Cerebral ischemia in newborns - symptoms, treatment methods, consequences. Consequences of cerebral ischemia in newborns

Cerebral ischemia is a response to oxygen deprivation due to blockage cerebral artery or narrowing of its lumen. Pathology is often observed in children (up to 90% of cases) due to influencing internal and external factors. Cerebral ischemia in children with untimely therapeutic measures will lead to serious complications.

What happens to the child

Cerebral ischemia in newborns is a consequence of hypoxic manifestations during the period when the woman was pregnant and during childbirth. Cerebral ischemia in infants is a condition in which the brain is insufficiently supplied with blood. This brain damage in a child is rarely observed; for example, this condition is observed in heart failure.

A newborn is suspected of having cerebral ischemia if:

• He is crying for no reason and is shaking.
• The skin has a marbled color.
• The child's sleep is disturbed.
• His breastfeeding is weakened and he has trouble swallowing.
• Pronounced weakened muscle tone, the child is lethargic.
• Enlarged head with fontanel.
• Respiratory function is impaired, convulsive seizures are noted.

What are the degrees of cerebral ischemia in a child?

Cerebral ischemia in newborns is presented in three degrees: mild, moderate and severe.

Cerebral ischemia of the 1st degree in a newborn is characterized by the fact that the baby is in an excited or depressed state from the first 4 to 7 days after birth.

They are treated in the maternity hospital, and then the child is observed by a neurologist.

With ischemic cerebral pathology of the 2nd degree in newborns there are convulsive states and neurological symptoms are pronounced. If grade 2 cerebral ischemia is diagnosed, the child should be hospitalized.

The third degree is the most severe, characterized by serious neurological disorders, requiring urgent resuscitation measures. After the child is discharged, he will have a long rehabilitation period.

Mild cerebral ischemia in a newborn is characterized by:

• Slightly increased tone muscles.
• Deep tendon reflexes are sharpened.
• The child sucks poorly at the breast, is whiny and sleepy.
• Symptoms stop within first three days.

If the child is premature, then ischemic manifestations of this degree are characterized by a decrease in reflexes and muscle tone.

With moderate cerebral ischemia in an infant, the following is observed:

• Decreased muscle tone and tendon reflexes
• The child throws his arms back with his head thrown back, sucking and grasping reflexes are weakened or not detected.
• Respiratory dysfunction in the form of pauses between inhalation and exhalation.
• Symptoms appear during the first day.

If the child recovers in the first couple of weeks, then the outcome is favorable.

Severe cerebral ischemia is characterized by the following:

• The child is in a stuporous or comatose state.
• Breathes irregularly and requires artificial ventilation.
• Muscle tone with tendon reflexes is reduced, Moro, sucking and grasping reflexes are not evident.
• There is a rhythmic incoordination of movements eyeballs with squint.
• Cardiac arrhythmia is evident.
• Convulsive states are manifested.

Why does it occur

Hypoxic manifestations are observed if a woman is pregnant or during childbirth. Oxygen starvation is provoked by the following circumstances:

• The presence of infections in the pregnant woman’s body, cardiovascular dysfunction, endocrine systems, ORZ.
• When consumed alcoholic drinks, smoking.
• With late toxicosis, reduced volume of amniotic fluid, pregnancy of more than one fetus, late labor.
• Placental and umbilical cord pathology.
• If the baby is premature.
• In case of a difficult birth, which consists in the fact that the baby is entwined with the umbilical cord, the birth continues longer than expected due to a large fetus, trauma during childbirth and other problems of labor.
• The child’s mother is over 34 years old or under 18.

All these factors disrupt the blood flow between the placenta and the uterus, which is manifested by a hypoxic state.

Date of birth and cerebral ischemia

Manifestations of brain disorders in asphyxial conditions in children born in due date and in premature infants differ. If the baby is born ahead of schedule (if the pregnancy is less than 31 weeks), then there is a possibility that he will develop necrotic changes in the white brain matter.

In the area of ​​cellular necrosis, cystic changes, which in many cases leads to cerebral palsy, the child becomes weak-minded.

When the baby is full-term, he has damage to the cortical medulla ( gray matter). The consequences depend on the number and location of defective nerve cells. In acute and severe asphyxial conditions, the cerebral trunk, which is responsible for respiratory function and rhythmic activity of the heart. Such consequences threaten the child’s life.

How is it diagnosed?

Manifestations cerebral ischemia are observed during the first days after the baby is born. Mild encephalopathic conditions occur quickly, but in the severe stage, from several hours to 2-3 days, the baby’s well-being improves, then immediately deteriorates sharply.

The examination procedures include:

• Examining the child. The activity of reflexes with weight, height, and the results of the Apgar scale are assessed.
• Blood tests including general and electrolyte tests. They also check the coagulability and volume of oxygen and carbon dioxide in the blood.
• Carrying out magnetic resonance imaging.
• Ultrasound examination of the brain during the initial diagnosis.
• An electroencephalographic examination to assess seizure activity and brain changes.

How to treat

There are no specific measures for the treatment of cerebral ischemia in newborns. Dead brain structures cannot be restored. Treatment is aimed at preventing the progression of hypoxic changes and rehabilitation of the child.

If in the first two minutes the baby does not breathe on his own, then he is resuscitated: an endotracheal tube is inserted and mechanical ventilation is performed. If the lesions are minimal, then under the supervision of a doctor the child breathes alone 2.5-3 minutes after the trachea has been intubated.

In case of prolonged intensive care, the baby is transferred to the appropriate department, where all his vital signs are under the control of medical staff.

Convulsive manifestations are relieved with Phenobarbital, Phenytoin and other means. The doctor selects an individual dose for the patient, and the seizures are stopped.

With the help of Dopamine and Dobutamine, the cardiac activity of a small patient is corrected.

There is evidence that a hypothermic state prevents the death of brain cells, stopping necrotic changes. This therapy is also supervised by specialists, and the patient is then gradually warmed up.

How complications are treated

Encephalopathic manifestations of severe and moderate forms often result in persistent brain symptoms. It may manifest itself mildly or the baby may become disabled. For any prognosis of encephalopathic changes, the use of medicines there are restrictions:

• Antiepileptic drugs for seizures.
• Muscle relaxants for severe form Cerebral palsy.

In order for a baby with ischemic complications to develop correctly, you need to regularly work with him:

• If a child has cerebral palsy, then he needs a special massage technique, which should be performed by a specialist at least in the early stages.
• Older children require exercise therapy.
• Special mechanisms are needed to correct correct posture. With spastic changes due to incorrect position, they intensify, which will lead to an unfavorable outcome. With the help of strollers, splints, bolsters, and special chairs, the most acceptable, physiological position of the body is ensured.
• The speech therapist will correct the baby’s speech, teach him to be attentive and assiduous.

About prevention

To prevent the development of ischemic manifestations in the unborn baby, a woman must:

• Plan your pregnancy carefully.
• Undergo the necessary examination procedures during pregnancy.
• If required, take iron supplements as prescribed by your doctor.
• Completely give up bad habits.
• Do moderate exercise.
• Eat a balanced diet, follow your daily routine, and get plenty of rest.
• If the pregnancy is difficult, you should be treated in a hospital.

This is the only way to minimize the likelihood of cerebral ischemia in the child.

In contact with

Cerebral ischemia is a disease characterized by insufficient oxygen supply to the brain along with blood due to blockage of one or more blood vessels. Because of this, the newborn's brain cannot develop normally. In case of untimely medical intervention Bleeding may occur in the tissues and pathological changes may develop. It is timeliness that plays an important role in the treatment of cerebral ischemia in newborns.

Signs and symptoms of cerebral ischemia in newborns

The disease manifests itself with obvious symptoms that attract attention.

• The child is easily excitable, cries for no reason, sleeps poorly, shudders, and has tremors.
• Muscle tone is reduced, the baby moves little, has difficulty sucking and swallowing.
• The fontanel is enlarged, intracranial pressure is increased due to the fact that fluid accumulates in the brain.
• Convulsions, twitching of the limbs and head, as well as comatose states with loss of coordination of movements and consciousness occur.
• The newborn's skin takes on a marbled hue.
• The functioning of the gastrointestinal tract is disrupted - bloating, constipation, and diarrhea are observed.

How does cerebral ischemia occur?

In 70% of cases, ischemia occurs in the fetus in the womb and is associated with the formation of a blood clot in one of the vessels supplying the brain, or with insufficient development of the vessel. Most often, the disease is diagnosed in premature babies whose vascular system is not yet fully formed.

As a result, in vital important organ Not enough blood is supplied, and with it, oxygen. Delay in providing medical care leads to damage to larger areas of the brain, cerebral hemorrhage and other serious consequences.

Causes

In the vast majority of cases, the causes of cerebral ischemia in newborns are various disorders of gestation in recent weeks, as well as non-standard situations during childbirth.

• Detachment of the placenta or disruption of blood flow in it.
• Compression of the umbilical cord, suffocation of the fetus.
• Congenital defects hearts.
• Circulatory problems.
• Intrauterine hypoxia.
• Infection during childbirth.
• Openness of the ductus arteriosus.
• Acute placental insufficiency.

Risk factors

Various vascular and neurological pathologies, problems with blood pressure (especially hereditary) in the mother should alert the doctor who is managing the pregnancy. Also, risk factors for cerebral ischemia in a child are:

• mother's age is more than 35 years;
• endocrine diseases;
• premature, protracted labor;
• multiple pregnancy;
• late toxicosis;
• failure of the mother to follow a healthy lifestyle;
• exacerbation of chronic or acute diseases in the mother during pregnancy.

Diagnostics

The disease is usually diagnosed within the first few hours.

The presence of pathology is indicated by deviations in reflex testing, general blood test. Usually the analysis shows increased content carbon dioxide in the body.

If obvious symptoms are detected serious illness carry out magnetic resonance imaging, and electroencephalography, revealing hidden convulsions and other abnormalities in the functioning of the brain.

Degrees of ischemia

Cerebral ischemia grade 1

A mild form, characterized by the presence of mild symptoms in the first 3-5 days after birth. Basically, it manifests itself in the form of:

• nervous excitement or oppression;
• slight muscle tone;
• strengthening tendon reflexes.

The child is monitored by a doctor, and the symptoms gradually disappear without complications.

Cerebral ischemia grade 2

Dangerous form diseases. It is characterized by:

• severe apnea (stopping breathing during sleep);
• decreased grasping and sucking reflexes;
• weak muscle tone;
• increase in head shape due to fluid accumulation;
• lack of coordination;
• loss of consciousness;
• changes in skin color.

Most often, grade 2 ischemia manifests itself in the first day of a newborn’s life, and symptoms can be observed for 2-4 weeks. At this time, the child is carefully monitored by doctors, and he undergoes a course of therapy. If necessary, carry out surgery to remove a blood clot.

Cerebral ischemia grade 3

The most severe form, in which:

• the baby has no reflexes;
• the child falls into a coma;
• heart rhythm is disrupted;
• blood pressure rises sharply;
• there are problems with independent breathing;
• strabismus is observed.

An experienced doctor can already determine the presence of signs and symptoms of grade 3 cerebral ischemia in the first 5 minutes of a newborn’s life. In this case, the child is sent to intensive care and, if necessary, connected to a device artificial ventilation lungs.

Treatment of cerebral ischemia in newborns

The goal of treatment is to restore normal blood circulation in the brain tissues and prevent pathological changes and eliminate the consequences of ischemia. For stage 1 disease, treatment usually involves prescribing massage to improve blood circulation.

For diseases of the 2nd and 3rd degrees it is used drug therapy And surgical intervention to remove a blood clot in a vessel and restore the structure of the vascular bed. In difficult cases, the baby undergoes a rehabilitation course of intensive therapy.

Prognosis and consequences of cerebral ischemia

It is much more effective to eliminate ischemia itself after the birth of a baby than to treat its complications. Among the consequences of cerebral ischemia of the 2nd degree:

• sleep disorders;
• headache;
• irritability;
• isolation;
• physical inactivity.
• Stage 3 disease has severe consequences:
• attention deficit disorder;
• mental retardation;
• Graefe's symptom, etc.

If all actions to eliminate ischemia were carried out by doctors in a timely manner, then the symptoms disappear during the rehabilitation period, which usually lasts 6-12 months.

Ischemia occurs due to the fact that in one or another organ there are disturbances in the blood supply, and, accordingly, with oxygen, because in this case there may not be enough of it. Subsequently, two directions of the disease can be distinguished: ischemia and hypoxia. With hypoxia, the cells of a certain organ or the body cannot receive oxygen at all or, for some reason, use it. With ischemia, there is not enough oxygen due to blockages in the vessels.

There are no cases when ischemia occurs just like that. There must be good reasons for the occurrence of this disease, and they can be:

Causes of cerebral ischemia in a newborn baby

Cerebral ischemia itself can occur for several reasons:

• poor circulation in the placenta during pregnancy;
• maternal hypertension;
• anemia;
• too long and difficult childbirth;
• infection of the child during childbirth;
• birth injuries in a child.

• the child’s mother was over 35 years old at the time of pregnancy;
• happened premature detachment placenta;
• the baby is lying incorrectly in the womb;
• the birth was late or premature;
• multiple births;
• with clouding of amniotic fluid.

Degrees of ischemia in a newborn and its treatment

Today there are three types coronary disease in newborn children. If baby light degree of the disease, then during the first week of life it will be possible to note excessive activity or severe depression. If convulsions and severe tremors have been noted for a long time, then doctors begin to talk about moderate ischemia. If a newborn child has been diagnosed with a severe degree of the disease, then he should be immediately sent to the intensive care unit. If your child has mild or average severity ischemia, then the risk of developing a neurological disorder is very low and such cases are rare today. But if there are still some disorders, they will most likely be classified as functional. If you start treating ischemia in time, you can get rid of the disorders quite quickly, without severe consequences for the child's health. If a severe degree of coronary artery disease is detected in a newborn, it immediately leads to serious damage. nervous system. The consequences in this case will be: convulsions, problems with hearing and vision, delays in physical and mental development.

How to treat cerebral ischemia in a newborn baby

Throughout this time, a lot will depend on the child’s parents. In order to prevent cerebral ischemia from negatively affecting the baby’s health, it is necessary to follow a few simple rules:

1. regularly visit a neurologist;
2. undergo all examinations prescribed by the attending physician;
3. give the child all medications prescribed by the doctor on time;
4. monitor the child and note any changes in his development and reaction to the world;
5. observe the daily routine very carefully: sleep and wakefulness;
6. if you notice in a child increased excitability, then there is no need to provoke it with external stimuli, which may be different for each child;
7. In no case should you frighten the child or do everything possible to make him too active and overexcited;
8. If there are problems with muscle tone, then massage should be used. It is worth considering that massage can only be performed by a specialist in order to avoid possible complications.

Cerebral ischemia is a disorder of the brain that develops as a result of prolonged lack of oxygen. After oxygen starvation brain vessels narrow or become completely blocked by blood clots.

In modern neurology of children it is recognized as one of the most pressing problems. This is caused primarily by the fact that the ways effective treatment illness is not enough yet.

General information

Hypoxia or lack of oxygen during pregnancy or childbirth can lead to negative consequences for the child's brain.
is also extremely dangerous. This especially applies to cases of untimely diagnosis and delayed or incorrect treatment.

Classification by severity

Cerebral ischemia in medicine is divided into degrees depending on the level of brain damage:

Cerebral ischemia grade 1. Neurological disorders are not clearly expressed, the following symptoms may be observed:

• headaches, feeling of constant heaviness in the head;
• general weakness, feeling of persistent fatigue;
• decreased concentration, memory failures;
• insomnia;
• emotional instability;
• in newborn children - unusual excitement or depression in the first week after birth.

Symptoms at this stage are not clearly specific; it is not always possible to recognize grade 1 ischemia in a patient with similar complaints.

Patients themselves rarely seek medical help, attributing their health to overwork.

Meanwhile, it is at this stage that cerebral ischemia is relatively easy to treat. It is possible not only to relieve current symptoms, but also to prevent the situation from getting worse.

Cerebral ischemia grade 2. The next stage of the disease has more severe symptoms. They also mean deeper neurological disorders. Among them:

• dizziness;
• profound memory impairment;
• instability when moving;
• disturbances in habitual movements;
• Newborn babies may have seizures.

At the 2nd stage of cerebral ischemia, the ability to work may be completely lost. This is caused by the appearance of focal lesions in the brain tissue. Abilities physical work lost due to lack of coordination. Mental work also ceases to be possible due to brain damage and the occurrence of pathological reflexes.

Cerebral ischemia grade 3. At this stage of the disease, brain dysfunction is extremely pronounced. Symptoms include:

• complete loss of ability to work;
• inability to self-service;
• frequent fainting;
• in newborns - hearing and vision impairment, seizures.

The 3rd degree of cerebral ischemia can be characterized by the absence of formulated complaints from the patient. For neurologists, making a diagnosis at this stage does not cause difficulties.

Cerebral ischemia in premature infants

The mechanism of development of the disease in premature infants differs from children who were born full term. This is due to the fact that in the first case the brain is not yet formed and is not resistant to damage.

In addition, the birth of a premature baby is often accompanied by other neurological problems. This both makes diagnosis difficult and can complicate treatment.

Symptoms in newborns

Among the signs of ischemia in newborns are the following:

• increased excitability, increased muscle reflexes, tremor;
• CNS depression syndrome. Decreased muscle tone, weakened reflexes.
• hydrocephalus syndrome;
• convulsions varying degrees expressiveness.

The diagnosis of cerebral ischemia is always based on the results of an ultrasound examination and a medical examination, including a study of reflexes.

The chronic stage is more common in older people. She was called irreversible changes brain tissue. The main factors in the transition of cerebral ischemia to chronic stage doctors believe:

• atherosclerosis;
• arterial hypertension.

The blood vessels of the brain are narrowed due to a blood clot or sclerotic plaque, which causes a lack of oxygen and then ischemia. Clinical manifestations The diseases are quite diverse, which complicates timely diagnosis.

Causes

Among the causes of cerebral ischemia in newborns, the most important is the lack of oxygen either during pregnancy or during childbirth.

For adults, the causes of the disease are much greater:

• cerebral atherosclerosis;
• heart failure;
• increased blood viscosity;
• cardiac arrhythmias.

All these diseases contribute to the deterioration of blood flow in the vessels supplying the brain. This almost inevitably causes ischemia.

Signs in children under one year of age

In most cases, newborns are diagnosed with the first stage of cerebral ischemia. It goes away within a few days after birth. Signs of cerebral ischemia in children may be as follows:

• at mild stage increased depression or excitation of the central nervous system.
• At the moderate stage, convulsions may occur.
• Severe degrees can cause visual and hearing impairment, coma.

Treatment and rehabilitation of children

In the treatment of cerebral ischemia in newborns, the main task is to restore impaired blood circulation in the brain. All intact areas of blood vessels are stimulated for maximum efficiency.

The 1st degree of the disease is corrected with the help of a special massage. The doctor may not even consider it necessary to prescribe medicines.

All subsequent stages of ischemia are treated exclusively under medical supervision and depending on the symptoms. You cannot delay treatment - this will help avoid huge problems in the future.

Cerebral ischemia is treated with the following drugs:

• vasodilators, which improve cerebral blood supply;
• nootropic, promoting brain activity;
• vitamins;
• diuretics.

If the case is particularly complex, the child is hospitalized and prescribed anticonvulsant treatment, IVs and intramuscular injections.

Parents must strictly comply with all appointments. A child with ischemia is advised to have a relaxing massage, baths with soothing mixtures and a ban on visiting crowded places. In some cases, electrophoresis with papaverine is prescribed.

The role of massage in treatment

At the first stage of cerebral ischemia, massage is the main method of treatment. In addition to its main purpose, therapeutic massage has a beneficial effect on the child’s muscle tone and well-being.

You cannot perform therapeutic massage on your own; it must be done by a specialist.. It is most effective to massage 4 times in the first year of life. The interval between courses should be 3 months. Massotherapy promotes

• relaxation of the nervous system;
• improvement of muscle tone;
• improvement general condition child.

Consequences

Among the possible consequences of mild and moderate cerebral ischemia in newborns:

• sleep disorders;
• headache;
• feeling tired and irritable;
• Difficulty studying, lack of concentration.

Severe degree causes in the future

• mental disability;
• inability to walk;
• epilepsy.

It is necessary to carefully study the behavior of a newborn child to promptly identify symptoms of cerebral ischemia.

The disease of the 1st degree responds well to treatment and leaves no consequences. The more time passes from the onset of the first symptoms, the more difficult the treatment will be..

Adults should protect themselves from risk factors as much as possible. These are obesity, alcohol abuse, smoking and stress.

Scientific medical knowledge on chronic cerebral ischemia is demonstrated in this video:

The birth of a child is one of the most joyful events in a person’s life. But, unfortunately, sometimes the joy is overshadowed by the fact that the baby enters the world with diseases acquired before birth. One of possible pathologies called cerebral ischemia. This sonorous and incomprehensible phrase literally means insufficient blood supply to the brain.

The consequences of cerebral ischemia for a child can be very serious. However, parents should not panic if the pediatrician made this diagnosis immediately after birth. The disease can manifest itself in different ways. Often this condition in infants goes away without treatment.

Cerebral ischemia develops not only in the youngest, but also in the oldest. Based on age gradation, the disease is divided into the following types:

• congenital – CI of newborns;
• acute;
• chronic.

Congenital cerebral ischemia

Cerebral ischemia in newborns in most cases begins in the late months of pregnancy and immediately during childbirth. Reduced blood supply (ischemia) to the brain leads to insufficient oxygen supply (hypoxia) to the tissues. Cerebral ischemia in a newborn is classified into 3 degrees, each of which has its own signs and consequences for the baby.

Cerebral ischemia grade 1 in a newborn

The most light form pathologists. Clinical picture lubricated. Experienced pediatricians define it by a set of three signs.

1. The baby is experiencing changes in behavior. The child is worried, often cries, despite drowsiness and lethargy, and does not sleep well.
2. There is some tension in the muscles.
3. Tendon reflexes are higher than normal.

Premature babies have two latest sign look different: muscle tone and tendon reflexes, on the contrary, are reduced.

There is no need to treat the baby; a restorative massage is usually enough. It is performed to relax the muscles, improve blood flow and oxygen supply to the brain. The room where the newborn is located must have enough oxygen, so it is recommended to ventilate it more often.

The prognosis is positive. The baby develops, keeping up with his peers.

Cerebral ischemia grade 2 in a newborn

The future for babies doesn't look so bright. Mental abnormalities are observed in almost half of the cases. 20% suffer from increased intracranial pressure. Cerebral ischemia grade 2 in a newborn has the following symptoms:

• breathing disorders during sleep;
• muscle weakness;
• weakened grasping and sucking reflex;
• pale skin with a bluish tint or a red-bluish pattern;
• possible enlargement of the head (hydrocephalic syndrome).

Treatment of cerebral ischemia of the 2nd degree in newborns is combined. Drugs are used to dilate blood vessels, against convulsions, reduce blood clotting, remove excess fluid in hydrocephalus, electrophoresis and massage. If necessary, surgical intervention is performed

Cerebral ischemia grade 3 in a newborn

A severe form of pathology in which the important functions brain In most cases, the following manifestations are recorded.

1. There is no reaction to external stimuli.
2. The child is unable to breathe or eat on his own.
3. Involuntary convulsions are observed.
4. Intracranial pressure is sharply increased.
5. Hydrocephalic syndrome is present.

The newborn has no chance of survival without emergency medical care. The baby is connected to the device artificial respiration. Surgically blood clots are removed. A shunt is installed to remove cerebrospinal fluid in the ventricles of the brain. Vasodilators, diuretics, and anticoagulants are prescribed.

However, immediate medical care is often unable to save the life of a newborn. In the third degree, the consequences of cerebral ischemia in newborns are extremely severe. Every second child does not survive. About 80% of survivors suffer from autism and cerebral palsy, and another 10% have minor psychical deviations. And only one in ten subsequently develops normally.

Causes

A disruption of the blood supply to the brain and the supply of oxygen to its cells occurs when one or more of the following factors are present:

• pathology of placental circulation;
• prematurity;
• Congenital heart defect;
• too fast or long labor;
• damage to the umbilical cord during childbirth;
• introduced infections;
• bleeding caused by various injuries.

Prevention

Since treatment of cerebral ischemia in newborns does not produce positive results in all cases, important is acquired by the prevention of diseases in the expectant mother. Kit preventive measures simple

1. News healthy image life: do not smoke, do not drink alcohol, do not follow a strict diet, but at the same time do not overeat, do regular exercise.
2. Attend antenatal clinics to treat infectious and other diseases.

Chronic cerebral ischemia

Chronic cerebral ischemia develops in older and older people. As with congenital cerebral ischemia, 3 degrees of the disease are classified.

Symptoms

Chronic cerebral ischemia manifests itself depending on the stage of development.

1. The first stage of the disease signals itself by the fact that the patient begins to quickly get tired when mental stress, he has mild problems with memory, hearing, and vision. Sleep disturbances, headaches, and general weakness are noted. Mood changes quickly without significant reasons. Most people attribute these signs not to illness, but to age.
2. Chronic cerebral ischemia of the 2nd degree is characterized by increasing problems. In particular, there is a sharp decline memory and performance. Dizziness occurs even with the simplest movements. Doesn't let go constant weakness, sometimes seizures occur. Negative changes occur in personal terms.
3. Chronic cerebral ischemia on final stage leads to organic damage brain and serious violations brain activity. The patient loses the ability not only to engage in intellectual work, but also to perform simple actions, for example, self-care. Dementia develops. Either minor strokes or major strokes occur. Due to violation cerebral circulation left ventricular failure may develop. And with acute left ventricular failure, the development of cardiac asthma and pulmonary edema is very likely.

Causes

There are two causes of chronic cerebral ischemia:

• atherosclerotic lesions of the arteries supplying the brain;
• arterial hypertension.

Atherosclerosis of the coronary and cerebral arteries is caused by cholesterol deposits on the walls of blood vessels. Cholesterol plaques disrupt normal blood flow in the body. Arterial hypertension is characterized by persistent high blood pressure. Both diseases are common, especially among older people. Leads to them genetic predisposition, and unhealthy lifestyle.

Both diseases have extremely negative effects on the brain. For example, they can cause cerebrovascular insufficiency, when focal lesions of small vessels occur in the brain.

Treatment and prevention

Treatment of chronic ischemic brain disease is combined. Mainly practiced drug treatment to expand the lumen of the arteries, improve blood supply to the brain and slow down the development of the disease (pentoxifylline, nimodipine, piracetam, etc.). Prevention is also aimed at this (refusal bad habits, healthy eating, moderate physical activity). With progressive damage to the main arteries of the head, surgical intervention is used.

Causes and treatment of chronic ischemic cerebral disease

Chronic cerebral ischemia occurs due to blockage cerebral vessels brain or their long-term narrowing. The result is gradual damage to brain tissue, which leads to microinfarctions, and also causes the formation of significant territorial brain infarctions.

• Causes
• Symptoms
• Stages of development
• Diagnostics
• Features of treatment
• Forecasts

As statistical data show, the relevance of chronic cerebral ischemia occurs in 70 cases out of 100. As for appropriate preventive measures and proper treatment, they directly depend on the immediate activity of the patients. Thus, it is mental and central nervous system disorders that have a direct impact on ability to work.

The most common causes of development of this disease are diabetes, myocardial disease, as well as atherosclerotic lesions of vessel walls. Among other things, factors such as problems with microcirculation, which most often appear as a result of an increase in blood viscosity, should not be ignored. They also cause blockage of small arteries and the formation of blood clots.

Causes

As modern medical practice, chronic cerebral ischemia can be caused not only by primary, but also by secondary causes. Let's look at them in more detail:

• With improper development of the arteries of the brain, as well as vessels involved in the systemic circulation. As a rule, such anomalies are not clearly visible. severe symptoms and begin to actively progress at the moment when any significant changes occur in the vascular system, and appropriate treatment is not carried out;
• The presence of pathology in venous system. These can be all kinds of thrombosis and thrombophlebitis;
• Diseases of the spine that cause disturbances in the blood circulation of the arteries and their untimely treatment. Such diseases include herniated intervertebral discs, osteochondrosis and others;
• Appearance in circulatory system And internal organs amyloid (insoluble protein);
• If you have any blood disease.

Symptoms

How timely chronic cerebral ischemia is detected and prescribed correct treatment, the consequences directly depend. It is for this reason that you should immediately pay attention to the appearance of the following symptoms:

• recurrent or constant headaches;
• feeling of heaviness in the head;
• periodic dizziness;
• decreased attention, which may gradually progress;
• memory deterioration with subsequent progression;
• the appearance of problems with sleep;
• the appearance of disturbances in coordination of movements, especially when walking;
• emergence of emotional instability and instability.

Essentially, the weaker the blood supply to brain neurons becomes, the more cerebral ischemia progresses, leading to the development of heart attacks.

Stages of development

Depending on the symptoms and various clinical signs, 3 main stages of the disease can be distinguished:

1. The initial (1st) stage is accompanied by headaches, memory loss, periodic dizziness, partial sleep disturbances, emotional instability, as well as a feeling of weakness throughout the body, without any neurological symptoms;
2. Subcompensation (2nd stage). Its main features are the progression of symptoms characteristic of stage 1, as well as a gradual change in personality. An apathetic attitude towards most events arises, a depressive state develops, and the range of interests sharply decreases. Among other things, mild impairment develops, oral automatic reflexes deteriorate and motor coordination disorders appear;
3. Decompensation (stage 3). It is characterized by severe disorders of the nervous system caused by multiple heart attacks, severe impairment of motor coordination, psychoorganic and other syndromes that were not characteristic of the 1st and 2nd stages. The patient begins to gradually develop vascular dementia(sharp decline in intelligence level, disruption of social adaptation).

Diagnostics

In most cases, chronic cerebral ischemia can be diagnosed using a history of the disease itself and its careful analysis. Neurological and neuropsychological symptoms, as well as various cardiological studies (ECG, EchoCG and others) are of no small importance.

MRI of the brain on days 1, 3 and 28 after stroke

They will allow you to install the real reason progression of the disease. Among other things, it is recommended to use laboratory methods diagnostics necessary to exclude or confirm somatic pathology.

For a full examination of brain tissue, it is necessary to do an MRI or CT scan, an ultrasound scan, or other specialized research.

Among other things, you should pay special attention to the amount of sugar, cholesterol and other substances in the blood. After all tests and studies, appropriate treatment is prescribed.

Patients who have the 1st, or, in other words, initial stage diseases, in most cases, suffer from periodic headaches, which over time can intensify and occur more often. Among other things, there is often noise and heaviness in the head.

Sleep problems appear and memory deteriorates. A patient with stage 1 suffers fatigue And increased weakness, becomes more irritable. From time to time, there may be disturbances in the coordination of movements and unstable emotional condition. Another symptom of stage 1 is a decreased interest in learning, as well as poor memory for recent events.

Series of CT scans of the brain

The 2nd stage of the disease is characterized by a significant intensification and progression of symptoms that appear from time to time in the 1st stage. Memory deterioration becomes more obvious and can progress every day. It becomes more and more difficult for the patient to concentrate his attention on a particular action, and also gradually loses the ability to plan and control his actions.

At stage 2, personal and emotional disorders increasingly occur, a depressive state develops, and the ability to criticize decreases. As a rule, it is at the 2nd stage that adaptation in social and professional terms is disrupted. But, along with the above disorders, the patient retains the ability to care for himself independently.

This stage combines the symptoms of stages 1 and 2, which begin to progress sharply. It becomes more and more difficult for the patient to control his movements and control muscle contraction.

At this stage, frequent fainting and epileptic seizures. The person begins to lose interest in everything that is happening, and also becomes more inhibited. In most cases, patients completely lose the ability to self-care and become maladapted socially and in everyday life, which was not observed in stages 1 and 2.

Features of treatment

The main goal of treating chronic cerebral ischemia is to prevent progression various disorders brain, as well as the prevention of possible small strokes and exacerbations, or, in other words, crises. Treatment of the disease is both therapeutic and primary preventive in nature. It includes the following steps:

• Gradual increase physical activity, giving up alcohol and tobacco, as well as changing your diet, thanks to which it becomes possible correction arterial hypertension without the use of drugs. In some cases, medications are prescribed. This stage is very important for the 1st and 2nd stages of the disease;
• Constant monitoring of blood sugar and cholesterol levels. If necessary, assigned special diet. If there is no effect, correction is carried out with medication;
• Treatment of disorders and processes that are somatic in nature and concomitant;
• Prescription of drugs that have vasodilating effects. The effect of such treatment directly depends on how severely the brain is damaged. Otherwise, sensitivity to drugs is minimized or simply absent. In most cases, it is relevant for patients with 1st and 2nd degrees of the disease. Among other things, patients are prescribed medications to prevent the formation of blood clots;
• Prescribing medications aimed at enriching the brain with oxygen and restoring normal blood circulation, preventing seizures, as well as improving the properties and characteristics of blood.

Forecasts

All changes must be adjusted accordingly. Special attention should be given to concomitant ailments, which often occur in severe forms.

If the 1st and 2nd stages of the disease, chronic cerebral ischemia is already over, and the disease is advanced, or, in other words, the patient sought help very late, this indicates that multiple micro-strokes and damage have already occurred in the brain. In such a situation, the prognosis will be extremely unfavorable. As a rule, the patient becomes disabled or dies.

Thanks to the achievements of modern medicine, today patients with chronic cerebral ischemia have the opportunity to promptly identify the disease and receive appropriate treatment. Unfortunately, such people are forced to be observed by specialists throughout their lives and from time to time undergo comprehensive examination and appropriate treatment. Ignoring all or even some of the recommendations can have fatal consequences and lead to a cerebral infarction.

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Causes and treatment of sinus bradyarrhythmia

A disease in which the heart rate decreases is called sinus bradyarrhythmia. Pathology can appear at any age. Violation heart rate starts from the sinus node. The main problem When diagnosing a disease, the cardiovascular system appears healthy overall and abnormalities are difficult to detect. Along with this, the body constantly suffers from hypoxia, which is caused by bradyarrhythmia.

The extensive medical section “cardiology” studies pathological processes at work of cardio-vascular system in adults and children.

Causes and mechanism of development