due to birth defects, but quite often the cause of such difficulties lies in a more serious disease.
4. Narrowed horizons to a minimum. Childhood is a period when a child wants to know everything at once. In case of loss of interest in the outside world, parents should check their offspring for a problem such as encephalopathy.
5. mental lability. Such a pathology provokes mood instability in a child. Even to a minor event, children with organic brain damage can react very violently and inadequately.

Encephalopathy in young and middle-aged people

• paresthesia. Similar neurological disorder in the form of a partial loss of sensitivity, it is characterized by tingling, burning of the skin and a feeling of “goosebumps” on it in the patient.
• migraine attacks. If in childhood with encephalopathy, a child may experience episodic headaches, but with an acquired disease, they are already significant.
• Fast fatiguability. voiced age category people is usually considered the most efficient labor unit. With clear signs of cerebral encephalopathy in adults, the vitality of the affected party is reduced to a minimum as the disease progresses.
• Sexual impotence. This dysfunction is directly related to the fact that the attraction (libido) to opposite sex a person experiences due to the participation of the cerebral cortex in the process of excitation. If, however, a significant failure occurred in the main catalyst for sensual desires, then a full-fledged sexual life do not have to speak.

encephalopathy in the elderly

1. Severe migraine attacks. They take a systematic character and are not stopped even with the help of potent painkillers.
2. Tremor of the limbs. At the same time, one should not confuse the essential form of such trembling of the legs, arms or head, characteristic of the elderly, with one of the symptoms of encephalopathy.
3. Memory and speech impairment. If in more early age the voiced problem could be attributed to the peculiarities of the formation of the organism, then in this case we are already talking about serious changes in the brain of an organic nature.
4. suicidal tendencies. A mature person who suffers from an advanced form of encephalopathy quite often begins to think about the frailty of life. With the death of brain cells, such thoughts visit him more and more often, sometimes pushing him to rash acts.

Diagnosis of encephalopathy of the brain

• CT scan. With the help of a cone beam CT, three-dimensional images of the head are taken in order to recognize the disease on its own. early stage its development.
• Rheoencephalography. Thanks to REG, specialists can determine the condition of the patient's vessels and the functioning of his cerebral blood flow.
• Ultrasound of the neck and head. Similar ultrasound dopplerography allows you to identify areas of vasoconstriction, cholesterol plaques and areas of aneurysm formation in a patient.
• General analyzes. In addition to traditional studies, tests are carried out for the presence of autoantibodies and narcotic substances in the blood (with toxic poisoning).

Features of the treatment of encephalopathy of the brain

Brain damage always has a cause for the development of a pathological process in the body. Fighting the underlying disease, and not its consequences, will help get rid of the existing problem.

Medicines for encephalopathy

1. Nootropic substances. They are intended to regulate metabolism and improve blood supply. Among the huge range of medicines of this pharmacological group experts usually recommend that a patient with a similar diagnosis take Piracetam and Pyriditol.
2. Antiplatelet agents. In order for encephalopathy not to form blood clots and thin the blood, the patient is prescribed drugs in the form of Aspirin or Pentoxifylline.
3. vitamins. In this case, it is best to take retinol (improvement of vision when it is lost against the background of brain cell death) and tocopherol (protection against heart attack and stroke). Voiced vitamins A and E are contained not only in medicines, but also in potatoes, carrots, beef liver, eggs and milk.
4. Angioprotectors. Treatment cardiovascular disease can not do without these drugs. Encephalopathy is usually prescribed nicotinic acid and Cavinton.
5. Biostimulants. A similar gift of nature in the form of an extract of aloe, ginseng, Schisandra chinensis and lure high helps the body fight chronic diseases that can cause brain damage.
6. Essential amino acids. Methionine is prescribed in case of metabolic and toxic encephalopathy. It helps the liver when present adverse factors function at the proper level.
7. Adaptogens. The most popular among them are herbal preparations that allow you to speed up the work. cell membranes. Eleutherococcus, a plant with a tonic effect, is prescribed for radiation, toxic and metabolic encephalopathy.
8. Drugs that regulate lipid metabolism. In this case we are talking about Cetamiphene and Essential, which are prescribed to patients with brain cell death in the underlying disease in the form of dysfunction of the biliary tract and liver.

Therapeutic procedures in the fight against encephalopathy

• Massage. This reflex effect on muscular system a person has a positive effect on his general well-being with progressive migraine and tremor of the limbs.
• Manual therapy. Some incompetent persons confuse these sessions with massage, in which only the patient's muscles are developed without involving the joints. Practice shows that when manual therapy significantly reduced headache in a patient who suffers from encephalopathy.
• Acupuncture. Experts believe that this technique more suitable for women. If a person has no contraindications to this procedure in the form of pathological pregnancy, infectious diseases, oncological and mental disorders, then acupuncture will alleviate the symptoms of encephalopathy.
• Physiotherapy. Electrophoresis helps the affected party turn on defensive forces of your body. Magnetotherapy allows you to correct the physical and mental condition patient. UV (blood ultraviolet) is necessary method for a beneficial effect on the human body at the cellular level, which is so important for encephalopathy.
• Physiotherapy. The so-called exercise therapy is selected individually for each patient. A special set of exercises serves both as a preventive measure and in the case of stage 3 of the disease, when the patient becomes disabled.

Folk remedies to combat encephalopathy

With a significant migraine, 2 tablespoons are needed. hawthorn pour 400 ml of boiling water, leave for 12 hours and drink then 20 minutes before eating.

If we are talking about cerebral encephalopathy in children, then it is better to use rose hips (2 tbsp fruits per 0.5 l of boiling water). Three hours is enough for the tincture to be ready. You need to give a miracle drink to a child 3 times a day, 100 ml each.

With perinatal encephalopathy, you can make infusions of valerian, lingonberry leaf and a motherwort. A spoonful of one of the voiced ingredients should be poured into 200 ml of boiling water and given to the baby three times a day in a dessert spoon.

Elderly people with this diagnosis are often disturbed by tinnitus, which clover flowers will help get rid of. For this, 2 tbsp. raw materials, pour 300 ml of boiling water, leave for 2 hours and take half a glass before eating.

With toxic encephalopathy, it is recommended to take 20 g of valerian root and hop cones, 30 g of mint and motherwort. The crushed mixture should be poured with 200 ml of boiling water and then simmered for 5 minutes in a water bath. Before eating, you need to drink 100 ml of this chilled and strained broth.

A mixture of meadowsweet, strawberry leaves and hawthorn will also help perfectly. Taking equal proportions of the voiced ingredients, pour 250 ml of boiling water over them and cook the broth over low heat for 5-7 minutes. It is recommended to leave the finished drink for 2 hours, and then take 100 ml three times a day, regardless of the meal.

If we are not talking about alcoholic encephalopathy and do not take drugs that are incompatible with alcohol, then you can try this treatment. It is necessary to take 5-6 heads of red clover, fill them with 150 g of vodka and insist for a couple of weeks. healing remedy taken 4 times a day before meals and in proportions of 1 tbsp. tincture per 100 ml of water.

How to treat encephalopathy of the brain - look at the video:

Vascular encephalopathy of the brain - what is it and how dangerous is it for humans? independent disease this pathology is not, its manifestations are associated with a violation of the normal nutrition of brain cells, a lack of oxygen and nutrients. Read this article until the end to find out how vascular encephalopathy of the brain, what is it and what can it lead to.

Encephalopathic damage to the brain leads to functional pathologies, due to a lack of oxygen against the background of vascular disorders.

general characteristics

Among other types of encephalopathies, vascular is characterized by slow development, which makes it difficult to diagnose. The disease occurs as a result of diseases of the blood vessels that feed the brain, leading to oxygen deficiency in the brain cells.

The vascular type of encephalopathy develops for other reasons, they are classified as follows:

1. atherosclerotic against the background of general atherosclerosis of cerebral vessels.
2. Bilirubin due to jaundice.
3. congenital, emerging on later dates pregnancy.
4. Hypertensive due to the development hypertension.
5. Hypoglycemic resulting from a deficiency of glucose in the blood.
6. hypoxic, occurs as a result of violations of metabolic processes leading to oxygen starvation.
7. diabetic, due to long duration diabetes accompanied by asthenic syndrome.
8. Radiation, due to severe radiation exposure.
9. Acute psychotic azotaemia(mental disorder with overexcitation of the nervous system).
10. Hepatic, due to chronic inflammation liver, viral nature.
11. Portosystemic, develops against the background of portosystemic shunting and is reversible, with temporary mental disorders.
12. DEP caused by a complex of causes, including atrosclerosis and hypertension.
13. toxic due to long-term use of drugs with neurotropic properties.
14. traumatic develops after a head injury.
15. Encephalopathy of the venous type caused by a slowdown in venous outflow from the cerebral vessels.
16. Encephalopathy due to Martland's syndrome typical for professional boxers.
17. Encephalopathy after prolonged loss of consciousness or coma (postanoxic).

Thus, the disease is distinguished by the fact that it is caused precisely by violations of the supply of oxygen to the brain tissues due to vascular diseases.

Symptoms and manifestations

An outside observer can suspect a disease in a person by characteristics indicating mental disorders.

With encephalopathy, multiple symptoms of impaired mental functions are observed:

• lack of initiative in labor activity;
• insomnia at night;
• fast fatiguability
• viscosity of thinking;
• ringing or noise in the head;
• monotonous incoherent talkativeness;
• impaired coordination of movements, dizziness;
• general depression;
• lack of desires, including life;
• tearfulness;
• drowsy daytime condition;
• narrowing the range of interests;
• decrease in vocabulary;
• memory impairment and confusion;
• frequent or persistent headaches;
• emotional instability.

In behavior, a significant decrease in intelligence is found, even in simple situations, patients with encephalopathy experience difficulties with decisions and actions. The slow and gradual fading of the intellect leads, ultimately, to marked dementia.

DEP is caused by a lack of blood in the vascular bed, its slow current.

There are atherosclerotic, hypertensive and venous forms or types:

1. Atherosclerotic dyscirculatory encephalopathy occurs as a result of the development of atherosclerotic changes in the walls of blood vessels that feed the brain. Atherosclerotic plaques form on the walls of the great vessels that branch off from the aorta. These vessels narrow their lumen, the volume of blood entering the brain becomes insufficient for its normal functioning. Gradually develops dystrophy of nerve cells and their functional failure. In cerebral atherosclerosis, as a rule, higher mental functions.
2. Venous encephalopathy due to congestion in the cerebral venous system. This phenomenon is due to the fact that the veins inside cranium are squeezed. Excessive fullness of the venous bed slows down the general blood flow, impairs the supply of the brain with fresh blood saturated with oxygen. Nerve cells suffer from oxygen starvation and cease to function fully.
3. Hypertensive dyscirculatory encephalopathy already observed in young age, since high blood pressure due to narrowed arteries of the brain leads to insufficient blood circulation in the brain structures, which leads to a noticeable decrease in intelligence and emotional instability. The disease is aggravated by hypertensive crises, which accelerate the development of pathology.
4. Mixed dyscirculatory encephalopathy called a combination of hypertensive and atherosclerotic forms. In this case, atherosclerosis affects the main blood vessels, that leads to high blood pressure blood in them. The mixed form manifests itself in people in adulthood and old age. This form of vascular pathology also leads to dementia if therapeutic and preventive measures are not taken.
5. Vascular leukoencephalopathy of the brain differs in that it is affected with degenerative processes by the white, and not the gray matter of the central nervous system, that is, not the nerve cells themselves, but their fibers and connections. Symptoms of the lesion are similar to classical encephalopathy.

stages

Since encephalopathy develops gradually for vascular reasons, for greater accuracy of its diagnosis, it is customary to distinguish three stages of the disease:

1. Violations cerebral circulation at this stage are reversible. Appeared pathological changes in the structure and functions nervous tissue minor, their symptoms are non-specific, they resemble many other diseases, from simple overwork to the consequences of injuries. The first stage of the pathology, detected during the diagnosis, makes it possible to minimize the impairment of brain functions with the help of conservative treatment and physiotherapy procedures, a rationally organized regime of work and rest. Pay attention to the following symptoms:

• the appearance of noise in the head;
• persistent aching headaches;
• the appearance of frequent and sudden dizziness;
• restless sleep, insomnia;
• memory problems;
• lack of interest in learning new things;
• unsteady, unsteady gait.

1. It is characterized by attempts to tighten self-control over their behavior. The attitude towards other people changes, there is a feeling of unfounded anxiety. The patient begins to commit spontaneous, rash acts, loses his social status. The symptoms that appeared in the first stage of the disease are intensified:

• a noticeable weakening of memory for recent events;
• uncontrolled spontaneous actions and deeds;
• appears pseudobulbar syndrome, that is, uncontrolled movement of facial muscles, sudden tearfulness or laughter for no reason;
• there is dissatisfaction with others, malice;
• permanent depression psyche.

At this stage of the disease, the loss of socialization, conflict, inability to work permanently becomes noticeable. Such patients are disabled, their opportunities are limited.

1. Stage of dementia, dementia. Patients become limitedly capable, the basic mental functions are lost. DEP in the third stage of acquired dementia is characterized by the following signs and symptoms:

• the ability to walk independently is gradually lost;
• spontaneous emptying of the bladder and intestines;
• manifestation of symptoms of Parkinson's disease, loss of personality;
• inability to serve oneself and eat independently;
• complete disinhibition of the remaining mental functions;
• complete loss of intellectual abilities, dementia.

When the third stage of encephalopathy sets in, the patient is not able to exist without outside help, is a profound invalid. At adverse conditions, the period from the first stage of pathology to the onset of the third is approximately 5 years.

Dyscirculatory encephalopathy in 10% of cases leads to irreversible senile dementia. The video in this article demonstrates characteristic behavior patient with senile dementia.

Diagnostic procedures

Encephalopathy due to vascular insufficiency brain, requires the earliest possible diagnosis of the disease.

To confirm the initial diagnosis, which the doctor establishes with primary examination and inspection, appointed:

• laboratory tests of blood, urine, physiological tests;
• instrumental methods of examination.

In order to establish the presence of signs of impending encephalopathy, the following is carried out:

• electrocardiogram at rest and during exercise;
• measurement of blood pressure in the dynamics of the day;
• removal of an electroencephalogram;
• carrying out rheoencephalography;
• ultrasound examination of the vessels of the head and neck;
• echocardiography of the heart on an ultrasound machine;
• computed tomography;

Diagnostic procedures allow you to classify the disease and prescribe treatment as the instructions say.

Treatment

For the treatment of dyscirculatory encephalopathy, medications that lower blood pressure and improve metabolic processes. The price of drugs is acceptable for treatment courses.

Table. Medications

In addition to drug treatment, encephalopathy is treated with other means:

• acupuncture;
• physiotherapy;
• manual therapy;
• surgical treatment;
• bioresonance stimulation;
• laser therapy.

The term "encephalopathy" is collective, they refer to all types of non-inflammatory organic lesions of the brain. There are various types of encephalopathies, which differ from each other in symptoms and causes of development. A widespread type of encephalopathy is dyscirculatory or vascular encephalopathy. Today we will talk about this lesion with the editors of the site www.site, we will tell you what is cerebral vascular encephalopathy, treatment, symptoms of this disease.

Dyscirculatory encephalopathy (vascular encephalopathy) is an organic lesion of the brain of a non-inflammatory nature, due to insufficiency of cerebral circulation.

Dyscirculatory encephalopathy has its own classification, which takes into account the causes of cerebrovascular accident. The most common are atherosclerotic, hypertensive, mixed, venous encephalopathy. But the development of disorders in the blood supply to the brain occurs in other diseases, for example, rheumatism, systemic hemodynamic disorders, blood diseases, etc. Therefore, in these diseases, the presence of symptoms of encephalopathy is also possible.

Atherosclerosis and hypertension lead to pathological changes walls of cerebral vessels. This leads to a decrease in the elasticity of blood vessels, which adversely affects the blood flow through these vessels. Over time, these changes become large enough, then the state of cerebral circulation directly depends on the state of cardio-vascular system. If the damage to the cerebral vessels is accompanied by diseases that disrupt hemodynamics, the condition of the brain may worsen and the symptoms of encephalopathy may increase.

In the development of vascular encephalopathy, 3 stages of development are distinguished, which are characterized by their own symptoms.

Symptoms of vascular encephalopathy

The first stage is called compensation. This means that the body is still able to cope with disorders and maintains cerebral circulation at a sufficient level. But despite this, the patient complains of frequent attacks of headache and dizziness, a feeling of heaviness in the head. Patients may suffer from disturbed sleep, those around them may notice emotional instability and mood lability.

The second stage is called subcompensated. In this stage, there is a further deterioration of the brain tissue, while the symptoms become more pronounced and almost permanent. Patients may complain of permanent headache and dizziness.

Dizziness leads to a violation of the stability of the body when walking. Along with these symptoms, the patient develops a persistent noise in the head, and his physical activity decreases.
Hypodynamic cerebral stenosis can often be observed, which is manifested by lethargy, tearfulness, depressed mood, and decreased attention. At this stage of the disease, the areas responsible for the innervation of the head and limbs are damaged in the brain.

Therefore, the patient often has a speech disorder, absence or disorder of the swallowing reflex, sneezing and coughing reflexes. Constant tremor of the hands and head, discoordination, visual and hearing impairment significantly reduce the social and labor adaptation of the patient.

The third stage is decompensated. At this stage, the body is not able to provide the brain with the necessary amount of oxygen, this is the most severe stage of the disease. The brain tissue begins to collapse, thus forming perivascular lacunae, in severe cases, atrophy of the cerebral cortex develops. The symptomatology becomes more pronounced, now it is possible to establish the most damaged area only by the symptom complex. The patient may suffer from epileptic seizures. The outcome of this stage of the disease is profound dementia.

Treatment of vascular encephalopathy

Treatment of discirculatory encephalopathy must begin with identifying the root cause of this condition and begin to eliminate it. As for the elimination of the symptoms of encephalopathy, the following drugs are used here.

1) Lipid-lowering and hypocholesterolemic drugs are used for atherosclerotic lesions of cerebral vessels. Essentiale, Polisponin, Clofibat, Lipamid are prescribed.

2) To relieve the symptoms of hypertension, a reception is prescribed antihypertensive drugs– Atenolol, Vinkopan, Kapoten, etc.

3) In case of violation of the venous outflow, Aescusan, Troxevasin, Eufillin, Glivenol are used.

4) It is also necessary to use angioprotectors - Anginin, Etamzilat, etc.

5) It is possible to improve microcirculation with the help of antiplatelet agents chimes, aspirin, anturan.

6) To improve cerebral blood flow and prevent vascular spasms, no-shpu, cinnarizine, complamin are prescribed.

These are the main drugs, the intake of which is mandatory. In addition to these drugs, the doctor may prescribe other drugs if necessary. Remember, self-treatment for dyscirculatory encephalopathy is unacceptable !! This is a fairly serious diagnosis, so wrong treatment can only aggravate the condition of the brain.

Encephalopathy of the brain is a complex of symptoms, a syndrome that reflects diffuse lesions of brain tissues. The main causes of cerebral encephalopathy are the mechanisms of impaired blood supply to tissues (ischemic factor) and the presence of oxygen starvation (prolonged hypoxia), as a result of which the process of nerve cell death is triggered. These factors lead to various diseases, trauma and pathological conditions. Encephalopathy is, strictly speaking, not a disease in the medical sense of the term, however, the effect of the encephalopathic syndrome on the body can range from mild health disorders to coma and death.

The reasons

Encephalopathy is a brain lesion caused by a high dependence of brain tissue on the supply of oxygen from the bloodstream. Without a constant and stable level of oxygen supply to the tissue, brain cells can live no longer than 6 minutes, after which the process of dying begins. sensitivity of nerve tissue toxic substances, entering the body from outside or produced in the body by infectious agents, organs with impaired functions, also causes an increased risk of diffuse damage to nerve tissues.

What is encephalopathy? Types of encephalopathic syndrome

Encephalopathy of the brain and the associated psychoorganic syndrome are classified depending on the nature of the cause that caused the death of brain cells, as well as on the development of symptoms of encephalopathy, changes in the patient's psyche.

Species by etiological grounds:

• hypoxic
• post-traumatic
• angioencephalopathy
• toxic
• toxic-metabolic
• radial

Hypoxic encephalopathy is a brain lesion caused by oxygen deficiency and/or starvation of nerve cells in the brain tissue. Allocate asphyxial (with strangulation), perinatal (generic), post-resuscitation (post-anoxic or resuscitation-conditioned) varieties of such a lesion.

Post-traumatic encephalopathic syndrome may appear immediately after a brain injury or as a long-term consequence of it.

Angioencephalopathy is also called the vascular or dyscirculatory form of the psychoorganic syndrome. It develops in violation of the blood supply to the brain, due to atherosclerosis of blood vessels, hypertension.

Toxic encephalopathy syndrome occurs due to acute or prolonged poisoning with toxic substances (carbon monoxide, lead, chloroform), alcoholic beverages, narcotic and certain drugs.

Toxic-metabolic encephalopathy of the brain develops with various types metabolic disorders. This means a long stay in the body of metabolic products with their increased production or disruption of the process of decay and withdrawal. There are bilirubin encephalopathies, hepatic, hyperglycemic and hypoglycemic, diabetic, uremic, etc.

Radiation encephalopathy is a diffuse lesion of brain cells under the influence of ionizing radiation.

Among the variants of the course of the syndrome, there are three main and several mixed ones:

• apathetic, accompanied by asthenia, high fatigue, irritability, weakness.
• the euphoric variant is initially accompanied by an elevated mood, disinhibition of drives, a sharp decrease in criticism;
• the explosive form of the flow is characterized by affective lability, increased irritability, sharply reduced criticism, narrowing of the range of interests, rudeness, a tendency to excessive reactions, and adaptation disorders up to episodes of antisocial behavior.

Depending on the time of occurrence of the syndrome, its congenital and acquired forms are distinguished.

Chronic vascular pathologies, such as cerebral ischemia, are among the most common disorders nervous activity. Strokes, hemorrhages in the brain tissue, are considered one of the most frequent consequences of coronary disease in the elderly, accompanied by an encephalopathic syndrome.

Variety of symptoms

Encephalopathy of the brain is a syndrome characterized by a variety of clinical manifestations. Their severity and specificity depend on the localization of tissue ischemia zones. So, damage to the subcortical regions causes tinnitus, general weakness, mood variability, sleep disturbance. Ischemic zones in the cerebral cortex affect the processes of mental activity, etc. Manifestations of disorders in to a large extent depends on which area of ​​the brain is damaged.

Early manifestations of the encephalopathic syndrome in adults include a decrease in mental performance, mental stability, rigidity of thinking, difficulty changing activities, primary short-term memory impairment, sleep deterioration, fatigue, etc.

On the this stage patients come with complaints of diffuse headache, noise, ringing in the ears, high fatigue and a feeling of weakness, increased irritability. When examined by a neurologist, increased tendon reflexes, nystagmus, impaired visual acuity, auditory function, an increase in pathological pyramidal and oral reflexes, autonomic disorders, impaired coordination of fine and gross motor skills.

These symptoms progress along with the deterioration of the condition caused by the underlying disease and can be expressed in clear neurological syndromes: parkinsonian, pseudobulbar, supplemented by mental disorders.

The clinical picture in severe generalized brain lesions, pronounced microcirculation disorders, significant edema of the brain tissue is expressed in severe anxiety, agitation, pain in the head, nausea and vomiting, dizziness, confusion. At the second stage, lethargy, apathy, paresis, convulsions, disorders of consciousness appear.

Perinatal encephalopathy syndrome (PES)

This diagnosis can be made in newborn children, depending on the severity of manifestations, immediately after birth or during the first year of life.

Developing perinatal encephalopathy during fetal development, during the passage through the birth canal and in the first 7-10 days after birth. There are three degrees of severity depending on the severity of symptoms, as well as periods of the course: acute (up to 30 days), early recovery of functions (3-4 months), late recovery(1-2 years).

Causes and signs of PEP

Allocate prenatal, perinatal and postnatal risk factors. They can be associated both with the mother's body itself and the course of pregnancy, as well as with injuries received during childbirth.

The first group includes:

• long-term somatic illnesses of the expectant mother;
• violations of metabolic processes;
• diseases of the kidneys, cardiovascular system;
• infections (flu, rubella);
• development of intrauterine infections;
• the presence of bad habits in a pregnant woman;
• long-term feto-placental insufficiency;
• the threat of miscarriage;
• toxicosis;
• late gestosis;
• expressed nervous feelings.

PEP can also develop as a result of:

• asphyxia of the child during childbirth,
• long dry period
• amniotic fluid infections,
• too fast or prolonged labor,
• injuries when passing through the narrow birth canal,
• entry of water into the respiratory tract,
• emergency delivery with placental abruption

Risk factors are also infectious diseases in the neonatal period, head injuries, surgical interventions, hemolytic diseases.

Signs and symptoms of PEP

Symptoms are a factor in determining the stage of severity of a child's condition.

A mild degree is expressed in a syndrome of general hyperexcitability: anxiety, irritability, tearfulness, difficulty with sucking, frequent regurgitation, hypo- or hypertonicity of muscles, convergent strabismus (not always).

The average severity is expressed by one or a combination of several neurological syndromes: convulsive, hydrocephalic, hypertensive, movement disorders, depression of the central nervous system, impaired reflexes.

At a severe stage, a pre-coma or coma is noted. The child does not respond to stimuli, brain functions depressed, reflex responses are weakly expressed or absent.

Treatment

Hypoxic damage to the brain tissue requires therapy even during the period of stay in maternity hospital. Recovery period if necessary, carried out in a hospital or prescribed therapeutic measures in children's clinics and at home.

The choice of method of therapy is based on the severity of the condition, the causes that caused PEP and the general condition of the child and his response to treatment.

In most cases, the following treatment options are prescribed:

• drug therapy aimed at detoxifying the body, reducing readiness for convulsions, improving metabolic processes and blood supply in the brain tissues;
• drug therapy that regulates the level of intracranial pressure;
• rehabilitation and developmental therapy (massage, electrophoresis, swimming, gymnastics for babies) is carried out during the recovery period.

Encephalopathy

Angioencephalopathy is spoken of in a situation where a psychoorganic syndrome occurs against the background of a violation of blood supply in the vessels of the brain and neck. The syndrome is observed mainly among the adult and elderly population. Starting from the age of 70, the risk of developing brain vascular pathologies increases by 3 times.

Causes of vascular pathologies of brain tissue

Angioencephalopathy is divided into several varieties depending on the etiology, disorder, disease or pathology that caused the development of the syndrome.

In angioencephalopathy, there are:

• atherosclerotic form, in 60% of cases provoked by atherosclerosis of the aorta or carotid artery;
• hypertonic form
• cardiovascular diseases ( bronchial asthma, diseases of the bronchopulmonary system, accompanied by stagnation of blood in the jugular veins, as well as direct thrombosis of the veins that carry out the outflow of blood from the cranial cavity, lead to the development of venous encephalopathy);

AT special group angioencephalopathy of mixed genesis should be distinguished. Encephalopathic syndrome of mixed genesis is observed in chronic heart failure, arrhythmias, cervical osteochondrosis, etc.

Symptoms and manifestations of angioencephalopathy

On the initial stage disorders of cerebral circulation, there are frequent changes in mood, a general decrease in well-being, a decline in strength and performance, and a depressive state is often diagnosed. Mental activity hardly suffers.

In the second stage of the encephalopathic syndrome vascular genesis cognitive functions suffer, there is a drop in attention, memory, logical thinking, problems with coordination begin.

The third stage is accompanied by dementia, somatic pain, a pronounced decrease in cognitive functions, gross mental disorders, loss of working capacity, self-service skills.

Therapy for angioencephalopathic syndrome

Treatment should primarily be aimed at reducing the severity and impact of the underlying disease or pathology that caused the psychoorganic syndrome. With drug therapy, drugs are prescribed for:

• reduction of arterial hypertension,
• reduce swelling of the brain tissue,
• decrease in intracranial pressure,
• reducing the likelihood of atherosclerosis or mitigating its manifestations by correcting the level and balance of cholesterol,
• regulation of metabolic processes,
• correction of hormonal disorders.

Without treatment of the underlying disease, the treatment of encephalopathic syndrome is not effective. Vascular preparations are prescribed to improve the nutrition of brain tissues. These can be drugs from the group of nootropics (Nootropil, Piracetam, etc.), or drugs to strengthen the walls of cerebral vessels (Cavinton, Cynarizine). Antioxidants are also used (, tocopherol acetate, vitamin C, Solcoseryl, etc.).

Varieties and manifestations of post-traumatic encephalopathic syndrome

This is a syndrome of diffuse damage to the brain tissue that occurs due to a severe single or several consecutive head injuries. It is dangerous with long-term consequences, since the effect of trauma on clinical manifestations practically impossible to assess in the first days after the incident. First characteristic symptoms can occur several weeks, months, and in some cases even years after the injury.

Causes

Encephalopathic syndrome in most cases occurs after concussions of the 2nd and 3rd degrees, contusions, head bruises, fractures of the bones of the skull, etc. Such injuries can be the result of a fall from a height, car accidents, domestic injuries or violence.

More than 80% of injuries with damage to the skull lead to the occurrence of post-traumatic encephalopathic syndrome.

Manifestations and signs

Depending on the severity of the injury and the characteristics of the body, symptoms may begin to appear several days after the injury or hide for an indefinite time. The main features include:

• general deterioration of the patient's well-being, drowsiness, fatigue, irritability, asthenic syndrome;
• paroxysmal pain in the head, poorly amenable to relief with anesthetics, in some cases - appearing and disappearing with a change in body position;
• feeling of nausea, short-term vomiting, regardless of the meal;
• dizziness, episodes of loss of consciousness are possible;
• violation of coordination of movements, balance;
• decreased concentration of attention, impaired memory, thought processes, slow reaction, reduced ability to criticize, analyze, etc.;
• convulsive conditions;
• depressed mood, depressive symptoms.

Diagnostic and therapeutic methods

The main research method for organic pathologies of brain tissues is MRI of the brain. In addition to this method, radiography, laboratory blood tests, an electroencephalogram, etc. can be used.

The therapy is carried out according to the above scheme with the use of drug treatment (vascular, antioxidant, nootropic groups of drugs). Acute period is subject to therapy in a hospital setting, then treatment is carried out under the regular supervision of neurologists, if necessary, periodic therapy in a hospital setting is recommended.

Encephalopathic pathologies of toxic genesis

Toxic encephalopathy is classified into different categories depending on the cause. It can occur under the influence of toxic substances that enter the body with food, water, air, through contact with the skin and / or mucous membranes, or be formed under the influence of toxins produced in the human body as a result of metabolic disorders. The last type of disease is called toxic-metabolic.

Most common causes in different age groups

The reasons for the development of the toxic form are directly related to the age of patients and their lifestyle.

Newborns are most often affected by fetal alcohol syndrome due to mother's alcoholism drug addiction, as well as non-compliance by the mother with prescriptions and restrictions during courses of treatment with drugs of anticonvulsant, antipsychotic groups, antidepressants. Leads to toxic-metabolic appearance high level bilirubin in the blood of a child with hemolytic jaundice.

The toxic form at the age of 0 to 3 years may be the result of a severe acute respiratory viral disease, intestinal infections, influenza, some bacterial diseases. This form is called neurotoxicosis.

For all children and adolescence, there is an increased risk of poisoning medications, household chemicals, gases, vapors of toxic substances (gasoline, chemicals, mercury), alcohol, etc.

Adults may have occupational risks of developing encephalopathic syndrome while working in the chemical industry. It is not uncommon to encounter injuries caused by contact with substances such as carbon monoxide, mercury, gasoline, manganese, sulfur carbon, pesticides, methyl alcohol, etc.

However, the most common type of syndrome is alcoholic encephalopathy. Do not discount drug poisoning. Toxic-metabolic syndrome develops against the background of diseases endocrine system, liver dysfunctions (fibrosis, tissue cirrhosis), uncompensated diabetes, as well as some viral diseases.

Manifestations and clinical picture

Newborns with bilirubinemia react with manifestations of jaundice: yellowing of the skin, sclera of the eyes, and mucous membranes. However, it should be borne in mind that newborn jaundice develops in 70% of children against the background of an increased postpartum level of bilirubin, which is typical for the period of infancy and does not mean the presence of lesions of the nervous tissue.

The bilirubin form is noted only in 3% of children with severe neonatal jaundice and is characterized by symptoms of damage to brain structures: drowsiness, inhibition of basic reflexes, including disorders in the mechanisms of sucking, swallowing milk, failure of the rhythm of the heartbeat, respiratory contractions, spasm of the cervical and occipital muscle groups , piercing cry. Such signs of encephalopathy are also observed in other types of toxic syndrome.

Toxic syndrome at any age varies depending on the type of exposure: acute form it is expressed in inhibition of reactions or excited behavior with a possible change of states, convulsive reactions, disturbances in the characteristics of breathing, the functioning of the cardiovascular system. The chronic toxic form is characterized by pain in the head, a feeling of nausea (episodes of vomiting are possible), deviations in indicators blood pressure from the norm in both directions, general deterioration of health, asthenic syndrome, increased irritability, emotional lability, impaired sensitivity in the arms and legs. With prolonged exposure to toxic substances, dysfunctions of the organs of the gastrointestinal tract are observed, accompanied by involuntary urination, defecation, and pronounced violations psyche (aggressiveness, hallucinatory, delusional states, convulsions, loss of consciousness). The most common example is " delirium tremens", spicy alcoholic psychosis toxic origin.

Diagnostic measures and therapy

Timely diagnosis is important for the treatment process and minimization negative consequences syndrome. Diagnosis and treatment are carried out in a hospital with mandatory hospitalization of patients with pronounced manifestations. Primary diagnosis of the cause of toxic effects is carried out by methods laboratory tests indicators of the composition of blood and urine, the contents of the stomach can be studied, etc.

When diagnosing an organic lesion of brain tissues, an assessment of their condition is necessary. It is carried out by the method of magnetic resonance therapy.

Acute and chronic stages of toxic encephalopathic syndrome are subject to therapy in a clinical setting, priority measures are aimed at detoxifying the body, subsequent courses of treatment are aimed at restoring and maintaining the functions of damaged tissues (drugs for vessels, noortopes, etc.).

Prevention of encephalopathy

It is well known that the occurrence of encephalopathy, as a rule, is not an independent process, but is caused by other pathologies of the body, or external causes. Therefore, in order to prevent organic disorders of the brain tissue, it is necessary to avoid factors that can lead to them. This means that prevention cordially- vascular pathologies, metabolic diseases, dysfunctions of the skeletal system and liver in many cases will help prevent premature development syndoma.

It is necessary to remember the need to maintain a healthy lifestyle, get rid of bad habits, and refuse to use harmful substances. We should also not forget about the prevention of injuries that carry a direct threat to the head. Pregnant women are encouraged to take care of their unborn child, normal course pregnancy, monitor it with the help of specialists and follow their instructions.