Atherosclerotic encephalopathy: types, causes, symptoms and treatment

The term "atherosclerotic discirculatory encephalopathy" refers to a pathological process, the course of which is characterized by damage to the vessels of the brain. The main reason for the development of the disease is poor cerebral blood flow and, consequently, oxygen starvation of tissues. These violations are a consequence of the deposition of atherosclerotic plaques on the walls of blood vessels, and therefore the disease is most often diagnosed in the elderly.

Blockage of blood vessels

Pathogenesis

Under the influence of various adverse factors in the liquid connective tissue, the concentration of "bad" cholesterol increases. It settles on the walls of blood vessels, due to which their lumen narrows. As a result, brain cells do not receive the necessary amount of oxygen and vital components. Over time, a person develops chronic ischemia of white matter. The consequence of this is a disruption of the brain and the occurrence of structural changes in the nervous system.

In addition to atherosclerotic encephalopathy, it is customary to distinguish hypertonic and mixed. In the first case, persistent arterial hypertension is the basis of pathogenesis. The mixed type combines clinical manifestations of both hypertensive and atherosclerotic encephalopathy. Recently, doctors separately isolated venous form of the disease. It develops against the background of violation of the outflow of blood from the cranial cavity.

The International Classification of Diseases (ICD-10) assigned atherosclerotic encephalopathy code I67.

Cerebral vascular obstruction

Etiology

The main reason for the development of the disease is atherosclerosis of the blood vessels responsible for the nutrition of the brain. The following diseases and conditions are provoking factors to increase the level of "bad" cholesterol:

  • Disorders of lipid metabolism.
  • High blood pressure.
  • Diabetes.
  • Smoking
  • Frequent use of alcohol-containing drinks.
  • Hereditary predisposition.
  • Overweight.
  • Unbalanced diet.

According to statistics, atherosclerotic encephalopathy is most often diagnosed in men. Doctors believe that this is due to the effect of hormones on cholesterol metabolism. In addition, age is a natural risk factor. The older the person, the higher the likelihood of developing an ailment.

Severity

It is customary to distinguish the following forms of atherosclerotic encephalopathy:

  • Easy. In this case, the symptoms are absent or mild. Characteristic signs are psychopathies of various kinds and cerebrosthenic syndrome.
  • Subcompensated. At this stage, structural changes in the brain become more pronounced. The clinical picture is aggravated, focal symptoms occur.
  • Decompensated. It is characterized by pronounced clinical manifestations. Organic changes can be detected in the brain, including cortical atrophy. The density of white matter is reduced.

Thus, the severity of the symptoms of atherosclerotic encephalopathy depends on the severity of the disease.

Atherosclerotic plaques

Clinical manifestations

The characteristic signs of pathology are indicated in the table.

StageSymptoms of the disease
Easy
  • Irritability.
  • Memory impairment.
  • Frequent episodes of headache.
  • Psychopathy.
  • Anxious dream.
Subcompensated
  • Persistent headache.
  • Lethargy.
  • Noise in ears.
  • Sleep disturbance.
  • Decreased concentration.
  • Memory impairment.
  • Disorientation in space.
  • Tremor.
  • Movement becomes slow.
  • Visual and hearing impairment.
Decompensated
  • Paralysis.
  • Paresis.
  • Seizures that are similar to epileptic.
  • Speech impairment.
  • Severe mental disorders.
  • Dementia
  • Often there is a stroke.

At the initial stage of the development of the disease, the symptoms are not specific. Most people attribute their presence to banal fatigue. Thus, many patients turn to a medical institution at the stage of rapid progression of the disease.

Clinical manifestations

Diagnostics

If the first signs of atherosclerotic encephalopathy occur, you should consult a doctor as soon as possible. The pathology is treated by a neurosurgeon, neurologist and vascular surgeon.

The primary diagnosis of the disease involves the collection of an anamnesis and a physical examination. In addition, the doctor assesses the condition of the vestibular apparatus, checks muscle and tendon reflexes, and also tries to understand how much clarity of speech and cognitive functions are preserved.

After the initial diagnosis, the doctor draws up a referral for a comprehensive examination, including:

  • MRI or CT with contrast.
  • REG.
  • Duplex scanning of blood vessels.
  • Fundus examination.

Based on the results of the diagnosis, the doctor chooses the patient management tactics.

Consultation with a doctor

Treatment

The disease requires a comprehensive therapeutic approach. In all cases, the treatment of atherosclerotic encephalopathy involves the use of medications.

The classical scheme of therapy of pathology consists of the following items:

  • Taking drugs with antihypertensive effect. The active components of the drugs help to lower blood pressure. As a rule, doctors prescribe Betalok ZOK and Physiotens to patients.
  • Taking medications with lipid-lowering effect. During treatment, the level of "bad" cholesterol in the blood is significantly reduced. Examples of funds: Atorvastatin, Krestor.
  • Reception of nootropics. The active components of these drugs positively affect the functioning of the brain. As a result, patients increase their speed of thinking and improve memory. As a rule, doctors prescribe Phenibut and Nootropil.
  • Reception of neuroprotectors and drugs designed to normalize blood circulation. Examples of preparations: Vinpocetine, Cerebrolysin, Pentoxifylline.

Other conservative treatments for atherosclerotic encephalopathy:

  • Acupuncture.
  • Electrophoresis
  • Ozone Therapy
  • Exercise therapy.

If the lumen of the vessel is almost completely blocked by large atherosclerotic plaques, the doctor assesses the advisability of surgical intervention. During the operation, stenting of the affected blood vessel is performed.

Drug treatment

Forecast

The outcome of the disease directly depends on the timeliness of going to the doctor. If pathology is detected at an early stage, it is possible to stop the progression of the disease.

In all other cases, the prognosis is less favorable. At the last stage, the patient is not able to serve himself. In this case, all therapeutic measures are aimed at stopping the clinical manifestations and maintaining life.

Ignoring the disease leads to its rapid progression and, accordingly, the development of complications. Lack of treatment can lead to a stroke.

Finally

Encephalopathy of atherosclerotic origin is a pathology, the basis of the development mechanism of which is an increase in the concentration of "bad" cholesterol in the blood and blockage of blood vessels by plaques. The brain stops receiving the amount of oxygen and nutrients that it needs. As a result, structural changes in the organ appear. The initial stage of encephalopathy has no specific signs. As the disease progresses, speech is disturbed, vision and hearing deteriorate, and a headache appears. In severe cases, paralysis and paresis occur.


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