In the article, we will consider the diagnosis of “DEP of the 2nd degree”. What is it, you will learn below.
DEP is an abbreviation, the decoding of which is dicirculatory encephalopathy, which means impaired brain activity due to defects in blood supply. Because of this, the brain is insufficiently supplied with oxygen, chronic prolonged hypoxia (oxygen starvation) causes impaired functioning of the brain.
The features of the mechanism of this disease are similar in some ways with ischemic stroke. But unlike a stroke, blood circulation during DEP is disturbed not suddenly and sharply, but gradually. Symptoms also increase gradually, sometimes even over a dozen years.
But what is this - a diagnosis of “DEP 2 degree”?
Difference from 1st degree
From the first degree of the disease, the second differs in that pronounced signs begin to appear, but the patient still does not lose his legal capacity. At the first stage, the symptoms are invisible, they can be easily confused with other pathologies, and sometimes do not pay attention to them at all. In the third degree, brain activity is disturbed to such an extent that a person completely loses the ability to self-care and work capacity.
Dyscirculatory encephalopathy is a very dangerous disease that leads the patient to disability, but in the third stage to absolute disability. Even at an early stage with circulatory failure in the brain, the risk of stroke increases, which also causes serious consequences. The neurologist is engaged in treatment. At the diagnostic stage, consultation with a nephrologist, cardiologist, ophthalmologist may be required.
But in most cases it is impossible to completely get rid of the second stage of DEP, since the disease is provoked by severely treatable, chronic diseases. The life expectancy of a patient with this diagnosis, if not treated, is approximately five years. If adequate therapy is given, the patient can live ten years or more. Life expectancy also depends on a person’s age and related diseases.
So, what is the diagnosis of “DEP of the 2nd degree” is more or less clear. We will understand the reasons.
Causes
The definition makes it clear that discirculatory encephalopathy is a lack of circulation of blood in the brain and the resulting symptomatic complex.
But blood circulation alone cannot be disturbed. In any case, this is a consequence of numerous diseases, mainly cardiovascular.
The second degree of discirculatory encephalopathy develops from the first. On average, it takes 2-5 years for the disease to develop into it. The process can be slowed down if the disease is treated in accordance with all medical recommendations.
DEP occurs due to the influence of the following reasons:
- With a diagnosis of “DEP of the 2nd degree of mixed origin”, atherosclerosis of BCA (brachiocephalic arteries of the brain) is observed very often. In arteries, fats are deposited on the inner walls, forming atherosclerotic plaques. Because of this, the vascular lumen narrows, which complicates the flow of blood.
- The second degree of hypertension and higher (at a pressure of more than 160 per 100). If the pressure is increased, then the arteries are compressed. Their spasm leads to circulatory difficulties. Hypertension itself can be caused by diseases of the adrenal glands and kidneys (pheochromocytoma, polycystosis, glomerulonephritis).
- Violation of blood circulation in the arteries of the spine. They send blood to the head vessels, therefore, diseases of the vertebral arteries cause circulatory disorders of the brain. Blood circulation of the spinal arteries can be disturbed due to spondylosis of the cervical spine and osteochondrosis.
- Inflammatory vascular pathology.
- Diabetes mellitus (often it causes vascular complications).
- Heart failure at stage 2B or more (the heart cannot provide normal blood supply to the brain).
- Thrombosis of the head vessels (the presence of blood clots in the vessels prevents the correct flow of blood).
- Hematomas inside the skull. Appear due to head injuries, constrict blood vessels.
- Brain tumors. Also able to compress blood vessels.
To make a diagnosis, you need to clarify the origin of the disease. However, the classification is rather vague, since a number of factors are most often involved in the formation of the disease. Pathology in this case is defined as a mixed, combined or complex genesis.
With a second-degree DEP, complaints are aggravated, a distinct neurological deficit is manifested. A neurologist at this stage can isolate a specific clinical syndrome complex:
- sensitive disorders;
- pyramidal;
- extrapyramidal;
- cerebellar;
- the diagnosis of "DEP 2 degrees with vestibulo-atactic syndrome."
Diagnostics
The diagnosis can be made directly only after analysis of the patient’s symptoms. Detailed diagnostics should be performed to determine the causes of circulatory defects in the brain.
For this purpose, you may need:
- blood test for the presence of atherosclerosis (high density lipoproteins, cholesterol, triglycerides, low density lipoproteins);
- blood test for its coagulability;
- duplex scanning of cervical and head vessels;
- assessment of the vessels of the fundus (for the second degree of DEP, a distinctive feature is the expansion of the veins of the bottom of the eye);
- angiography of the vessels of the brain of the head;
- MRI of the brain;
- if the patient has hypertension, an ultrasound scan of the adrenal glands and kidneys or their MRI is performed, as well as a blood test for urea and creatinine;
- heart examination: ultrasound, ECG, Holter monitoring during the day.
The diagnosis of "DEP 2 degrees" (decoding see above) can only be made by a qualified specialist.
Symptomatology
The second degree of DEP is accompanied by a number of neurological defects, in particular:
- Dizziness.
- Persistent headaches.
- Noise in ears.
- Fatigue and lethargy.
- Drowsiness and insomnia.
- Mood swings, tearfulness.
- Visual impairment (including glaucoma) and hearing, a diagnosis of "DEP 2 degrees" and glaucoma are often interrelated.
- Poor gestures and facial expressions, fuzzy speech.
- Violations of fine motor skills of the hands (for a patient, for example, it is difficult to thread a needle) and coordination (gait becomes shaky), slow movements;
- Poor time orientation and forgetfulness.
- In some cases, convulsive attacks.
The diagnosis of "DEP 2 degrees of mixed origin"
Symptoms during treatment may be weakened, due to which the person’s quality of life improves. If there is no necessary therapy, the signs continue to progress, more and more symptoms are added to them, and then the pathology develops into the third stage.
Among the alleged complications, an ischemic stroke is distinguished, which can develop at any stage of the disease with a diagnosis of DEP of the 2nd degree of mixed origin.
Drug treatment
A whole complex is included in the treatment of DEP disease, which is aimed at eliminating pathological signs and factors that cause changes in the brain. This issue in the modern world is of great importance. If the disease is not treated, it can cause disability, the patient will not be able to work.
The goal of the main therapy with a diagnosis of CVH, DEP of the 2nd degree is to prevent acute vascular disorders in the brain, to correct the course of the disease, due to which discirculatory encephalopathy appeared. It is also important to restore the functional activity and blood circulation of the brain.
Drug treatment for the diagnosis of “DEP of the 2nd degree” includes conducting courses of various drugs repeatedly. Unfortunately, due to difficulties in diagnosing the disease at the initial stage of occurrence, the main treatment is prescribed for the first time, when the second degree is diagnosed. With strict adherence to medical recommendations, therapeutic courses provide the opportunity to restore the individual's life and ability to work.
Many are interested in what it is and how to treat the diagnosis of “DEP 2 degree”? First of all, medical treatment of high blood pressure is carried out. In this case, the following drugs are prescribed:
- “Losartan”, “Capropril”, “Lisinopril”, etc. Thanks to these drugs, blood pressure is normalized in patients, the likelihood of chronic ischemic damage to the brain and stroke is reduced, and blood flow is established. Medicines are prescribed for atherosclerotic lesions of the renal artery, patients who suffer from heart failure and hypertension, and diabetics. For each patient, the attending physician selects a strictly individual treatment course with these means.
- If a patient has asthma, diabetes mellitus, cardiac conduction is impaired, he is prescribed “Atenolol”, “Pindolol”, “Anaprilin” and other drugs of this group of medications to lower blood pressure.
- Prescribing Verapamil, Nifedipine, Diltiazem drugs will help normalize heart rhythms, eliminate vascular spasms, improve blood circulation in the brain of the head, lower blood pressure, and eliminate headaches.
- With the appointment of "Furosemide", "Veroshpiron", "Hypothiazide" and other diuretics, blood pressure decreases due to the removal of excess water from the patient's body.
Treatment of the pathology of second-degree dyscirculatory encephalopathy in addition to normalizing blood pressure indicators should include the fight against atherosclerosis. Medicines are prescribed by a specialist if exercise therapy and diets do not help. For this purpose, drugs from among statins, fibrates, as well as medications based on fish oil or nicotinic acid can be prescribed.
Treatment of the second degree of DEP includes the mandatory prescription of vasodilators, such as Trental, Redergin, Cavinton, Cinnarizine, and new drugs, such as Vazobral. In the treatment of the disease, the specialist necessarily includes drugs that improve the processes of nerve tissue metabolism, the person’s memory and attention, his stress resistance and mental abilities, in the course of therapy. These include neuroprotectors and nootropic drugs. In addition, a multivitamin complex is prescribed.
Due to the fact that venous thrombosis becomes one of the causes of DEP disease, many patients are required to be treated with antiplatelet agents and anticoagulants.
In addition, the mandatory treatment of pathological symptoms is required. Its main goal is to eliminate the patient’s depressive state and establish an emotional background. For this, the doctor prescribes drugs with a sedative effect, as well as tranquilizers. To eliminate long-term disorders, therapeutic exercises and massages are required.
Non-drug treatment
The patient must strictly adhere to:
- proper diet;
- exclusions of smoking and alcohol;
- normalization of weight;
- physical activity.
Treatment of this disease also involves surgical intervention. They perform surgery only in difficult situations, when more than 70% of the vessels of the brain are narrowed.
Therapy of DEP disease of the first and second degree implies the use of infusions and decoctions of medicinal herbs. You need to know in this case that their treatment course will be long in time.
Here is the most popular traditional medicine recipe. Dry leaves of red clover are taken, poured into a liter jar so that they do not reach five centimeters to the top. Vodka is poured, the mixture is placed in a dark corner and stands there for two weeks. After that, it is filtered through a strainer, taken three times a day for a small spoon with such a disease, then you must definitely take a sip of cold water. You should consult your doctor before using a prescription. The specialist will tell you what time to drink the infusion.
The question that worries patients suffering from this disease is the duration of life with it. In the first and second degrees, if all the requirements of a doctor are met, you can live up to several tens of years.
Disability with a diagnosis of "DEP 2 degrees"
In the second stage of the disease, many patients may already be assigned disability. The group will depend on the severity of the symptoms.
The third group is assigned with the diagnosis of “DEP of the 2nd degree”. Its signs are so pronounced that they interfere with working capacity. But the patient has not yet lost the ability to self-care, he rarely needs outside help in everyday life.
The second group is assigned with the third degree of DEP. Symptoms suddenly cause a person’s disability. Against the background of the disease, he had already suffered a microstroke.
So, we have clarified that this is a diagnosis of grade 2 DEP.
Consequences and Complications
It was already mentioned above that with the second degree of DEP, you can get the second group of disability. However, this is not a sentence, since there is the possibility of stopping the progression of pathology and normalizing vital functions. Experts say that the second degree can be slowed down for five or even decades. However, it must be remembered that when delaying a visit to the doctor and ignoring the signs, significant complications or the transition of the disease to the third stage may appear. Among the most serious consequences can be identified: cerebral edema; strokes blockage of cerebral vessels and associated pathologies.
Therefore, is the timeliness of treatment so important in the diagnosis of "DEP 2 degrees"? We consider the prognosis of the disease below.
Forecast
In the second stage of DEP, the prognosis is not as favorable as in the first. If the circulatory disturbance of the brain is caused by diseases of a chronic nature, it can no longer be completely cured. You can only stop the growth of signs and the progression of the process.
If the patient complies with all medical recommendations regarding symptomatic therapy and treatment of the main disease, it is possible to delay the development of pathology into the third stage from seven to ten years.
If the disease is provoked by circulatory disorders of the brain, it can be completely cured (most often by surgery), and then it is possible to eliminate DEP. But operations to eliminate brain tumors (including benign) and hematomas inside the skull, compressing the vessels, in any case are associated with an increased likelihood of complications and death of a person.
That is why with the second degree of DEP the prognosis is rather unfavorable.
Preventive measures
There are not too many preventative measures for the second degree of DEP, however, when they are carried out, it is possible, if not prevent the disease, then at least slow down the development. Prophylaxis is necessary in the initial stages of the development of the disease. To do this, you must: constantly monitor blood pressure and try to keep it normal; monitor the degree of cholesterol and its fractions in the blood. In addition, situations of stress, psychological distress and emotional stress should be avoided. In the presence of pathology, one or two times a year should be completely examined and treated to avoid the progression of the disease.
We examined the diagnosis of "DEP 2 degrees." What is it, you now know.