The narrowing of the lumen in the arteries of the brain or their complete blockage leads to the fact that the blood flow is significantly weakened, hypoxia occurs, leading to impaired normal circulation. Ischemic brain disease develops, which requires diagnosis, urgent adequate treatment. If no measures are taken, then the pathology easily becomes chronic. As a result of this, the patient has an aggravation of dysfunction, which leads to untreatable consequences, and all because hypoxia causes tissue necrosis.
Ischemia or ischemic disease of the brain is a disease accompanied by insufficient supply of oxygen to the brain cells, in more understandable language, then oxygen starvation occurs. And the human brain most of all needs a constant supply of oxygen. Despite the fact that it makes up no more than 4% of the total body weight, it can pass a fifth of all the blood in the human body through itself.
Which people are at risk?
Doctors are at high risk:
- people of advanced age;
- persons suffering from pathologies of blood vessels and heart;
- patients with diabetes;
- abusers of alcohol and smoking;
- working in hazardous industries;
- often experiencing stress.
But the main category of risk is older people, although today the list of age categories of people with coronary artery disease of the brain has expanded. Both young and old are sick, the number of patients among newborns has increased.
What are the causes of ischemia?
The main cause of ischemia is the blockage of blood vessels in the brain, through which oxygen flows to each cell. The brain does not receive the necessary amount of oxygen, therefore, it is not able to function fully. Vascular blockage occurs for several reasons:
- with a violation of the heart muscle, which leads to arrhythmias and chronic ailments;
- a decrease in blood flow in the brain due to arterial damage to atherosclerosis;
- hypertension, causing spasms in the vessels of the brain and malfunctions of the venous outflow;
- diabetes and a high composition of insulin in the circulatory system;
- amyloidosis, found mainly in the elderly;
- pathologies that affect the circulatory system, reduce oxygen capacity and lead to the formation of blood clots.
If there is a blockage of the vessels of the brain, then the cause of this condition can be diseases such as atherosclerosis and high blood pressure. Atherosclerosis leads to an increase in fat deposits on the walls of blood vessels, which leads to blockage, which means that if no measures are taken, symptoms of coronary artery disease will soon appear. Most often, it quickly acquires a chronic form, since narrowing of blood vessels is a gradual process. The acute form of the disease forms instantly and is caused by the presence of a blood clot.
Atherosclerosis and thrombosis are the most dangerous causes leading to brain ischemia and death in every third patient. The acute form can be triggered by the development of such conditions:
- bradycardia;
- anemia;
- harmful gas poisoning;
- obesity;
- the use of harmful substances.
The disease occurs in almost all categories of people, from newborn babies to the elderly. But the most terrible is considered a sign of ischemic brain disease in newborns. This disease is considered a most dangerous ailment, therefore it is important to seek qualified help at the first symptoms. How not to miss the first signals?
Symptoms of Ischemia
Symptoms of ischemic brain disease are many:
- Malfunctioning of the nervous system, which manifests itself in the form of speech disorders or vision problems.
- Fast fatiguability.
- Weakness in the whole body.
- Drowsiness.
- Decreased performance.
- Short-term memory loss.
- Sharp mood swings.
- Irritability, nervousness, apathy.
- Insomnia.
- Headache.
- Blood pressure jumps.
- Malfunctioning in breathing.
- Dizziness.
- Loss of consciousness.
- Vomiting and nausea.
- Numbness of arms and legs.
- Cold feeling in limbs.
If you do not take any measures and do not start timely treatment, the symptoms of coronary artery disease of the brain can only increase. Doctors divide the disease into three main stages or degrees. Some experts also single out the fourth.
Sometimes it’s difficult to determine the symptoms of the disease in newborns, because they themselves can not talk about their condition. Therefore, parents need to pay attention to such signs:
- increased irritability: the child constantly shudders, tremors of certain parts of the body are observed, restless sleep, crying for no apparent reason;
- depression of the nervous system: lethargy, weak sucking and swallowing reflexes, strabismus, facial asymmetry;
- an increase in the size of the head;
- high intracranial pressure;
- unconsciousness;
- cramps.
If the child has at least one of the described symptoms, then you need to immediately consult a doctor.
Degrees of coronary disease
Coronary disease of the brain is classified by degree, and there are only three, although they say that there is a fourth. The most difficult is considered to be 3 degree.
The first degree is characterized by a mild disorder of attention and intelligence. More often, patients without special problems cope with complex tasks, but it takes a lot of time. There are no obvious coordination disorders, there are no restrictions on vital functions, but small signs are already showing up:
- shuffling gait;
- numbness and pain in the hands after exertion;
- nervousness;
- weakness.
Coronary disease of the 2nd degree brain manifests itself in the form that the patient is not quite able to control his actions. In performing certain tasks, he needs outside help, which is bad for his professional activities. The patient may also lose some of the existing skills, a general malaise appears.
Grade 3 ischemia manifests itself as severe neurological disorders in the form of Parkinson's disease, urinary incontinence and serious coordination problems.
The patient may lose the ability to independently navigate in space, his legs do not obey. There are problems with speech, memory suffers, thinking is disturbed. If no measures are taken, the consequences of coronary artery disease of the 3rd stage are disappointing: the complete collapse of the personality, stroke and cerebral hemorrhage.
Types of Ischemia
As for the types of pathology, there are two of them: acute and chronic.
The acute form is characterized by a sudden manifestation and a short flow time. If the blood flow is disturbed suddenly, acute ischemia appears. Signs arise immediately, from which part of the brain has stopped receiving oxygen, the corresponding symptoms appear. The acute form can cause muscle weakness, blindness and dizziness.
Chronic ischemic brain disease is caused by a prolonged lack of oxygen in the cells. This form does not have the painful manifestations that are characteristic of acute. During the chronic appearance, the arteries are mainly affected. It can arise as a result of a protracted acute form, so it is important to start treatment in a timely manner. If you select effective drugs and bring the course to the end, then the prognosis is favorable.
Diagnostics
Coronary artery disease of the brain can be confirmed after collecting complete information about the existing diseases in the patient, examination by a doctor and a number of additional studies:
- During an ophthalmoscopy, the state of the optic nerve can measure intracranial pressure and the degree of vascular disorders.
- Doppler ultrasound of the vessels of the neck allows you to determine the speed of blood flow, to find obstacles to the free passage of blood through the carotid and vertebral arteries.
- Transcranial assessment of blood flow in the main vessels of the brain helps to obtain additional information.
- Cerebral angiography is considered the most informative technique that helps determine if there is a suspicion of atherosclerosis or blood clots.
- ECG, ECHO, x-ray of the cervical spine in some cases help to identify the cause of the development of the disease.
Only after the cause that research and symptoms point to is precisely established, the treatment of coronary artery disease will be more effective.
Therapeutic methods
The main goal of the treatment of the chronic form of ischemia is to stabilize as quickly as possible the destructive process of ischemia, as well as to stop the progression, activation of sanogenetic compensation mechanisms. It is necessary to take preventive measures to prevent stroke, as well as conduct therapy for somatic processes.
The chronic form does not imply urgent hospitalization, unless it was complicated by the presence of a stroke or severe somatics. If the patient has cognitive impairment, then withdrawal from the usual environment may exacerbate the disease. Treatment of ischemic brain disease is carried out by a neurologist.
Drug therapy provides two directions:
- normalization of blood flow in brain tissues by affecting different levels of the heart and blood vessels;
- effect on platelet link.
As a result, blood circulation in the brain returns to normal.
Antihypertensive therapy helps maintain adequate blood pressure and helps prevent and stabilize the development of the chronic form. If the doctor prescribes antihypertensive drugs, then by all possible means it is necessary to avoid sudden surges in pressure, since the development of the disease considers the mechanisms of blood flow autoregulation in the brain.
Among antihypertensive drugs, specialists prefer two groups:
- angiotensin enzyme inhibitors;
- angiotensin II receptor antagonists.
Both types gently and gradually expand the lumen of blood vessels, exerting an antihypertensive effect, reliably protect organs that suffer from arterial hypertension.
The effectiveness of these drugs increases if you additionally combine them with other antihypertensive drugs, for example, Indapamide and Hydrochlorothiazide.
In patients with atherosclerotic plaques in the vessels of the brain and dyslipidemia, not only a strict diet is provided, excluding all animal fats from food. It will be correct to recommend lipid-lowering drugs: "Statins", "Simvastatin", "Atorvastatin". They have on the body not only the main effect, but also help to improve the functions of the endothelium, reduce blood viscosity, and also have an antioxidant effect.
An increase in the platelet-vascular link of hemostasis is characteristic of the chronic form of coronary artery disease of the brain vessels, for this reason it is recommended that the patient be prescribed antiplatelet agents, acetylsalicylic acid. At the discretion of the doctor, the patient may additionally be prescribed other antiplatelet agents, such as Clopidogrel, Dipyridamole.
Treatment of coronary artery disease of the brain vessels can be carried out with combined drugs. Given that there is a wide variety of mechanisms that underlie the chronic form, then in addition to the described basic drugs, the doctor can also recommend medications to the patient that improve blood composition, venous outflow, microcirculation. They may also have angioprotective and neurotrophic properties. The doctor may prescribe:
- "Vinpocetine" - from 150 to 300 mg per day;
- ginkgo biloba leaf extract;
- "Cinnarizine" 75 mg + "Piracetam" 1.2 g;
- "Piracetam" 1.2 g in conjunction with 15 mg of "Vinpocetine";
- "Nicergoline" up to 30 mg per day;
- Pentoxifylline 300 mg per day.
All of the above drugs are recommended to be taken in courses, no more than twice a year, with breaks of two to three months.
If the symptoms of ischemic cerebrovascular disease are severe, then the patient may be recommended surgical intervention. He is most often advised to patients who are actively developing occlusive stenotic disturbance of the large arteries of the head. In such cases, reconstructive surgery is performed on the internal arteries - carotid endarterectomy, stenting of the carotid arteries.
Treatment of patients with a chronic form must be carried out under the strict supervision of the attending physician, who will be able to adjust the treatment if necessary.
Preventative measures
Treatment can not always cope with the chronic form of coronary artery disease of the brain, the patient is provided with disability. A person can no longer lead a familiar lifestyle, engage in the same type of activity. In order not to bring yourself to such a difficult state and to be able to live a full life, it is necessary to take all preventive measures in advance:
- First of all, the elderly should closely monitor their health. They need to include in their daily routine physical activity, using the available types of physical activity - from physiotherapy to sports. Loads will help normalize blood circulation, accelerate metabolic processes in the body. They also prevent the deposition of cholesterol and thrombosis.
- The age of the patient after 40 years is the basis for mandatory annual examinations by a doctor.
- If the doctor recommends a preventive treatment, then this must be done, because the main thing is to prevent the disease, and then it is very difficult to treat it. Such therapy involves the use of anticoagulants. A good solution would be to use traditional medicine.
A specialist may recommend a course of hirudotherapy. The importance of secondary preventive measures, which include the treatment of pathologies of the heart, blood vessels and hypertension.
Diet food
Dietary nutrition, which is considered an integral part of the treatment of ischemic cerebral cortex, helps well in the prevention. The diet is selected individually for each patient. Its main task is to reduce blood sugar and cholesterol. There can be many options for medical nutrition, because it is important to consider the individual characteristics of the patient. To develop a special nutritional program for a patient, nutritionists adhere to the following principles:
- eat at least 5-6 times a day;
- servings should be small;
- use of salt to minimize;
- the use of animal fats should be minimal, for example, pork can easily be replaced with a rabbit or chicken;
- carbohydrates must enter the body with vegetables and fruits;
- completely eliminate baking, sugar and confectionery from the diet;
- Do not consume carbohydrates more than 300 mg per day.
Forecast
If you approach the treatment of coronary disease of the brain and stroke in a comprehensive manner, you can not only compensate for impaired cerebral functions and cerebrovascular disease, but also prevent the development of various complications. The doctor’s regular monitoring and timely treatment measures promise a favorable prognosis.
If the treatment of such concomitant ailments as arrhythmia, hypertension, cardiomyopathy, diabetes mellitus does not start in a timely manner, this can provoke a vestibular disorder, the development of microstrokes, cerebral edema and the death of nerve cells. In this case, the forecast may be disappointing. You can not wait for a full cure, disability occurs or death threatens the patient. Take care of your health, do not self-medicate, visit a doctor when the first unpleasant symptoms appear. This is the only way to protect yourself from serious ailments.