Symptoms and treatment of spasms of blood vessels in the brain, legs, vasospasm of the retina

Author Andrey Belyakov

07/18/2007 19:07 (Updated: 05/21/2021 11:33)

Health » Your health

Vascular spasms (angiospasm) are usually a consequence of hypertension, hypotension, vegetative-vascular dystonia or coronary heart disease.

Naturopath, candidate of medical sciences Valentin Sergeev recommends natural methods of removing and preventing them.

General information

Vascular spasm (syn. angiospasm) is a pathological transient narrowing of the lumen of large/small arteries and capillaries due to prolonged intense/excessive contraction of the muscles of the vascular wall, causing disturbances in blood circulation/tissue metabolism.
Angiospasm can be considered as a variant of vascular crisis (acute vascular dystonia). Normally, due to their elasticity, blood vessels ensure uninterrupted and adequate blood flow to various organs, which ensures their functioning. With vascular spasm of varying degrees/localization, the parameters of local/systemic hemodynamics are correspondingly disrupted.

Maintaining vascular tone is carried out due to the tension of the vascular muscle layer, and the contractile activity of the muscle layer is directly regulated by nerve impulses from the brain arriving through sympathetic nerve fibers. It is the myogenic reactions of blood vessels that support circulatory homeostasis . In addition to muscle regulation of tone, its maintenance is carried out due to metabolic, humoral-hormonal and neurogenic mechanisms of vascular regulation.

Developing arterial insufficiency due to spasm of the arterial network leads to tissue ischemia in the area of the spasmodic artery and the development of hypoxia of various organs and tissues, which is manifested by disturbances in their functions. Previously, vasospasm was classified as a disease of “old age,” but currently there is a clear trend towards rejuvenation of vascular disorders. The reason is the high pace of life with frequent stress and unfavorable environmental conditions. The consequence of vasospasm is ischemia .

Angiospasms can occur in different vascular regions, mainly in diseases characterized by damage to the arteries/nervous apparatus ( aneurysms , atherosclerosis , vasculitis , etc.) or disorders of the neurohumoral regulation of vascular tone ( neuroses , hypertension , pathological menopause , hypothalamic syndrome , etc. .). Angiospasm often shapes the dynamics of clinical symptoms in organic vascular diseases, such as thrombosis , atherosclerosis , embolism, etc.), significantly complicating their course. Prolonged chronic or acute arterial insufficiency in the heart (coronary vasospasm), brain (cerebral vasospasm), and in the retina (retinal vasospasm) can cause the development of acute vascular insufficiency. As a rule, acute arterial obstruction is the cause of such serious conditions as myocardial infarction , stroke , and visual impairment.

Vascular stenosis develops in most cases with atherosclerotic damage to the arteries, which is caused by the deposition of cholesterol plaques on the walls. Chronic arterial insufficiency of the lower extremities is also widespread. What are the types of vascular diseases in the legs? In the lower extremities, so-called “occlusive vascular diseases” are quite common, provoked by narrowing/clogging of the iliac arteries/abdominal aorta as a result of the deposition of atherosclerotic plaques on their walls, which significantly impairs the blood flow of the lower extremities. These are obliterating diseases of the peripheral arteries of the legs ( atherosclerosis obliterans , thromboangiitis obliterans , endarteritis obliterans , diabetic angiopathy ), characterized by a steadily progressive course with the transition of increasing intermittent claudication to a constant pain syndrome. Critical leg ischemia leading to gangrene is an extremely severe outcome of long-term arterial insufficiency.

The mechanism of pathology development

In a healthy person, blood vessels dilate and contract with increased activity, stress or fear. But when a spasm occurs, a sharp narrowing of the artery or vein occurs, reducing blood flow to the tissues. At the same time, oxygen levels decrease and toxin levels increase. The brain reacts to an attack with dizziness, severe pain, vomiting or clouding of consciousness.

Previously, vasospasms were diagnosed in older patients. Aging negatively affects the condition of blood vessels, leading to loss of elasticity and firmness. In recent years, the number of young people with symptoms of the disease has increased 5–6 times. The problem requires studying the cause and threatens the development of vascular dystonia and hypertensive crisis.

Pathogenesis

The pathogenesis of vasospasm has not yet been fully studied, which is largely due to its non-identity for arteries of different vascular regions. It is generally accepted that a common factor in the mechanism of development of vasospasm includes functional disorders of the membranes of smooth muscle cells of the vessel, the essence of which is a violation of the exchange of potassium, calcium, and sodium ions through the membranes, which disrupts the alternation of muscle contraction/relaxation phases. Enhanced/accelerated depolarization of membranes, as well as an increased influx of free calcium ions into cells, contribute to intense muscle contraction, and a delay in membrane repolarization (preceding muscle relaxation) contributes to prolonged contraction of the arterial wall.

Disturbances of this kind may be caused by disturbances in the innervation of vascular walls, an imbalance in the production/destruction of humoral regulators of tone, increased sensitivity of vascular wall receptors to the effects of vasoconstrictors, and a disorder of humoral regulators of vascular tone. Often, stenosis can develop against the background of local changes in the vessel wall in areas of thrombus , vascular inflammation, scars (for example, near the area of coronary artery thrombosis/location of an aneurysm or atherosclerotic plaque).

Zonal segmental self-massage

We simultaneously influence dozens of biologically active points of the body, which helps to quickly relieve vasospasm.

Slowly stroke the forehead with relaxed palms from the bridge of the nose to the temples, forehead, face to the chin (“washing”), the back of the head - from the neck to the shoulder blades, shoulder girdles and shoulder joint - first on the left with the right hand, then on the right with the left palm.
Using your fingertips, we knead the temples in a circular manner. Then we rub the wrist joint, clasping it in a ring of the thumb and index fingers of the other hand. At the same time, we bend and straighten the massaged arm at the elbow joint.
We finish the self-massage by rubbing the knee joint between the palms, repeating each technique at least 15-20 times.

Causes

The causes of vascular spasms have not been sufficiently studied, however, a number of diseases can be identified that are accompanied by vasospasm in different vascular regions:

Atherosclerosis at the stage of pronounced atherosclerotic changes in the vascular bed.
Osteochondrosis of the spine in the cervical region.
Hormonal disorders in diseases of the endocrine system ( diabetes mellitus ).
Diseases of the cardiovascular system ( hypertension , atrial fibrillation ).
Dysfunction of the autonomic nervous system.
Traumatic brain injuries.
Frostbite.
Stress and overwork.
Brain hemorrhages.
Vasculitis is inflammation of the artery (vascular walls).
Brain tumors.
Chronic intoxication (poisoning with lead/carbon disulfide compounds).

The most common/significant risk factors for the development of vasospasm are: arterial hypertension , smoking, alcohol abuse, male gender, old age, dyslipidemia , physical inactivity and excess body weight. Among them, the greatest importance is given to disorders of fat metabolism and arterial hypertension.

Obviously, the causes of vasospasm in different vascular regions differ, that is, the causes of spasms of cerebral vessels and the causes of vasospasm of the retina or lower extremities are different.

Symptoms

Symptoms of vascular spasm are determined by its localization and are manifested by manifestations of dysfunction of ischemic tissue of various organs. Let's look at just a few of them:

Symptoms of vascular disease in the legs (using the example of obliterating atherosclerosis ). Depending on the severity of insufficiency of arterial blood supply to the limb, several stages of clinical manifestations of the disease are distinguished:

Stage of functional compensation . At this stage, cramps, chilliness and paresthesia of the lower extremities are characteristic, and less often - burning/tingling in the fingertips, leg fatigue, and increased fatigue. As the skin cools, it becomes pale and cold to the touch. As a rule, when walking on level ground after 1000 meters or more, intermittent claudication appears due to insufficient blood supply to the muscles, accumulation of under-oxidized metabolic products in tissues and disruption of the process of oxygen utilization.
Subcompensation stage . There is an increase in the intensity of intermittent claudication, which already occurs after traveling a distance of about 200 m. The skin of the legs/feet becomes dry, loses elasticity and flakes, and hyperkeratosis . Characterized by a slowdown in hair growth (patches of baldness appear) and nails, which become dull, brittle, thickened and acquire a matte color. Initial signs of atrophy of the foot muscles and subcutaneous fat are noted.
Stage of decompensation . Against the background of ongoing spasm of the vessels of the legs of the affected limb, pain appears at rest, and walking is possible at a distance not exceeding 25 meters. Progressive atrophy of the leg/foot muscles is noted, the color of the skin of the legs changes, and the skin turns pale when the limb is raised and redness appears when it is lowered. The skin becomes easily vulnerable and various types of minor injuries (abrasions/ bruises ) lead to the formation of non-healing chronic wounds , cracks , and painful superficial ulcers . The patient has limited ability to work. With severe pain syndrome, disturbances in night sleep are observed, patients take a forced position - the “doll” pose.
Stage of destructive changes . At this stage, vasospasm of the lower extremities causes the development of necrobiotic processes. And the rate of their increase is determined by the level of the gap between the amount of blood flow to the tissues and their need for oxygen. The pain in the fingers and feet is extremely intense. The resulting ulcers are located mainly in the distal parts of the legs (usually on the fingers). The bottom/edges of the ulcers are covered with a gray-dirty coating without granulation, and there is inflammatory infiltration around them. Swelling of the foot/leg develops. Characteristic is the development of wet gangrene of the fingers and feet. The ability to work at this stage is completely lost.

Symptoms of cerebral vascular spasms

Angiospasm of cerebral vessels, contributing to the development of chronic circulatory failure of brain structures (dyscirculatory encephalopathy) can develop with damage to the main arteries (stenosis of the vertebral/carotid arteries), narrowing/thickening of intracerebral arteries against the background of arterial hypertension and due to narrowing of the lumen due to thickening of the walls of small arteries.

There are several stages of development of dyscirculatory encephalopathy. The initial symptoms of the disease may be latent for some time. At this stage, the disease manifests itself with complaints of noise in the head, headaches , dizziness , and decreased non-professional memory and performance. Patients may be tearful, distracted, irritable, and depressed. They experience difficulty transitioning from one type of activity to another.

At the next stage, non-professional/professional memory impairments progress, a narrowing of the range of interests, a decrease in intelligence, and fixation on a specific problem are noted. The patients are quarrelsome, and personality changes are increasing. Such patients sleep poorly at night and are drowsy during the day. Neurological symptoms increase, spasms in the head are noted, movements slow down and their coordination is impaired, staggering when walking/mild speech impairment is characteristic, and performance is significantly reduced.

Subsequently, against the background of ischemia, gross changes in the tissue of certain brain structures occur, which intensifies the manifestations of neurological symptoms, and mental disorders develop. Patients stop recognizing loved ones, can get lost while walking, perform inappropriate actions and almost completely lose their ability to work.

Angiospasm of the retina

Bilateral retinal vasospasm is typical, less often a unilateral process is noted. Patients complain of the appearance of “fog” before the eyes and the flickering of “floaters”. With a short-term spasm, blurred vision is possible, but it is transient. Distortion of visual perception in the form of meta/photomorphopsia is possible. In some cases, a feeling of discomfort appears in the orbital area; patients may feel pulsation in the temples, headache and dizziness . After the attack is over, the patient’s condition returns to normal and visual function is restored. In severe cases (acute obstruction of the central retinal artery) can lead to a pronounced/irreversible decrease in visual acuity.

Autogenic training

To enhance the antispasmodic effect of self-massage, it is supplemented with autogenic training.

We repeat the formula to ourselves slowly as we exhale:

"I am calm. No worries. I relaxed. I'm resting. My blood vessels relax. The spasms go away. My heart beats evenly and calmly. I feel a pleasant warmth in the area of my heart and head. The head becomes light."

Please note that self-massage is carried out 2-3 times a day for at least five minutes. You can do it in bed in the morning, in the afternoon and evening, or before going outside on a windy day, or before a possible stressful situation.

Tests and diagnostics

The diagnosis of “angiospasm” is based on the presence of characteristic symptoms of vasospasm and their dynamics, characteristic of the development of transient ischemia in the area of the spasmodic artery. To establish a diagnosis, the following is carried out:

Ultrasound of leg vessels (Doppler/duplex scanning).
CT angiography (with contrast agent) of cerebral vessels, which allows you to clearly determine the diameter of the lumen of the vessels and visualize the places of narrowing.
Dopplerography of cerebral vessels (to assess the speed of blood flow in the intracranial arteries in various areas).
MRI of the brain/cervical spine.
Doppler ultrasound of the brachiocephalic arteries.
Fundus ophthalmoscopy.
Functional tests (Goldflam/thermometric, etc.).

Laboratory methods include biochemical blood tests, determination of blood cholesterol levels, and coagulogram. In the presence of cognitive impairment - neuropsychological testing.

Doctor's recommendations

Your attending physician will tell you in detail how to treat cerebral vasospasm. But taking the above medications should be combined with a healthy lifestyle.

For this it is recommended:

Stop smoking and drinking alcohol.
Establish sleep and wakefulness patterns and nutrition.
Promptly undergo treatment for infectious and dental diseases.
Conduct massage courses for the collar area.
Visit the sanatorium periodically.
Take a course of reflexology, physiotherapy, for example, electrophoresis, hydrotherapy.

Great importance should be attached to nutrition and body weight. Doctors recommend eating porridge in the morning and seafood and vegetables for lunch. It is not recommended to eat fatty, dairy, canned, fried and smoked foods, as well as sweet foods.

Coffee and tea can be replaced with herbal infusions and decoctions that help strengthen the walls of blood vessels. Such herbs include St. John's wort, rose hips, nettle and others. Carbonated drinks should also be excluded.

It is important to drink plenty of fluids daily, at least two liters. This will make it possible to avoid stagnation in the blood vessels, as well as remove harmful substances and toxins from the body.

A person’s diet should contain a lot of plant foods, fruits, vegetables, and herbs. You can add nuts and dried fruits to cereals prepared for breakfast; for lunch, you should eat legumes and lean meat along with seafood.

Prevention

Prevention of vascular diseases, including vasospasm, consists of maintaining a healthy lifestyle, including:

Balanced diet.
Active lifestyle.
Stop smoking.
Body weight control.
Monitoring blood pressure , cholesterol /sugar levels.
Periodic medical examinations.

The basis for the prevention of thrombosis and vascular diseases is the strengthening of blood vessels, which is achieved by regular practice of procedures such as contrast showers/douches, contrast foot baths, bath procedures, lymphatic drainage massage, pine/turpentine baths.

Treatment

Mostly conservative methods are used as therapy, which involve strengthening blood vessels and the state of health in general. For the treatment result to be effective, it should begin with a consultation with a doctor, who will collect anamnesis, prescribe additional studies and select the correct treatment method.

Depending on the symptoms, rubbing of the limbs, surgery, novocaine blockade and appropriate medications are prescribed, and a number of other measures are taken to alleviate the patient’s condition.

Consequences and complications

The consequences of vasospasm are determined by the duration/severity of ischemia in the area of the spasmodic artery, the sensitivity of tissues/organs to oxygen deficiency, as well as the development of collateral circulation in the affected organ. The brain and heart muscle, kidneys, and spleen are especially sensitive to hypoxia. Accordingly, ischemia of these organs is accompanied by a high risk of developing ischemic stroke and myocardial infarction . Prolonged vasospasm of the arteries of the lower extremities can cause the development of obliterating diseases ( atherosclerosis obliterans , thromboangiitis obliterans , endarteritis obliterans , diabetic angiopathy ), retinal vasospasm - visual disorders, and so on.

List of sources

Krylov V.V., Gusev S.A., Titova G.P., Gusev A.C. Vascular spasm in subarachnoid hemorrhage. M.: Medicine; 2000.
Avksentyeva M.V., Krysanov I.S., Chupin A.V. Pharmacoeconomic aspects of the treatment of obliterating diseases of the peripheral arteries of the lower extremities // Angiology and Vascular Surgery. 2012. T. 18, No. 4. P. 16-21.
Drozhzhin E.V., Darwin V.V. The role of rheological disorders in the pathogenesis of the obliterating process in the arterial system // Collection of scientific papers of Surgut State University. Vol. 12. Natural sciences. Surgut: Surgut State University Publishing House, 2003. pp. 67-69.
Zudin A.M., Zasorina M.A., Orlova M.A. Epidemiological aspects of chronic critical ischemia of the lower extremities // Surgery. 2014. No. 10. P. 78-82.
Savelyev V.S., Koshkin V.M. Critical ischemia of the lower extremities. M.: Medicine, 1997. - 160 p.