Vascular dementia is a deterioration in the functioning of the vessels of the brain. As a result of this violation, brain cells die due to problems with blood supply. By the nature of the course of the changes and the symptoms, several variants of dementia are distinguished.
As a result of the pathology, significant deviations in the psyche are observed, which are divided into emotional, behavioral and cognitive. The patient's behavior changes, causeless depression is observed, and gradually the person begins to degrade.
Already at the initial stage of the course of vascular dementia, the disorders are quite significant, which affects the patient's life. A person should always be under the control of relatives and friends.
Features of the disease
Acquired cognitive impairment that adversely affects a person’s daily activity and behavior is called vascular dementia (ICD code 10 F01). This type of disease is associated with circulatory pathologies in the brain.
The patient can not immediately notice that he has dementia. Due to the deterioration in blood flow, certain areas of the brain begin to experience constant oxygen starvation, resulting in cell death.
The disease has several degrees of severity. It is important to recognize the available symptoms in a timely manner, to carry out the treatment prescribed by the doctor.
What types can be
Vascular dementia has an ICD code of 10 F01, suggests two forms of development, namely, total and lacunar. The partial form is characterized by the fact that dangerous deviations are observed in the form of memory loss . Excessive sensitivity and tearfulness may be observed. The main type of lacunar dementia can be considered Alzheimer's disease, which occurs in the initial stage.
Complete vascular dementia according to ICD 10 is characterized by complete degradation of the individual. The patient is susceptible to intellectual impairment. In addition, the emotional sphere changes, as a result of which a person loses his sense of duty, shame, spiritual values and interests. From a medical point of view, there are such types of vascular dementia (ICD code 10 of which F01), such as:
- atrophic;
- vascular;
- mixed type.
Atrophic damage occurs mainly against the background of primary degenerative disorders that occur in the cells of the nervous system. Vascular disorders are formed as a result of pathologies of blood circulation in the vessels. Mixed type dementia is characterized by the fact that its development mechanism is similar to atrophic and vascular.
Dementia generally does not develop due to pathologies that lead to the death or damage of brain cells, but can manifest itself as a complication of the disease.
Stages of the disease
ICD vascular dementia 10 belongs to the group of mental disorders and is divided into several degrees. A mild degree is characterized by limited work. Disability is assigned to the patient (depending on his age). At the same time, he may well perform the required hygiene procedures, cook food, take walks. He is fully aware of the presence of the disease and independently controls the administration of medications.
A moderate degree implies that the disease proceeds in a complicated form. A person suffers from forgetfulness all the time. However, he may well go to the toilet and eat on his own.
A severe degree is characterized by complete impaired memory and problems with coordination of movements. In this case, the patient should be under the constant supervision of relatives. If they are not, then a person will be placed in a specialized medical institution for life.
If you start treatment at the initial stage of the disease, you can maintain a mild degree for many years.
Disease in children
Vascular dementia can affect not only the adult population, but also children. Children's types of dementia are conditionally divided into residual-organic and progressive. The residual-organic type of the disease is characterized by the fact that meningitis, traumatic brain injury, as well as drug poisoning lead to its development. A progressive type of dementia refers to a self-developing pathology. It refers to genetic abnormalities, vascular lesions and diseases of the nervous system.
Such a violation in a child can be a sign of mental pathology, in particular, oligophrenia or schizophrenia. Symptoms begin to manifest very early. The child's ability to perceive and remember information disappears. In addition, mental abilities decrease.
Therapy in a child is based on the complete cure of the disease that provoked dementia, as well as taking into account the characteristics of the pathology. In any case, the treatment is carried out medically. The doctor prescribes medications to improve cerebral circulation and cellular metabolism.
Regardless of the type of dementia, relatives should be sympathetic to a sick child, as he is not aware of what he is doing.
Features of the lesion in the elderly
Vascular dementia in the elderly is caused by a sharp course with an increase in dangerous symptoms, since vascular pathology often joins it, and concomitant diseases only aggravate the patient’s well-being. In especially dangerous cases, delusions, psychoses, hallucinations can be observed all the time.
However, it is worth noting that vascular dementia rarely reaches a critical stage. A person often retains all available household skills, a critical attitude towards himself.
Causes of occurrence
In many cases, vascular dementia results from vascular catastrophes, in particular heart attacks and strokes. When the cerebral artery ruptures, blood is poured into the brain tissue, causing mass death of neurons. The highest likelihood of developing the disease if neurons of the cortex and some areas of the subcortex of the brain die, since it is these departments that are responsible for the cognitive abilities of a person. If hemorrhage occurs in other areas, then mental disturbances may not be observed, and only a deterioration in coordination of movements and orientation in space is noted.
Another reason for the occurrence of mental disorders in patients is heart failure. This is explained by a weakening of blood circulation in the arteries of the brain, since a diseased heart cannot function normally. As a result of this, neurons also die, which negatively affects the psyche of a person suffering from heart failure.
In the development of dementia, chronic ischemia plays an important role, when the brain tissue is deprived of a full supply of oxygen and blood. As a result of this, persistent and prolonged hypoxia develops, the consequences of which are expressed in the death of neurons and the subsequent occurrence of signs of dementia. The main reason for the weakening of mental activity is a violation of the cerebral and cardiac circulation, provoked by constantly increased or decreased pressure. There are also certain factors that in one way or another can affect the weakening of cognitive functions. These include:
- age;
- bad habits;
- gender;
- genetic predisposition.
In addition, chronic diseases are of great importance. These include, in particular, infectious vasculitis, diabetes mellitus and autoimmune disorders. It is worth noting that people with a high level of intelligence and well-educated dementia develop much less often than those with low intelligence. This is explained by the difference in the reserve capabilities of the brain.
Main symptoms
Often, symptoms of vascular dementia are observed in patients who have recently suffered a stroke. These signs include violations:
- memory;
- speech;
- coordination of movements;
- thought processes;
- abstract thinking.
In addition, it is possible to highlight the concomitant symptoms of an acute form of pathology, namely, such signs:
- weakening of muscle tone of the limbs;
- various manifestations of the intensity of reflexes in the limbs;
- violation of walking.
In addition to the acute manifestation, there may be a gradual development of dementia. It is observed mainly with an ischemic form of the disease. Vascular dementia in this case is characterized by a gradual increase in symptoms. The gradual development of the disease occurs over about 3-5 years. The manifestation of such a violation begins with a change in personality. In particular, such signs may be observed:
- acute manifestation of certain character traits;
- development of conservative judgment;
- worsening of ongoing mental processes;
- loss of norms and rules of moral behavior.
Then, memory deterioration is gradually observed, and also a person gradually ceases to orient in time and space. At the same time, for a long time, the behavior does not change at all, and there are no impaired gestures and speech.
At the last stage, trembling of the fingers and hands, exhaustion, impaired walking and coordination are noted. The subsequent development of the disease is characterized by intermittent speech, as well as fragmented information about yourself. The patient cannot take care of himself and observe the basic rules of personal hygiene. Symptoms of manifestations largely depend on the area of the affected area of the brain.
Diagnostics
Symptoms and treatment of vascular dementia largely depend on the stage and features of the course of the disease, which is why it is necessary to conduct a comprehensive diagnosis. It is based on the basis of psychodiagnostic research and neuroimaging techniques. Doppler imaging and brain tomography are used as imaging techniques. Biochemical blood tests are also prescribed.
The patient, when the first signs occur, is placed in a hospital, a comprehensive examination is prescribed. At the initial stage, the doctor conducts an oral survey of the patient for an accurate diagnosis. Then a study of a history of diseases is required.
To determine cognitive impairment, special tests are carried out, pressure control is carried out, as well as blood sampling for sugar. Based on blood tests, cholesterol and lipids are determined. To assess the electrical activity of the brain, an electroencephalogram is shown.
Ultrasound of the brain helps to analyze the state of blood vessels, and Dopplerography allows you to detect abnormalities in the vascular system of the brain. Based on the diagnosis, the doctor assesses the patient's condition and prescribes appropriate treatment.
Treatment features
Since there are many risk factors, treatment of vascular dementia should be based on addressing the cause of the disease. In particular, if the disorder develops in patients with prolonged arterial hypertension, then therapy should be selected strictly individually. In this case, you do not need to try to reduce the pressure, as this can provoke insufficient blood supply to the brain, which will contribute to even greater progression of disorders.
There are a number of guidelines for treating vascular dementia. The doctor prescribes antiplatelet agents that prevent platelet adhesion, as well as normalize blood circulation. In addition, drugs that improve brain cell metabolism and neuroprotectors are required. The following drugs meet all these requirements:
- "Cerebrolysin";
- "Akatinol memantine";
- Cavinton
The drug “Cerebrolysin” contributes to the normalization of metabolic processes, and also has a neuroprotective effect. This medicine helps to improve cognitive function and has virtually no side effects.
The drug "Akatinol memantine" helps to improve concentration, accelerates mental processes and improves memory. Cavinton reduces the resistance of spasmodic vessels, improves blood microcirculation and has antiaggregatory qualities, contributing to faster glucose excretion.
In addition, medications of other groups may be prescribed, the effectiveness of which is clinically proven. In particular, drugs such as Gingko Biloba and ergot alkaloids are prescribed.
Forecast
Many people who are diagnosed with this disease are interested in how much they live with vascular dementia, which disorders can occur. Complete cure is possible only in 10-16% of cases. In the acute course of the disease, the prognosis is rather unfavorable. A significant percentage of mortality is observed mainly 4-5 years after the onset of the initial symptoms of the disease.
In the presence of an ischemic form of the disease, it is often possible to slow down the pathology, especially if the complex treatment of the diseases that provoked the disorder is timely carried out.
Life expectancy largely depends on the attention of relatives and the living conditions of the patient. If the disease is detected at the initial stage and appropriate therapeutic measures have been taken, a person can live 10-20 years. Full recovery occurs mainly in young people, while the processes of brain activity can still be restored.
Prophylaxis
Particular attention is paid to the prevention. Among the main preventive measures, it is necessary to highlight such as:
- moderate physical activity;
- proper nutrition;
- maintaining normal mental health;
- blood pressure control.
If there is forgetfulness, you should definitely consult a doctor for diagnosis and subsequent treatment.