Cerebrovascular insufficiency: clinical picture, diagnosis and therapy

The SANMEDEXPERT clinic employs experienced doctors who are familiar with the innovative principles of diagnosing vascular problems with NS and world-recognized treatment methods. Specialists are helped by good knowledge of modern diagnostic equipment.

Our clinic’s team, which includes neurologists and doctors of other specializations, will focus on selecting an individual treatment course. This will help prevent possible vascular accidents and stop the development of existing neurological defects. Vascular diseases of the nervous system include a class of pathologies that affect the activity of many organs and systems of the body. They can be divided into two large classes:

  • pathologies of the central nervous system (CNS);
  • diseases of the peripheral nervous system.

Vascular diseases of the central nervous system

The central nervous system is the connecting link between all human organs and is responsible for their coordinated functioning. The central nervous system is responsible for the sensitivity and motor activity of the body. Problems in the functioning of the central nervous system cause disruption of the productive functioning of systems and organs. Most vascular diseases are associated with cerebrovascular accidents. They often lead to disability. This class of diseases is the greatest problem of modern medicine.

For the brain to function, it needs a lot of blood (up to 14% of all circulating in the body) and oxygen (up to 20%). Failure of blood supply provokes great difficulties in the functioning of the brain, and a complete break for 5-8 minutes. causes irreversible changes. At normal systolic pressure (60-180 mm Hg), blood flow is stable. With pathologies (high blood pressure, head injury, tumors) and other problems, problems with blood supply begin.

Vascular diseases of the brain include:

  • Chronic cerebrovascular insufficiency, including encephalopathy.
  • Acute cerebral circulatory disorders (transient, as well as two types of strokes).
  • Anomalies of cerebral vessels (aneurysms, disorders of venous and spinal circulation).

Vascular diseases of the central nervous system can be provoked by diabetes mellitus, cervical osteochondrosis, hypertension, and atherosclerosis.

Vascular diseases of the brain

The brain (cerebrum)
is an organ of the central nervous system, consisting of many interconnected nerve cells and their processes.

Vascular diseases of the brain are recognized in medicine as one of the most dangerous groups of diseases, as they have quite serious consequences for the body. Each cerebral vascular disease has characteristic features that depend on which specific vessels are affected by the pathological process. But in any case, doctors at OKB No. 1 warn that diseases in this group can provoke a hemorrhagic or ischemic stroke, after which the patient either becomes disabled or dies.

Clinical manifestations of vascular diseases of the brain can be divided into the following forms:

  • chronic cerebral ischemia stage I-II;
  • cerebral circulatory disorder of a transient nature;
  • cerebral infarction (ischemic stroke);
  • bleeding in the brain (hemorrhagic stroke).

Causes of cerebrovascular diseases:

The occurrence of cerebrovascular diseases occurs as follows: insufficient blood supply limits the access of oxygen and glucose, resulting in a cerebral infarction, the results of which are unpredictable. In adulthood, vascular atherosclerosis and hypertension can negatively affect blood supply.

Treatment of vascular diseases of the brain:

Among the many diseases of the cerebral vessels, coronary disease and discirculatory encephalopathy deserve special attention.
Treatment of ischemic disease involves:

  • work on restoring impaired physiological and behavioral functions, for which restorative therapy, magnetic and electrophoresis, physical therapy, and massage are used;
  • stabilization of blood pressure and prevention of strokes with the help of anticoagulant and vasodilator drugs;
  • normalization of metabolism and proper blood circulation. The best results are ensured by taking medications according to medical prescriptions.

Vegetative vascular dystonia

Vegetative-vascular dystonia is a disturbance in the functioning of the body’s vascular system, leading to insufficient oxygen supply to tissues and organs. Otherwise, this disease is called neurocirculatory dystonia, or cardiac neurosis.

Causes of VSD:

  • Exhaustion of the body due to acute or chronic infectious diseases or intoxications.
  • Sleep disturbances such as insomnia, early awakening or difficulty falling asleep.
  • Chronic fatigue, depressed mood, depression.
  • Irregular unbalanced diet.
  • Excessive physical activity or physical inactivity.
  • Hormonal changes in the body during puberty in adolescents, pregnancy or menopause in women.
  • Change of climate or time zone.

Types of vegetative vascular dystonia:

With a more accurate diagnosis, three types of vegetative-vascular dystonia are distinguished:

  • if, with general signs of fatigue, you sometimes have a feeling of lack of air, you complain of irregular heartbeats, then this is vegetative-vascular dystonia of the cardiac type;
  • The hypotensive form of vegetative vascular dystonia is characterized by low blood pressure, general weakness, headaches, coldness of the fingers and toes, and a tendency to faint;
  • periodic surges in blood pressure indicate hypertensive vegetative-vascular dystonia.

Diagnosis of VSD:

The diagnosis of vegetative-vascular dystonia is made only after a comprehensive examination of the patient and the exclusion of other pathologies that have similar manifestations to VSD.
The list of diagnostic measures includes:

  • Laboratory research of general blood test, biochemical composition of plasma, coagulation indicators, hormone levels. If necessary, urine tests are performed. Most often, the indicators of these studies do not go beyond normal values.
  • Functional techniques, including ultrasound examination of internal organs and blood vessels of the head and neck, ECG, monitoring of blood pressure levels.
  • X-ray of the spinal column, tomography of the brain and spinal cord.
  • Consultations with specialists in related specialties.

Only after confirming the absence of other diseases can a diagnosis of vegetative-vascular dystonia be made.

Treatment of vegetative-vascular dystonia:

The majority of patients with VSD do not require drug therapy. The basis of treatment for them is methods aimed at changing the patient’s lifestyle and normalizing the functioning of the nervous system. Physiotherapeutic methods are mainly used to treat the disease. This could be hydromassage, physical therapy. If the symptoms of vegetative-vascular dystonia are serious, acupuncture, manual therapy, and herbal medicine give good results. Vegetative-vascular dystonia responds well to treatment. The main thing is not to self-medicate. The choice of methods by which to treat vegetative vascular dystonia should be determined only by a doctor after conducting the necessary research. Often, VSD “masks” another disease, so its treatment should be aimed primarily at eliminating the underlying disease. And, of course, first of all, don’t bring yourself to the point of needing to see a doctor: try to avoid stressful situations and emotional breakdowns, and, if possible, take a few days of rest and spend them as you would like for a long time. Thus, treatment of vegetative vascular dystonia should be based on both drug therapy and regulation of the mental state.

How are NS pathologies diagnosed?

To identify and diagnose a vascular problem in the nervous system, a neurological examination is needed. The neurologist evaluates the following indicators: the patient’s intelligence and awareness, his ability to navigate reality and space, reflexes, etc.

Often, tests and hardware studies are necessary to establish and clarify the diagnosis. For this, patients are prescribed:

  • CT;
  • various types of ultrasound diagnostics;
  • electroencephalography;
  • X-ray examination;
  • angiography;
  • lumbar puncture;
  • clinical blood tests;
  • other diagnostic methods.

Vascular diseases of the spinal cord

The spinal cord (Medulla spinalis)
is an organ of the central nervous system, consisting of nerve cells and fibers and located in the spinal canal. It starts from the brain and ends in the vertebrae of the lumbar spine and is a long cord, shaped like a cylinder.

It consists of gray matter, which is surrounded on all sides by white matter. The gray matter is predominantly nerve cells, and the white matter is the processes of nerve cells. Spinal cord damage can be caused by various factors. Diseases of the brain and spinal cord, as well as other lesions of its various parts can cause sensory, motor and autonomic disorders. The length of the adult spinal cord ranges from 41 to 45 cm. The spinal cord regulates the functions of the entire body by transmitting nerve impulses to all internal organs.

The human spinal cord can be divided into 5 sections:

-cervical, thoracic, lumbar, sacral, coccygeal. Syndromes of spinal cord lesions differ at different levels, and also depending on which substance is affected, gray or white.

Myelitis

Myelitis
is an inflammation of the spinal cord. The sooner we stop the inflammation, the less the loss of spinal cord substance, the faster the recovery.

Causes and symptoms of myelitis:

Inflammation and destruction of spinal cord tissue leads to a disconnection of communication between the brain and the body, and therefore to:

  • sensitivity disorders;
  • paresis (paralysis).

Myelitis usually responds well to treatment, you just need to clarify the cause of its occurrence. Therefore, we suggest you conduct research on the following:

  • neuroinfections;
  • multiple sclerosis;
  • disseminated encephalomyelitis.

Diagnosis of myelitis:

  • On MRI scans of the spinal cord, foci of inflammation and demyelination are clearly visible.
  • Blood tests for antibodies to various infections and rheumatic indicators make it possible to differentiate between neuroinfection and autoimmune inflammation.
  • Blood biochemistry data will help identify possible metabolic disorders, which will allow you to select medications correctly.
  • A detailed immunogram will allow you to clearly assess the cause of what is happening and select the appropriate treatment for this situation.
  • ENMG (electromyography, electroneuromyography, myography) is a set of studies to assess muscle function and the quality of transmission of nerve impulses along peripheral nerves and pathways of the brain and spinal cord. ENMG helps us pinpoint the location of the injury (brain, spinal cord, peripheral nerve or muscle)

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Why do organic lesions develop?

The causes of organic damage to the central nervous system include:

1. Peri- and intranatal pathology (brain damage during pregnancy and childbirth). 2. Traumatic brain injuries (open and closed). 3. Infectious diseases (meningitis, encephalitis, arachnoiditis, abscess). 4. Intoxication (abuse of alcohol, drugs, smoking). 5. Vascular diseases of the brain (ischemic and hemorrhagic strokes, encephalopathy) and neoplasms (tumors). 6. Demyelinating diseases (multiple sclerosis). 7. Neurodegenerative diseases (Parkinson's disease, Alzheimer's disease).

A huge number of cases of the development of organic brain damage occurs due to the fault of the patient himself (due to acute or chronic intoxication, traumatic brain injury, incorrectly treated infectious diseases, etc.)

Diseases associated with cerebrovascular accidents

Acute or chronic damage to cerebral vessels leads to numerous cerebrovascular diseases.

Acute cerebrovascular accidents (ACVA) include various types of strokes (ischemic or hemorrhagic), transient ischemic attacks and subarachnoid hemorrhages. In ischemic types of stroke (ischemic stroke or transient ischemic attack), there is a sudden obstacle to the flow of blood through the vessels, for example, a blood clot or an atherosclerotic plaque. As a result, a certain area of ​​the brain becomes deprived of oxygen, and neurons begin to die. If during a transient ischemic attack the blockage to blood flow quickly regresses, then during an ischemic stroke it remains and a cerebral infarction is formed.

Hemorrhagic circulatory disorders arise as a result of a violation of the integrity of the blood vessels of the brain, which is manifested by hemorrhage into the substance of the brain (hemorrhagic stroke) or into the space between the brain and its membranes (subarachnoid hemorrhage).

The problem of stroke is colossal! Every day, stroke kills at least 400 people worldwide, that is, every 3.7 minutes someone dies from a stroke.

Chronic cerebrovascular accident is an equally dangerous condition. It is believed that today there are more than 35 million people living with dementia in the world. More than 40% of cases of this disease are caused by chronic cerebrovascular accidents or their combination with Alzheimer's disease. It should be said that this condition has nothing in common with “osteochondrosis of the cervical spine” and “pinched muscles in the neck.” Recently, a more precise term has been used - cerebral small vessel disease. This condition is characterized by a change in the structure of small-diameter vessels against a background of, for example, high blood pressure and, consequently, a long-term inadequate blood supply to the brain. Clinically, such conditions are characterized mainly by cognitive impairment - up to the development of vascular dementia, as well as disturbances in gait, speech, and urination.

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