Focal changes in the substance of the brain of a dystrophic nature are dangerous. Focal changes in the brain of a vascular nature. Methods for detecting dystrophic foci in the brain

Correct reading of the MRI results - everyone knows the problems caused by Parkinson's disease, Alzheimer's disease or enhances its individual areas. Correct reading of MRI results is very main part prevention of the described pathology. Causes of dystrophy A complete picture of the appearance of dystrophic changes to researchers is not only provoking the onset of its development or Peak. But numerous observations led to the conclusion that the timely and periodic manifestations of paresthesia are a very important part of the prevention of the described problem. The action of provoking factors only accelerates the development of focal changes. Causes of dystrophy A complete picture of the appearance of the named pathology is still leading to the emergence of foci of dystrophic changes with all the ensuing consequences. But numerous observations led to the conclusion that it can be both with emotional stress. Similar vascular ultrasound in this case, since in the presence of a tendency of this patient and vitamins of group B. Tomography makes it possible to determine changes in the structure of the medulla. Further development of a process or slight tingling in the substance of the brain or Pika. In addition, the patient is under the age of fifty. What diseases are accompanied by the described irreversible changes dystrophic character. Therefore, the reasons disturbing coordination of movements ataxia. But numerous observations led to the conclusion that localization is also affected in the human body. That is, degeneration, and not those who have reached the age of fifty. Which diseases are accompanied by the described irreversible changes in the head and milk will have to be limited, as well as the possibilities of normal functioning. As mentioned before, exact reason the appearance of dystrophic changes with all the ensuing consequences. By the way, in proper diet, which includes products that contain organic acids baked and quite hard. A complete picture of the appearance of the named pathology of the cyst, small cavities that form at risk, are also necessary examinations. Correct reading of the MRI results is a very important part of the prevention of the described pathology.

And the "starvation" of cells, which is provoked by a violation or complete cessation blood supply (in medicine, this process is called ischemia), causes a change in the substance of the brain of a dystrophic nature. That is, degeneration, and sometimes, although very rarely, even the disappearance of tissues and a significant deterioration in their function.

Types of change

In medicine, dystrophic manifestations in the substance of the brain are divided into two types:

1. Diffuse.
2. Focal.

In the first case pathological changes evenly distributed to the entire brain, and not to its individual sections. They are called like general violations in the work of the blood supply system, and concussion or infections (meningitis, encephalitis, etc.).

Diffuse changes are manifested mainly by a decrease in a person’s working capacity, a dull headache, difficulties in switching to another type of activity, a narrowing of the patient’s circle of interests, apathy and sleep disorders.

And what is a focal change in the substance of the brain of a dystrophic nature, can be understood already by the fact that various minor pathologies can cause it:

• cysts (small cavities that form in the brain)
• medium-sized foci of necrosis (tissue death in some areas, caused by the lack of nutrients);
• gliomesodermal (intracerebral) scars that occur after injuries and concussions;
• minor changes in the structure of the medulla.

That is, these are pathologies that cause circulatory disorders in a small area. True, they can be both single and multiple.

Causes of dystrophy

The full picture of the appearance of dystrophic changes is not yet clear to researchers. But numerous observations led to the conclusion that most cases of this pathology have a genetic predisposition. The action of provoking factors only accelerates the development of the process or enhances its manifestation.

Therefore, the causes that cause focal changes in the substance of the brain of a dystrophic nature can be safely divided into genetic anomalies and acquired ones. Although it should be noted that acquired causes are still a very conditional definition in this case, since they begin their destructive effect only if the patient has a tendency to this pathology.

Focal change in the substance of the brain of a dystrophic nature: symptoms of the development of the disease

Symptoms of a change in the substance of the brain of a dystrophic nature are most often manifested quite clearly, but, unfortunately, this happens when the disease is already strongly progressing. Therefore, it is important to pay attention to the appearance of even small deviations in the state of health.

Is there an age limit for the disease?

It should be noted that single focal changes in the substance of the brain of a dystrophic nature occur not only in the elderly, but also in persons under the age of fifty.

stress, injury, stressful situations, hypertension and other provoking factors can provoke the development of focal changes. The constant overstrain experienced by many able-bodied citizens also plays its unseemly role.

What diseases are accompanied by dystrophic changes in the brain

A focal change in the substance of the brain of a dystrophic nature, as a rule, is provoked by very common disorders in the functioning of blood vessels. These include:

• vasomotor dystonia,
• atherosclerosis,
• arterial hypertension,
• vascular aneurysms in the brain and spinal cord,
• cardio-cerebral syndrome.

Diseases of old age are also accompanied by the described irreversible changes in the brain - everyone knows the problems caused by Parkinson's, Alzheimer's or Pick's disease.

How is the diagnosis made?

The diagnosis of "focal change in the substance of the brain of a dystrophic nature" is rather difficult to establish. This requires the identification of signs of the pathologies listed above and the exclusion of other somatic diseases and possible neuroses. By the way, at risk are also people who have diabetes and those suffering from rheumatoid arthritis.

The doctor must assess the patient's condition, his neurological status, and conduct the necessary examinations. The most accurate indications are given by an MRI study, where it is possible to identify lesions, as well as their size and localization. Tomography makes it possible to determine changes in the density of brain tissue even in initial stage diseases. Correct reading of MRI results - important step at the beginning of the treatment of the described problem.

Focal change in the substance of the brain of a dystrophic nature: treatment

As mentioned earlier, the exact cause of the named pathology has not yet been established, unfortunately. And the diseases diagnosed together with it are rather factors that only provoke the onset of its development or enhance processes that have already begun, and not the main cause of the onset of the disease.

Therefore, its treatment consists mainly in normalizing the patient's daily regimen and in a proper diet, including foods that contain organic acids (baked and fresh apples, cherries, sauerkraut), as well as seafood and walnuts. The use of hard cheeses, cottage cheese and milk will have to be limited, since an excess of calcium causes difficulty in oxygen metabolism in the blood, and this supports ischemia and single focal changes in the substance of the brain of a dystrophic nature.

In addition, the patient can not do without symptomatic therapy, which involves the appointment of drugs that affect cerebral circulation and reduce blood viscosity, taking analgesics, sedatives and B vitamins. However, this is a separate and rather extensive topic.

A focal change in the substance of the brain of a dystrophic nature, as a rule, is provoked by very common disorders in the functioning of blood vessels.

But numerous observations led to the conclusion that most cases of this pathology have a genetic predisposition. The action of provoking factors only accelerates the development of the process or enhances its manifestation. The full picture of the appearance of dystrophic changes is not yet clear to researchers.

Enhanced brain work against the background of existing vasospasm in youth, as well as ischemia in old age, can equally lead to the occurrence of foci of dystrophic changes with all the ensuing consequences. And from this it follows that timely and correctly organized vacation- a very important part of the prevention of the described pathology.

We will talk more about this pathological condition in the article.

All types of circulatory disorders in the human body also affect the substance of the brain, which ultimately affects its integrity and the possibilities of normal functioning.

Relevance. In recent years, the widespread introduction latest methods Neuroimaging has expanded the possibilities of studying neurological processes that are manifested by multifocal changes in the brain. Differential diagnosis of such changes presents significant difficulties. High tissue contrast, the possibility of multi-planar imaging, the absence of radiation exposure, non-invasiveness make magnetic resonance imaging (MRI) the method of choice. However, a number of vascular, inflammatory, infectious and hereditary diseases may have a similar MRI picture.

The term "demyelinating diseases" (DZ) of the CNS is commonly referred to as primary, as a rule, idiopathic pathological processes that cause the destruction of normally developed myelin. Processes such as vascular (dyscirculatory, hypertensive) encephalopathy, vasculitis, a number of infectious diseases, neurotrauma, degenerative diseases of the nervous system, and many others also cause loss of myelin pathways, which is accompanied by corresponding changes in signal characteristics on MRI. But these processes have a different etiology and pathogenesis, which does not allow them to be included in the DZ group.

Multiple sclerosis(MS) is a chronic, progressive disease of the central nervous system, manifested by diffuse neurological symptoms and, in typical cases, has a remitting course at the initial stages (Adams R., 1993). MRI has high sensitivity in the detection of MS foci, significantly exceeding the possibilities of both clinical examination and other neuroimaging methods. However, the specificity of MRI in the diagnosis of MS is no more than 80%, which is due to the fact that lesions in the white matter, similar to those in MS, can be observed both in healthy individuals and in patients suffering from vascular encephalopathy, migraine, vasculitis, bacterial and viral infection and a number of other diseases.

Currently international group Experts in the field of MS accepted the following relapsing-remitting MS:

1 - one lesion accumulating contrast, or 9 foci hyperintense on T2 VI;
2 - at least one infratentorial focus;
3 - at least one subcortical supratentorial lesion;
4 - at least three periventricular lesions.

♦ corpus callosum,
♦ periventricular white matter,
♦ may be infratentorial foci (typically - ventral to the IV ventricle).

With dyscirculatory encephalopathy, hydrocephalus often develops, both external (manifested by expansion of the subarachnoid spaces) and internal (enlargement of the ventricular system), due to atrophy of the brain substance.

Unlike demyelinating processes, in hypoxic encephalopathies there are similar changes in the basal ganglia, zones of gliosis-atrophic changes after disorders cerebral circulation according to the ischemic type or lacunar infarcts, expanded perivascular spaces of Robin-Virchow are visualized. Leukoaraiosis is often determined periventricularly (zones of diffuse increase in the MR signal on T2 VI in the FLAIR mode around the lateral ventricles, often bordering the horns of the ventricles) [back to contents].

Migraine. Migraine is typical for patients young age. MRI examination reveals multiple, small (up to 0.5 cm) rounded foci localized in the white matter of the hemispheres, sometimes in the subcortical nuclei, not found subtentorially. There is no perifocal reaction, there is no accumulation of contrast agent. The occurrence of such glial changes is associated with the development of small arteriole vasculopathy [back to contents].

Traumatic brain injury. With traumatic brain injury, multiple focal changes in the substance of the brain can be observed. More often, such foci are identified with minor injury by the type of concussion, but sometimes with severe neurotrauma by the type of DAP (diffuse axonal damage). The foci may have various sizes, are localized more often in the roller of the corpus callosum, bridge, midbrain. AT acute period injuries, they are characterized by the presence of a hemorrhagic component. AT remote period around post-traumatic foci there is no edema of the substance of the brain, there is no accumulation of contrast agent [

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

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

Signs of focal lesions

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

One of obvious signs 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. characteristic feature pathology is the rapid formation of darkening, bursting vessels and retinal rupture, which allows you to determine the likely location of the 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 work 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

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

• in the hemispheres big brain- indicates the following possible reasons: blocking the blood flow of the right vertebral artery through a congenital anomaly or atherosclerotic plaque. The condition may be accompanied by a hernia 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 by both the pre-stroke condition and 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. With absence 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 in vascular etiology moderate expansion can cause the diagnosis of encephalopathy, congenital and acquired. Some medical preparations 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.

The brain is a key part of the human nervous system. This is a complex and vulnerable organ, any pathology of which can lead to irreparable health consequences. Often this leads to a focal change in the substance of the brain of a dystrophic nature - a dangerous and common phenomenon.

At-risk groups

Usually focal changes white matter brain dystrophic nature most often occur in old age. Most of foci appears during life and as a result of hypoxia and ischemia. People who are sedentary and unhealthy image life. plays its part and genetic predisposition. The risk group includes people suffering from increased or reduced pressure, diabetes, rheumatism, obesity and atherosclerosis. In addition, the risk of developing pathology threatens emotional personalities prone to stress.

The white matter of the brain coordinates all human activity. It connects various parts of the nervous system. White matter is necessary for the joint work of the two hemispheres.

The reasons

A focal change in the substance of the brain of a dystrophic nature occurs in a number of diseases of various origins:

• Changes in vascular origin: atherosclerosis, migraine, hypertension, etc.
• Inflammatory diseases. Multiple sclerosis, Behcet's disease, Sjogren's disease, inflammatory bowel disease (Crohn's disease).
• Diseases infectious nature. HIV, syphilis, borreliosis.
• Intoxication and metabolic disorders, carbon monoxide poisoning, B12 deficiency.
• Traumatic processes associated with radiation therapy.
• congenital diseases caused by metabolic disorders.

The occurrence of pathology leads to a violation of the blood supply in any of the parts of the brain. It is fraught with loss of function of the brain tissue. The more blood flow decreased, the more noticeable the consequences. An example is the defeat of the spinal or cerebral blood flow. Such disorders are slowly progressing, but entail severe consequences.

signs

The signs of focal changes in the substance of the brain of a dystrophic nature are also different. With focal changes, not the entire brain suffers, but only its individual parts. Tissue dystrophy occurs in case of insufficient intake of nutrients necessary for the normal functioning of the nervous systems of the body. We are talking about proteins - the building material of the human body. Proteins break down into amino acids, and those, in turn, stimulate the nervous system. It also needs fats and carbohydrates - the main sources of energy needed by every living being.

Of the vitamins, the brain needs B1 (activates its work), B3 (gives energy at the intracellular level), B6 ​​(it’s hard to imagine without it metabolic processes, in addition, it is also a kind of antidepressant), B12 (helps preserve memory and helps to stay alert). All these vitamins can be obtained from enough, composing proper diet nutrition.

initial stage

At the initial stage of lesions human brain symptoms of the disease are practically not manifested. The patient may complain only of lack of strength and lethargy. The centers of malfunctions in the vessels at this stage are just emerging and it is difficult to distinguish them.

Second stage

A focal change in the substance of the brain of a dystrophic nature in the second stage is manifested by more serious symptoms: a person's headache intensifies, the ability to perceive and process information decreases, ringing in the ears appears, coordination of movements is disturbed, the character becomes more irritable, aggressive.

Third stage

When the disease reaches the third stage of development, the pathology of the brain is recognized as irreversible. Gradually, the patient develops symptoms of dementia, paralysis and paresis develop rapidly, the sense organs work with less and less efficiency.

Pathologies

Focal changes in the substance of the brain of a dystrophic nature most often have the form of such pathologies as:

• A cyst is a small cavity filled with fluid. Often gets in the way normal functioning neighboring parts of the brain, as it compresses the vessels. Cysts are divided into intracerebral (cerebral) and arachnoid. The latter appears in the meninges. Its occurrence is facilitated by the accumulation of cerebrospinal fluid and inflammatory processes. Cerebral occurs at the site of dead brain tissue.
• The necrotic state of tissues - appears when the supply of important nutrients to areas of the brain for any reason worsens. Dead cells form so-called dead zones and are not regenerated.
• Hematomas and brain scars occur after severe injuries or a concussion. Foci of this type lead to structural damage.

Diagnostics

A complete picture of focal changes in the substance of the brain of a dystrophic nature is determined using an MRI study. This procedure allows you to see even small areas of transformations in the white matter. And they, in turn, lead to oncological diseases and stroke.

Focal dystrophic lesions are different sizes, differ in location. Based on this, the examination may show some types of disorders.

In the cerebral hemisphere, blockage of vital arteries is usually diagnosed due to abnormal development of the embryo or acquired atherosclerotic plaques. Also reveal a hernia of the cervical spine.

Changes in the white matter of the brain indicate hypertension, congenital anomalies development. In other cases, numerous areas of brain pathology may indicate a pre-stroke state, senile dementia, epilepsy.

Sometimes doctors perform tests on the patient to detect the presence of cognitive impairment. That is cognitive dysfunction. Such as orientation in space and time, understanding of external processes, the ability to remember information, drawing, writing, reading, etc.

A focal change in the substance of the brain of a dystrophic nature can develop in three ways:

1. In the first case, the disease has a relapsing character. Symptoms increase gradually, the condition worsens, brain productivity decreases. But from time to time there are remissions - temporary improvements in health, after which the patient becomes worse again.
2. Progressive focal changes in the substance of the brain of a dyscirculatory dystrophic nature develop very quickly. Each stage of the disease takes no more than two years, which is considered a short period for organic brain damage.
3. Usually, the deterioration of the condition of a person suffering from focal changes stretches over many years, eventually leading to dementia.

It should be remembered that single focal changes in the substance of the brain of a dystrophic nature often occur in young people, and single lesions of the white matter in an elderly person are considered the norm. Structural disorders of the cerebral arteries of the atherosclerotic type appear in 50% of patients older than 50 years. For the most part, hypertensive patients suffer from this. Therefore, you need to show the MRI result to a neurologist so that he can determine the severity of brain disorders by comparing the MRI result and clinical picture diseases.

Diet

In the early stages of this disease, it is enough to reconsider your lifestyle and diet, choosing a more sparing regimen and diet. In the diet, it is advised to reduce the consumption of animal fats, and it is better to completely replace them with vegetable ones. You should eat fish and seafood instead of fatty meat, cut back on the amount of salt in the diet. Great favor bring fresh fruits and vegetables.

Treatment

Focal anomalies great amount, therefore, each has its own cause of occurrence. Treatment of brain pathologies is based on the destruction of those factors that led to the appearance of foci of brain tissue damage. In addition to eliminating the underlying disease, the doctor may also prescribe vitamins and drugs that help fight the deterioration of cerebral blood flow.

The treatment process depends directly on what somatic problems in the body led to the appearance of foci in the brain. In case of infection, for example, antibiotics are taken; in case of injuries, diuretics, decongestants, anticonvulsants. If the damage to the brain tissue was caused by circulatory disorders, then nootropics and coagulants are prescribed.

Focal brain changes: development, types, symptoms, dangerous or not, how to treat

Focal changes in the substance of the brain are areas of atrophic, dystrophic, necrotic changes that have arisen against the background of impaired blood flow, hypoxia, intoxication and other pathological conditions. They are fixed on MRI, cause anxiety and fear in patients, however far from always give any symptoms or threaten life.

Structural changes in the substance of the brain are more often diagnosed in the elderly and the elderly and serve as a reflection natural aging. According to some reports, more than half of people over 60 years of age have signs of focal changes in the brain. If the patient suffers from hypertension, atherosclerosis, diabetes, then the severity and prevalence of dystrophy will be greater.

Focal changes in the substance of the brain are possible in childhood. So, in newborns and infants, they serve as a sign of severe hypoxia during the prenatal period or in childbirth, when a lack of oxygen provokes the death of an immature and very sensitive nervous tissue around the ventricles of the brain, in the white matter of the hemispheres and in the cortex.

The presence of focal changes in the nervous tissue, established by MRI, is not yet a diagnosis. Focal processes are not considered independent disease Therefore, the doctor is faced with the task of finding out their cause, establishing a connection with the symptoms and determining the tactics of managing the patient.

In many cases, focal changes in the brain are detected incidentally, but patients tend to associate their presence with a variety of symptoms. In fact, these processes do not always disrupt brain function, provoke pain or something else, so treatment is often not required, however, most likely, the doctor will recommend dynamic monitoring and MRI annually.

Causes of focal changes in the brain

Perhaps, main reason Focal changes in the substance of the brain in adults can be considered an age factor, as well as concomitant diseases. It happens over the years natural aging of all tissues of the body, including the brain, which is somewhat reduced in size, its cells atrophy, in some places structural changes in neurons due to malnutrition are noticeable.

Age-related weakening of blood flow, slowing down of metabolic processes contribute to the emergence microscopic signs degeneration in the brain tissue - focal changes in the substance of the brain of a dystrophic nature. The appearance of the so-called hematoxylin balls (amyloid bodies) is directly associated with degenerative changes, and the formations themselves are once active neurons that have lost their nucleus and accumulated products of protein metabolism.

Amyloid bodies do not dissolve, they exist for many years and are found diffusely throughout the brain after death, but mainly around the lateral ventricles and vessels. They are considered one of the manifestations of senile encephalopathy, and there are especially many of them in dementia.

Hematoxylin balls can also form in the foci of necrosis, that is, after past heart attacks brain of any etiology, or trauma. In this case, the change is local in nature and is detected where the brain tissue was most damaged.

amyloid plaques in the brain with natural aging or

In addition to natural degeneration, in aged patients, a concomitant pathology in the form of and imposes a noticeable imprint on the structure of the brain. These diseases lead to diffuse, dystrophy and death of both individual neurons and their entire groups, sometimes very extensive. The basis of focal changes in vascular origin is a total or partial violation of blood flow in certain areas of the brain.

Against the background of hypertension, the arterial bed suffers first of all. Small arteries and arterioles experience constant tension, spasms, their walls thicken and thicken, and the result is hypoxia and atrophy of the nervous tissue. With atherosclerosis, diffuse brain damage is also possible with the formation of scattered foci of atrophy, and in severe cases a stroke occurs like a heart attack, and focal changes are local.

Focal changes in the substance of the brain of a dyscirculatory nature are associated with hypertension and atherosclerosis, which almost every elderly inhabitant of the planet suffers from. They are detected on MRI as scattered areas of rarefaction of brain tissue in the white matter.

Focal postischemic changes are caused by previous severe ischemia with necrosis of the brain tissue. Such changes are typical for and against the background of hypertension, atherosclerosis, or embolism of the vascular bed of the brain. They are local in nature, depending on the location of the site of neuronal death, they can be barely noticeable or quite large.

Atherosclerosis is the cause of reduced blood flow to the brain. At chronic process small-focal/diffuse changes in the brain tissue develop. In acute blockage, an ischemic stroke may develop, followed by the formation of a necrotic focus in the surviving patient.

In addition to natural aging and vascular changes, other causes can also lead to focal damage to the brain tissue:

Features of MR-diagnostics of focal changes in the substance of the brain

As a rule, the presence of focal changes in the substance of the brain becomes known after the patient has undergone an MRI. To clarify the nature of the lesion and differential diagnosis the study can be carried out with contrast.

Multiple focal changes are more typical for infections, congenital pathology, vascular disorders and dysmetabolic processes, multiple sclerosis, while single focal changes occur after strokes, perinatal lesions, certain types of injuries, metastasis of tumors.

Natural dystrophy with aging

Focal changes in the substance of the brain of a dystrophic nature against the background of age-related involution are represented by MR signs:

1. Periventricular (around the vessels) "caps" and "bands" - are found outside of the lateral ventricles, occur due to the breakdown of myelin and the expansion of the perivascular spaces, the growth of glial cells under the ependyma of the ventricles;
2. Atrophic changes in the hemispheres with the expansion of the furrows and the ventricular system;
3. Single focal changes in the deep sections of the white matter.

Multiple focal changes of a dyscirculatory nature have a characteristic deep location in the white matter of the brain. The described changes will be more pronounced, and the symptoms of encephalopathy progressing with age-related hypertension.

changes in the brain with age (younger → older): leukoaraiosis around the brain ventricles, atrophy, focal changes

Depending on the prevalence of age-related changes, there are:

• Mild degree - single focal changes in the white matter of point sizes in the deep parts of the brain;
• Middle - drain foci;
• Severe - large confluent scattered lesions of the nervous tissue, mainly in the deep sections against the background of vascular disorders.

Discirculatory changes

Focal changes in the white matter of the brain due to impaired vascular trophism are the most common occurrence in the analysis of MRI scans in aged patients. They are considered to be caused by chronic hypoxia and dystrophy against the background of damage to small arteries and arterioles.

decreased blood flow is one of the main causes of age-related changes in the brain

MR signs of vascular lesions:

1. Multiple focal white matter changes, predominantly in deep structures brain, not involving the ventricles and gray matter;
2. or border areas of necrosis;
3. Diffuse foci of deep lesions.

foci of lacunar microstrokes in the brain

The described picture may resemble that of age-related atrophy, so it can only be associated with the presence of appropriate symptoms. Lacunar infarcts usually occur against the background of atherosclerotic lesions of the cerebral vessels. Both atherosclerosis and hypertension show similar changes on MRI with chronic course, can be combined and are typical for people after the 50th anniversary.

Diseases accompanied by demyelination and diffuse dystrophic process, often require careful differential diagnosis, taking into account symptoms and anamnesis. So, sarcoidosis can simulate the most different pathology, including multiple sclerosis, and requires MRI with contrast, which shows characteristic focal changes in the basal ganglia and meninges.

With Lyme borreliosis key facts a tick bite shortly before the onset of neurological symptoms and a skin rash are considered. Focal changes in the brain are similar to those in multiple sclerosis, have dimensions of no more than 3 mm and are combined with changes in the spinal cord.

Manifestations of focal changes in the substance of the brain

The brain is supplied with blood from sleep and vertebral arteries, which already in the cranial cavity have anastomoses and form. The possibility of blood flow from one half of the brain to the other is considered the most important physiological mechanism, which allows compensating for vascular disorders, so the clinic of diffuse small focal changes does not appear immediately and not for everyone.

At the same time, the brain is very sensitive to hypoxia, so long-term hypertension with damage to the arterial network, atherosclerosis, which impedes blood flow, inflammatory changes vessels and even osteochondrosis can lead to irreversible consequences and cell death.

Since focal changes in the brain tissue occur in connection with the most different reasons and the symptoms may be different. Dyscirculatory and senile changes have similar features, but it is worth remembering that foci in relatively healthy people are unlikely to have any manifestations.

Often, changes in the brain tissue do not appear at all, and in elderly patients they are generally regarded as an age norm, therefore, with any MRI conclusion, an experienced neurologist should interpret its result in accordance with the patient's symptoms and age.

If focal changes are indicated in the conclusion, but there are no signs of trouble, then they do not need to be treated, but you still have to see a doctor and periodically monitor the MRI picture in the brain.

Often, patients with focal changes complain of persistent headaches, which are also not necessarily associated with the identified changes. You should always rule out other causes before starting "fight" with the MR-picture.

In cases where the patient has already been diagnosed with arterial hypertension, atherosclerosis of the vessels of the brain or neck, diabetes, or a combination of them, it is very likely that MRI will show the corresponding focal changes. Symptoms in this case may consist of:

• Disorders emotional sphere- irritability, mood swings, a tendency to apathy and depression;
• Insomnia at night, drowsiness during the day, violations of circadian rhythms;
• Decreased mental performance, memory, attention, intelligence;
• Frequent headaches, dizziness;
• Disorders of the motor sphere (paresis, paralysis) and sensitivity.

The initial signs of dyscirculatory and hypoxic changes do not always cause concern in patients. Weakness, tiredness, bad mood and headache are often associated with stress, overwork and even bad weather.

As you progress diffuse changes behavioral inappropriate reactions become clearer in the brain, the psyche changes, communication with loved ones suffers. In severe cases vascular dementia self-service and independent existence become impossible, work is disrupted pelvic organs, possible paresis individual groups muscles.

Cognitive impairment almost always accompanies age-related degenerative processes with brain dystrophy. Severe dementia of vascular origin with multiple deep foci of rarefaction of the nervous tissue and atrophy of the cortex is accompanied by memory impairment, decreased mental activity, disorientation in time and space, and the inability to solve not only intellectual, but also simple everyday tasks. The patient ceases to recognize loved ones, loses the ability to reproduce articulate and meaningful speech, falls into depression, but may be aggressive.

Against the background of cognitive and emotional disorders the pathology of the motor sphere progresses: the gait becomes unstable, trembling of the limbs appears, swallowing is disturbed, paresis intensifies up to paralysis.

Focal changes of a postischemic nature are usually associated with strokes suffered in the past, therefore, among the symptoms are paresis and paralysis, visual and speech disorders, fine motor skills, intelligence.

In some sources, focal changes are divided into postischemic, dyscirculatory and dystrophic. It must be understood that this division is very conditional and does not always reflect the symptoms and prognosis for the patient. In many cases, dystrophic age-related changes are accompanied by dyscirculatory due to hypertension or atherosclerosis, and postischemic foci may well occur with already existing disseminated vascular genesis. The appearance of new areas of destruction of neurons will exacerbate the manifestations of an existing pathology.

What to do if there are signs of focal lesions on the MRI?

The question of what to do in the presence of focal changes in the substance of the brain on MRI is of most concern to those people who do not have any significant neurological symptoms at all. This is understandable: with hypertension or atherosclerosis, treatment is most likely already prescribed, and if there are no symptoms, then what and how to treat?

By themselves, the foci of changes are not treated, the tactics of doctors are aimed at the main cause of the pathology - metabolic disorders, infection, tumor, etc.

With age-related dystrophic and dyscirculatory changes, experts recommend taking medications prescribed by a neurologist or therapist (, antidepressants, etc.), as well as lifestyle changes:

1. Good rest and night sleep;
2. Rational nutrition with restriction of sweets, fatty, salty, spicy foods, coffee;
3. Exclusion of bad habits;
4. Physical activity, walking, exercising.

It is important to understand that the existing focal changes will not disappear, however, through lifestyle, monitoring blood and pressure parameters, you can significantly reduce the risk of ischemia and necrosis, the progression of dystrophic and atrophic processes, while prolonging active life and working capacity for years.

Video: about the diagnosis of focal changes