Brain dyscirculatory encephalopathy has a vascular etiology. The development of this syndrome of a chronic lesion of a progressive nature is associated with constant insufficiency of blood supply or acute repeated circulatory disorders. In this case, the course of acute circulatory disorders of the brain is observed in combination with the clinic of strokes or without it. Silent heart attacks are detected in such cases using neuroimaging or MRI. Dyscirculatory encephalopathy of the brain is clinically manifested by mental, neurological and / or neuropsychological disorders.
Based on the recommendations of the Research Institute of Neurology, the RAMS distinguishes three degrees of severity (or stage) of the disease.
In the first degree, there is a predominance of subjective symptoms. These include noise in the head, decreased attention, dizziness, increased fatigue, headache, sleep disturbance, and instability while walking. During the examination, pseudobulbar manifestations are revealed to a mild degree, anisoreflexion, a decrease in step length, and revitalization in tendon reflexes. A neuropsychological study reveals the presence of moderate cognitive impairments of the fronto-subcortical nature (impaired cognitive activity, attention, memory) or neurosis-like disorders, mainly of the asthenic type. However, the patient can compensate for neurosis-like disorders. Thus, they do not limit its social adaptation.
Discirculatory encephalopathy of the brain in the second stage is characterized by the formation of clear clinical manifestations. At the same time, a significant decrease in the patientโs functional capabilities is observed: clinically obvious cognitive impairment that is associated with dysfunction in the frontal lobes. At the same time, a slowdown in mental processes, a decrease in memory, and impaired thinking are observed. The patient is not able to control and plan actions. There are also pronounced vestibulo-cerebellar disorders, disturbances during walking, postural instability, pseudobulbar syndrome. The second stage proceeds accompanied by apathy, depression, emotional lability, increased disinhibition and irritability. In rare cases, parkinsonism is observed. The disease may be accompanied by frequent urination at night. The second stage of the disease affects social and professional adaptation, while there is a significant decrease in the patient's working capacity, however, the ability to self-service yourself remains. Discirculatory encephalopathy of the brain in the second stage corresponds to the second or third group of disability.
The third stage of the disease proceeds with the manifestation of the same symptoms as in the second stage. However, it is necessary to note the strengthening of their disabling effect. Cognitive impairment acquires a moderate or severe degree of dementia, accompanied by gross behavioral or affective impairment. These manifestations include apathetic-abulic syndrome, a gross decline in criticism, disinhibition. Walking is also accompanied by gross disturbances, frequent falls caused by an upset of postural balance. Cerebellar disorders become more pronounced, urinary incontinence, severe parkinsonism appear. Violation of social adaptation is accompanied by a loss of self-care ability. At this stage of the disease, the patient is assigned the first or second disability group.
Alcoholic encephalopathy of the brain
This disease occurs most often with toxic organ damage caused by alcohol consumption, eating disorders (eg, anorexia) and in persons with high degree of exhaustion.
Encephalopathy of the brain in children
This disease appears, as a rule, between the twenty-eighth week of gestation and the first week after childbirth. The disease can be triggered by oxygen starvation, infection or entanglement of the umbilical cord. The causes of the disease include premature or difficult birth.