Multiple focal changes in the substance of the brain. Small-focal changes in the substance of the brain of a dystrophic nature

The human brain is a unique organ. It controls all functional systems in the human body. Proper brain function depends on a good blood supply. Insufficient blood flow leads to necrosis of neurons and causes focal changes in the substance of the brain of a dyscirculatory nature, or dyscirculatory encephalopathy.

The nature of the pathology

The entire brain is permeated with an extensive blood supply system. It consists of four main main arteries, from which small vessels diverge, penetrating into all brain structures. Violation of blood flow (dyscirculation) in some parts of the brain leads to its oxygen starvation, rapid focal degradation of neurons and brain cells.

There are two types of pathology:

Risk group

Previously, dyscirculatory encephalopathy was a disease characteristic of the elderly. Now the disease is much younger, from 50 to 30 years old. It can develop in people who lead an inactive lifestyle, have harmful addictions (smoking, alcohol, drugs, overeating).

Persons suffering from type I and II diabetes mellitus, hypercholesterolemia, or having a genetic predisposition are also at risk of focal destructive changes in the structural brain tissues.

In men, more often than in women, the disease may appear against the background of constant stress or psycho-emotional overstrain.

Stages and symptoms of the development of the disease

The disease is progressive. It is characterized by a paroxysmal course, with sharp rapid deterioration. Discirculatory focal changes have several stages of development.

Initial

Insignificant processes of tissue changes begin in small areas of the brain. Their occurrence is facilitated by mild dysfunction of the vascular circulatory system.

Symptoms:

increased fatigue;
recurrent headaches;
slight distraction;
increased emotional sensitivity (irritability and tearfulness);
noise in the head, frequent dizziness;
partial loss of unprofessional memory;
concentration on the performance of any one type of activity;
mild ataxia.

Medium

The blood supply to the brain is significantly reduced. Blockage of blood vessels provokes necrosis of cells in the surface structures of the brain (gray matter).

The symptoms of the initial stage are aggravated, the following signs are added:

Sleep disturbance. The patient often sleeps during the day, and sleep lasts longer than at night.
Interest in new knowledge disappears, the intellect is dulled.
Behavior becomes aggressive, character - egocentric.
There is a lack of coordination of movements (staggering gait, uncertain hand movements).
There is a progressive loss of memory and professional skills.

heavy

Due to the development of chronic dyscirculatory encephalopathy in the lesion, most of the cells of not only gray, but also white matter die. This causes disturbances in the brain.

At this stage, neurological changes reach their peak. The clinical picture is disappointing. All previous symptoms become irreversible, which entails such consequences as:

complete loss of ability to work and self-service;
loss of memory and skills, development of dementia (dementia);
loss of control over motor and speech functions.

Early diagnosis of the disease is difficult because at its initial stage there are no pronounced symptoms. Delayed diagnosis makes treatment difficult.

If the blood flow per minute slows down up to 10 ml/100 g and below, starts the process of instant destruction of brain tissue, which is irreversible.

The reasons

The duration of the development of each stage of the disease depends both on the causes that caused it and on the age of the patient. Foci of damage can be either single, dystrophic, or multiple. The following causes of dyscirculatory encephalopathy are known:

If there is a history of such diseases, accompanied by atypical signs, regular monitoring by a neurologist is necessary. This will allow you to identify a possible pathology before it becomes irreversible.

Diagnostics

Since dyscirculatory focal changes are similar to chronic fatigue syndrome for a long time, the disease needs accurate diagnosis. The diagnosis is established after a thorough examination, as well as a six-month follow-up by a neurologist. The basis for a medical opinion on the nature of the pathology is the constant presence of the main symptoms.

When applying, the doctor prescribes a comprehensive examination, which consists of the following methods:

Laboratory research. Check the composition of the blood, determining the presence of negative factors. This requires a general and biochemical blood tests, a coagulogram. Also determine the level of cholesterol and sugar.
Continuous monitoring of blood pressure.
ECG and echocardiography.
Echogram and electroencephalography of the brain.
Fundus examination.

Advantages of MRI diagnostics

As a result of pathological dyscirculatory changes in the structural tissues of the brain, characteristic morphological signs appear. They are diagnosed using magnetic resonance imaging methods: nuclear MRI, magnetic resonance imaging and angiography.

An MRI examination allows you to identify foci of dyscirculatory encephalopathy, localize their exact location and determine the cause of the pathological change in the brain.

The presence of focal changes in the brain is the basis for a periodic preventive examination at least once every three months.

Therapy

Treatment of dyscirculatory focal lesions depends on the stage of the disease and the causes that provoked its appearance. To achieve a positive effect, it must be timely, and take place under the supervision of the attending physician.

Therapy of pathology in arterial hypertension can stop the spread of the disease and reduce the likelihood of stroke by 45-50%. Drug treatment is designed to stabilize pressure and ensure uniform blood flow in the vessels of the brain. The following drugs are used:

ACE inhibitors;
beta blockers;
antiplatelet agents;
anticoagulants;
vitamin complexes.

If the cause of the disease is atherosclerosis, statins (cholesterol-lowering drugs) and diet are added to the standard hypertension treatment. It is administered to normalize cholesterol levels and prevent the formation of atherosclerotic blood clots.

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 calcification. 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 nuclei, 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 certain 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 includes 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 previous stroke or 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 onset of this stage is indicated by impaired memory, 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.
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.

Thirdly, 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.

MRI for focal brain lesions

Focal lesions Focal lesions of the brain 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.

Signs of focal lesions

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.

A change in vascular genesis can lead to mental disorders, cause an increase in 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 work 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 normal blood supply stops, causes provoking changes in soft tissues. Resonance tomography helps to identify the causes of disorders and conduct a differential analysis of the disease.

Small focal changes, which at first do not cause concern, may result in 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.

Every person sooner or later begins to grow old. Along with it, the whole body ages. Aging primarily affects the brain. There is a failure in the system of the heart and blood vessels. The cause of such failures is insufficient blood circulation in the brain and spinal cord.

Violation of cerebral circulation is divided into:

focal,
diffuse.

If a person is ill with ischemia, then local changes in the gray matter of the brain of the head occur in the brain, due to a lack of blood supply to the brain. This condition can be seen after osteochondrosis of the neck of the spine or a stroke, when the arteries of the vessels through which blood enters the brain are disrupted. Changes in the substance of the brain of the head can lead to any injury or tumor.

Focal changes

Violation of the integrity of the brain tissue in any one place is called a focal change in the brain substance of the head of a dystrophic nature. As a rule, these are those parts of the brain that receive practically no nutrients. In this state, tissue processes are reduced, and the affected part of the brain begins to malfunction.

Focal changes in the substance of the brain include:

small cysts,
Small foci of necrosis
gliomesodermal scars,
Absolutely insignificant changes in the substance of the brain.

Single focal changes in the substance of the brain of the head of a dystrophic nature give the following symptoms that a person simply cannot help but notice:

Frequent and pain
paresthesia,
Dizziness,
hyperkinesis,
Paralysis,
violation of coordination of movements,
Decreased intelligence
memory loss,
Disorders in the emotional sphere,
sensitivity disorders,
ataxia,
Agraphia.

Upon examination, the doctor will have to identify the cause of the appearance of severe changes in the substance of the brain and the accompanying diseases:

vasomotor dystonia,
Atherosclerosis,
Various somatic diseases
arterial hypertension,
Aneurysm in and spinal cord,
Cardiocerebral syndrome.

When does the disease appear?

Local focal changes in the substance of the brain of a dystrophic nature occur after seventy years and are characterized by manifestations of senile dementia. With this disease, a thought disorder or dementia occurs. Dominant diseases include:

Alzheimer's disease,
Pick's disease
Huntington's disease.

By the way, single focal changes in the substance of the brain of a dystrophic nature can occur not only in old age, but also in young and middle-aged people. Any infection or mechanical injury can disrupt the integrity or patency of the blood vessels that feed the brain and spinal cord.

How to treat?

In treatment, the main thing is to have time to recognize the disease, when the symptoms of focal changes in the substance of the brain are not yet so pronounced and the process of change can still be reversed. Many different therapeutic measures will be prescribed to improve the blood supply to the brain: normalization of the rest and work regimen, selection of the right diet, the use of sedatives and analgesics. Drugs that improve the blood supply to the brain will be prescribed. The patient may be offered sanatorium treatment.

Who is susceptible to illness?

Individuals undergo a single focal change in the substance of the brain of the head of a dystrophic nature:

Suffering from diabetes,
Patients with atherosclerosis
Suffering from rheumatism. Such people need to first cure the main disease, follow a special diet, monitor and, of course, visit a doctor regularly.

Local focal changes in the substance of the brain can be cured if approached in a qualified and timely manner. Unfortunately, only senile changes in the substance of the brain are difficult to treat.

To date, specialists have identified a large number of diseases associated with lesions cerebral vessels.

These are quite serious violations that can lead to:

mental disorders;
partial memory loss;
strokes or heart attacks.

That is why the patient should receive immediate treatment.

What is the vascular genesis of the brain.

Vascular genesis- this is not a disease, but only an indication of the nature of the occurrence of the disease. It refers to circulatory disorders, which very often become the cause of heart attacks, strokes and various other diseases. Vascular genesis occurs today quite often.

Causes of the disease.

Before treating any disease, you need to know the reasons its occurrence. The healing process depends on this.

The following factors can provoke the occurrence of circulatory disorders:

stress;
various head injury;
surplus the weight;
abuse alcoholic beverages and narcotic substances;
aneurysms;
sedentary Lifestyle;
reduced arterial pressure;
sugar diabetes;
various diseases of the heart and circulatory system;
osteochondrosis;
arrhythmia.

Diseases appear in various forms.

It can be:

disorders of blood circulation in the brain. They can be cerebral or focal. But with the right method of treatment, the process is reversible and it is quite possible to restore functions;
blockage of the arteries. In this case, the nutrition of the brain is reduced or completely stopped, which leads to cell death. Treatment is carried out only by a surgical method;
vessel rupture. Simply put, a stroke, which can be ischemic or hemorrhagic.

Symptoms of vascular genesis.

General signs accompanying vascular genesis:

arrhythmia. These are noticeable (up to ninety beats per minute) violations of the pulse even during a period of complete rest;
unexplained episodic or recurring high blood pressure(more than one hundred and forty mm Hg);
unreasonable weakness in the limbs;
headaches or dizziness. It should be noted that their nature directly depends on the type of circulatory disorders;
attention disorder. Patients cannot concentrate and highlight the main thing from a large amount of information;
fatigue.

The diagnosis can be made with accuracy according to the pain experienced by the patient. Therefore, it is necessary to pay attention to its character.

Growing ringing in the head, throbbing pain and a feeling of a pulse appear with changes in the craniocerebral arteries. Most often, the symptoms appear in the background high pressure. At the last stage of the disease, the pain begins to acquire a dull character, nausea often appears.

With a large fullness of the veins of the brain, a person feels heaviness in the back of the head, which indicates the focus of the violation in this area. Headache in the morning, experts explain that in an upright position, the outflow of blood occurs more efficiently. It often happens, and vice versa - in this position, the circulation slows down, which leads to pain and insomnia.

One of the main signs of vascular genesis are some mental disorders. The most important manifestation of the presence of the disease is a superficial and short-term period of sleep. The patient always feels tired and weak after waking up. In this case, only physical activity can help.

Various manifestations of vascular genesis of this nature include:

sensitivity to bright light or sound;
increased irritability;
impaired attention and memory;
tearfulness.

It is worth noting that the patient in this case perfectly understands his condition. In case of a mental disorder, it is necessary to pay attention to the fact that it is difficult for the patient to remember the event, its date and chronology.

In the case when the disease progresses, the asthenic condition also intensifies, which means that the following appear:

anxiety,
uncertainty,
constant discontent and irritability without any good reason.

Treatment is carried out medically.

White matter focus of vascular origin

Compared to gray matter, white matter has a much larger number of lipids and a smaller amount of water.

In diseases of the nervous system, the lesion of the white matter can manifest itself:

as multiple sclerosis. When diagnosing the disease, MRI is used and a focus of increased density is detected, which is located in the cerebellum, corpus callosum and can be multiple;
encephalomyelitis. The source of occurrence is located in the subcortical regions of the brain and, in the presence of multiple ones, are capable of merging;
sclerosing panencephalitis. The focus of this disease is located in the basal ganglia;
neurosarcoidosis. Often affects the membrane of the brain, as well as the focus occurs in the pituitary gland, chiasm, hypothalamus.

Minor lesions of the brain

Diseases that cause the appearance of small foci of vascular origin are chronic.

The reasons may be:

hypertension;
cysts;
tissue death;
intracerebral scars that may remain after head injuries;
atherosclerosis;
aneurysm;
other various disorders of blood circulation of the brain or spinal cord.

This disease most often affects men over fifty-five years old with a predisposition that is hereditary. Develops on the background of hypertension.

Diagnosis of vascular genesis.

Magnetic resonance imaging is one of the most used methods in detecting cerebrovascular disorders. Thanks to a three-dimensional image, a specialist can analyze all ongoing processes and see violations or neoplasms.

Method MRI used primarily for diagnosis. Apply the same neurological examinations and ultrasound brain tissues.

The complexity of diagnosing vascular genesis lies in the fact that these diseases Dont Have acute

leaks and are accompanied by vague symptoms.

To find out accurate diagnosis the doctor should collect tests as carefully as possible, and long-term observation is also required.

Additional ways to study diseases of vascular origin are:

spectroscopy;
diagnostics of electrical activity of brain cells;
duplex scan;
positron tomography;
tomography using radionuclides.

Treatment of vascular genesis.

All procedures for the treatment of diseases and disorders of the blood circulation of the brain are carried out with the aim of eliminate high blood pressure and atherosclerotic symptoms.

For the proper functioning of the brain, normal blood pressure, then the physico-chemical processes will proceed correctly. In addition, it is necessary to normalize the state of fat metabolism.

Used to restore brain function drug treatment.

Methods used in the treatment of vascular genesis plaque removal to restore normal circulation. The part of the vessel that has been damaged can be replaced with surgery.

In recovery, an important role is played by the period of rehabilitation of the patient. For this, physiotherapeutic procedures are used, as well as various physical exercises aimed at improving blood circulation.

It can be difficult to identify diseases of vascular origin, since the disease does not have pronounced symptoms and an acute form. In order to make a correct diagnosis, magnetic resonance imaging, spectroscopy, duplex scanning, as well as long-term observation of the patient.

Against the background of circulatory insufficiency, focal changes in the substance of the brain of a dyscirculatory nature develop. The brain is supplied with blood from 4 vascular pools - two carotid and two vertebrobasilar. Normally, these pools are interconnected in the cranial cavity, forming anastomoses. These compounds enable the human body to compensate for the lack of blood flow and oxygen starvation for a long time. In areas that experience a shortage of blood, blood flows from other pools by overflow. If these anastomotic vessels are not developed, then they speak of an open circle of Willis. With such a structure of blood vessels, circulatory failure leads to the appearance of focal changes in the brain, clinical symptoms.

The most common diagnosis in the elderly, made only on the basis of complaints, is dyscirculatory encephalopathy. However, it must be remembered that this is a chronic, steadily progressing circulatory disorder that develops as a result of suffering from brain capillaries, which is associated with the development of a large number of microstrokes. Focal brain damage can be diagnosed only if certain criteria are met:

there are signs of brain damage, which can be confirmed objectively;
constantly steadily progressing clinical symptoms;
the presence of a direct relationship between the clinical and instrumental picture during additional examination methods;
the presence of a cerebrovascular disease in a patient, which is a risk factor for the development of focal brain damage;
the absence of other diseases with which the origin of the clinical picture could be associated.

Focal changes in the substance of the brain of a dyscirculatory nature are manifested by impaired memory, attention, movement, emotional-volitional sphere.

The main influence on the functional state and social adaptation of the patient is exerted by cognitive disorders. When there is a focal lesion of the brain substance in the area of the frontal and temporal lobes of the dominant hemisphere, then there is a decrease in the memory of attention, a slowdown in thought processes, a violation of planning and the consistent execution of daily routine work. Cognitive impairments are explained by dystrophy of the brain of vascular origin. With the development of neurodegenerative focal changes in the brain, a person ceases to recognize familiar objects, speech suffers, emotional and personality disorders join. First, asthenic syndrome and depressive states appear, which respond poorly to antidepressant treatment.

Progressive dystrophic, degenerative disorders lead to the appearance of egocentrism, there is no control over emotions, an inadequate reaction to the situation develops.

Movement disorders are manifested by staggering when walking, coordination disorders, central paresis of varying severity, trembling of the head, hands, emotional dullness and amimia. Steadily progressive focal lesions of the brain lead to the final stage of the disease, when the patient cannot eat due to constant choking. Violent emotions appear, for example, laughter or crying out of place, the voice becomes nasal.

Predisposing factors

Diseases leading to small-focal changes in the substance of the brain include arterial hypertension, stenosing and occlusive vascular lesions, disorders of lipid and carbohydrate metabolism.

The main mechanism for the development of dyscirculatory encephalopathy is manifested by the fact that foci of ischemia and infarction are formed. This is a condition when dystrophic changes begin to develop against the background of oxygen starvation, reduced blood flow, and a slowdown in metabolism. Areas of demyelination, edema, gliosis degeneration, expansion of perivascular spaces appear in the brain. The above factors are the main ones. They explain the existing lesions and the genesis of the brain.

Additional examination methods

The main method for diagnosing this pathology is MRI of the brain, in which hyperintense foci, small heart attacks, postischemic degeneration, and expansion of the ventricular system are determined. The number of heart attacks can be from single to multiple cases, the diameter is up to 2.5 cm. Small focal changes say that this is such a serious lesion that can lead to the patient's disability. It is in this place that blood circulation suffers.

Doppler ultrasound, duplex scanning are used, which can show blood flow disturbance in the form of its asymmetry, stenosis, occlusion of the main vessels, increased venous blood flow, atherosclerotic plaques.

Computed tomography will allow you to see only traces of past heart attacks in the form of gaps filled with liquor, i.e. cysts. Thinning is also determined - atrophy of the cerebral cortex, expansion of the ventricles, communicating hydrocephalus.

Modern approaches to therapy

Treatment should be directed to the underlying disease that led to brain disorders. In addition, it is necessary to use means that prevent the progression of the disease.

Without fail, vascular agents are prescribed, such as pentoxifylline, vinpocetine, cinnarizine, dihydroergocriptine. They have a positive effect on cerebral circulation, normalize microcirculation, increase the plasticity of erythrocytes, reduce blood viscosity and restore its fluidity. These drugs relieve vascular spasm, restore tissue resistance to hypoxia.

As an antioxidant, nootropic, antihypoxic treatment, cytoflavin, actovegin, thioctic acid, piracetam, ginkgo biloba are used.

Treatment with vestibulotropic agents reduces the effects of dizziness, eliminates unsteadiness when walking, and improves the quality of life of patients. Treatment with betahistine, vertigochel, dimenhydrinate, meclozin, diazepam justifies itself.

With high blood pressure, regular monitoring of pressure figures and heart rate and their normalization according to indications is necessary. Aspirins, dipyridamole, clopidogrel, warfarin, dabigatran are used to thin the blood. Statins are used to treat high cholesterol levels.

Currently, special attention is paid to calcium channel blockers, which, along with the function of normalizing blood pressure, have a neuroprotective effect. Cerebrolysin, cerebrolysate, gliatilin, mexidol restore cognitive functions well.

Neurotransmitters, for example, citicoline, has a nootropic and psychostimulant effect, normalizes memory, attention, improves well-being, and restores the patient's ability to self-service. The mechanism of action is based on the fact that the drug reduces cerebral edema, stabilizes cell membranes,

L-lysine aescinate has anti-inflammatory, decongestant, and neuroprotective properties. Stimulates the secretion of glucocorticoids, restores vascular permeability, tones the veins and normalizes venous outflow.

Selective therapy for cognitive disorders

To restore memory, attention, performance, donepezil is used - a drug that normalizes the exchange of neurotransmitters, restores the speed and quality of transmission of nerve impulses as intended. Restores daily activity of patients, corrects apathy, thoughtless obsessive actions, eliminates hallucinations.

Galantamine normalizes neuromuscular transmission, stimulates the production of digestive enzymes, secretion of sweat glands, lowers intraocular pressure. The drug is used for dementia, dyscirculatory encephalopathy, glaucoma.

Rivastigmine is an effective remedy. But its intake is limited by the presence of gastric ulcer, duodenal ulcer, conduction disorders, arrhythmia, bronchial asthma, urinary tract obstruction, epilepsy.

With severe psycho-emotional disorders, antidepressants are used. Selective serotonin reuptake inhibitors have proven themselves well in this pathology. These drugs include venlafaxine, milnacipran, duloxetine, sertraline. Drugs in this group in pharmacies are sold only by prescription. The attending physician prescribes these drugs, taking into account the severity of intellectual-mnestic disorders, depression, delusions.

Prevention

Prevention of dyscirculatory encephalopathy- this is, first of all, the treatment of the causes that lead to arterial hypertension, stress, diabetes, obesity. In addition to maintaining a healthy lifestyle, normalizing sleep, resting the work regime, it is necessary to avoid manual therapy on the spine. An unsuccessful tilt of the head and neck can lead to irreversible disruption of blood flow in the vertebrobasilar basin and cause disabling or fatal complications.

If there are signs of increased fatigue, memory loss, attention to working capacity, you should consult a doctor and perform examinations that will eliminate the violation of blood flow through the vessels supplying the brain. To identify cardiac, pulmonary, endocrine pathology and start treating in a timely manner is the way to success in the fight against dyscirculatory encephalopathy.

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 onset of this stage is indicated by impaired memory, 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

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.
Suffering from rheumatism.

How to overcome?

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

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

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 may 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.