What are the characteristics of cerebrovascular accidents, symptoms, treatment. Occurrence of signs and symptoms

Cerebral circulation is blood circulation in the vascular system of the spinal cord and brain. Pathological process that causes a disorder cerebral circulation, can also affect the cerebral and main arteries (brachiocephalic trunk, aorta, external and internal vertebral, carotid, subclavian, spinal, radicular arteries and their branches), jugular and cerebral veins, venous sinuses. The pathology can be different in nature: embolism, thrombosis, looping and kinks, aneurysms of spinal and cerebral vessels, narrowing of the lumen.

Signs of cerebrovascular accident

Signs of impaired proper blood circulation in the brain of a morphological nature are divided into diffuse and focal. TO diffuse signs include small organizing and fresh foci of necrosis of brain tissue, small-focal multiple changes in the brain matter, small cysts and hemorrhages, gliomesodermal scars; focal - cerebral infarction, hemorrhagic stroke, intrathecal hemorrhage.

According to the nature of cerebral circulatory disorders, they are divided into acute (intrathecal hemorrhages, transient, strokes), initial stages and chronic disorders of spinal and cerebral circulation (dyscirculatory encephalopathy and myelopathy).

Symptoms of cerebrovascular accident

Initially, the disease may be asymptomatic. But without proper treatment, the disorders progress quickly. Symptoms of cerebrovascular accident are as follows:

Headache. This is the very first symptom of circulatory disorders in the brain. If headaches become systematic, you should immediately consult a doctor.

Dizziness. You should consult a doctor immediately if dizziness occurs more than three times a month.

Pain in the eyes. Pain in the eyes due to circulatory disorders in the brain tends to intensify during the movement of the eyeballs. Most often, such pain is observed at the end of the working day, when the eyes are tired from straining throughout the day.

Nausea and vomiting. You should consult a doctor if nausea and vomiting occur together with headache, dizziness and eye pain.

Cramps. Seizures can be of many different types. As a rule, they occur quite rarely.

Congestion, ringing and noise in the ears. When there are circulatory problems in the brain, it feels as if water has gotten into the ears.

Numbness. Those who have cerebrovascular accidents may experience numbness in their arms, legs, or other parts of the body. Numbness does not occur as usual, after being in an uncomfortable position for a long time, but just like that. This is a direct consequence of disruption of normal blood circulation in the brain.

Acute cerebrovascular accident

Acute circulatory disorders in the brain can be persistent (cerebral stroke) or transient.

A transient cerebrovascular accident occurs due to a hypertensive crisis, cerebral vasospasm, cerebral atherosclerosis, arrhythmia, heart failure, and collapse. Symptoms of a transient cerebrovascular accident can occur within a few minutes or throughout the day.

Treatment of cerebrovascular accidents

Treatment of cerebral circulatory disorders consists of normalizing cerebral blood flow in tissues, stimulating metabolism in neurons, treating underlying cardiovascular diseases, protection of brain neurons from hypoxia factors.

Prevention of cerebrovascular accidents

Prevention of circulatory disorders in the brain is quite simple. To avoid violations, you must:

Do not smoke or use psychotropic substances;

To live an active lifestyle;

Reduce salt intake;

Control and maintain normal body weight;

Monitor glucose levels, lipoproteins and triglycerides in the blood;

Treat existing heart diseases vascular system.

Video from YouTube on the topic of the article:

Cerebral circulation- blood circulation in the vascular system of the brain and spinal cord.

The severity and localization of morphological changes in brain tissue in patients with cerebrovascular accidents are determined by the underlying disease, the blood supply of the affected vessel, the mechanisms of development of this circulatory disorder, age and individual characteristics sick.

Morphological signs of cerebrovascular accident can be focal or diffuse. Focal ones include hemorrhagic stroke, intrathecal hemorrhages, cerebral infarction; to diffuse - multiple of various nature and of varying duration, small focal changes in the brain substance, minor hemorrhages, small fresh and organizing foci of necrosis of brain tissue, gliomesodermal scars and small cysts.

Clinically, with cerebrovascular accidents, there may be subjective sensations ( headache, dizziness, paresthesia, etc.) without objective neurological symptoms; organic microsymptoms without clear symptoms of loss of central nervous system function; focal symptoms: motor disorders - paresis or paralysis, extrapyramidal disorders, hyperkinesis, coordination disorders, sensitivity disorders, pain; dysfunction of the sensory organs, focal disorders higher functions cerebral cortex - aphasia, agraphia, alexia, etc.; changes in intelligence, memory, emotional-volitional sphere; epileptic seizures; psychopathological symptoms.

According to the nature of cerebral circulatory disorders, initial manifestations of insufficiency of cerebral blood supply are distinguished, acute cerebral circulatory disorders (transient disorders, intrathecal hemorrhages, strokes), chronic slowly progressive disorders of cerebral and spinal circulation (dyscirculatory encephalopathy and myelopathy).

Clinical symptoms of initial manifestations of insufficiency of blood supply to the brain are those that appear, especially after intense mental and physical work, stay in stuffy room, headache, dizziness, noise in the head, decreased performance, sleep disturbance. Focal neurological symptoms in such patients are usually absent or represented by scattered microsymptoms. To diagnose the initial manifestations of insufficient blood supply to the brain, it is necessary to identify objective signs of atherosclerosis, arterial hypertension, vasomotor dystonia and the exclusion of other somatic pathologies, as well as neurosis.

Acute cerebrovascular accidents include transient cerebral circulatory disorders and strokes.

Transient cerebrovascular accidents are manifested by focal or general cerebral symptoms (or a combination thereof) lasting less than 1 day. They are most often observed in cerebral atherosclerosis, hypertension and arterial hypertension.

There are transient ischemic attacks and hypertensive cerebral crises.

Transient ischemic attacks are characterized by the appearance of focal neurological symptoms (weakness and numbness of the limbs, difficulty speaking, static disturbances, diplopia, etc.) against the background of mild or absent cerebral symptoms.

Hypertensive cerebral crises, on the contrary, are characterized by a predominance of general cerebral symptoms (headache, dizziness, nausea or vomiting) over focal ones, which sometimes may be absent. An acute cerebrovascular accident, in which focal neurological symptoms persist for more than 1 day, is considered a stroke.

Acute disorders of venous circulation in the brain also include venous hemorrhages, thrombosis of the cerebral veins and venous sinuses.

Chronic cerebrovascular accidents (dyscirculatory encephalopathy and myelopathy) are the result of progressive insufficiency of blood supply caused by various vascular diseases.

With discirculatory encephalopathy, scattered organic symptoms are detected, usually in combination with memory impairment, headaches, non-systemic dizziness, irritability, etc. There are 3 stages of discirculatory encephalopathy.

Stage I, in addition to scattered, mildly expressed persistent organic symptoms (asymmetry of cranial innervation, slight oral reflexes, inaccuracy of coordination, etc.), is characterized by the presence of a syndrome similar to the asthenic form of neurasthenia (memory deterioration, fatigue, absent-mindedness, difficulty switching from one activity to another). another, dull headaches, unsystematic dizziness, poor sleep, irritability, tearfulness, depressed mood). Intellect does not suffer.

Stage II is characterized by progressive deterioration of memory (including professional memory), decreased performance, personality changes (viscosity of thought, narrowing of interests, apathy, often verbose, irritability, quarrelsomeness, etc.), decreased intelligence. Daytime sleepiness with poor night sleep is typical. Organic symptoms more distinct (mild dysarthria, reflexes of oral automatism and other pathological reflexes, bradykinesia, tremor, changes in muscle tone, coordination and sensory disorders).
Stage III is characterized by both worsening mental disorders (up to dementia) and the development of neurological syndromes associated with predominant defeat specific area of ​​the brain. These may be pseudobulbar palsy, parkinsonism, cerebellar ataxia, pyramidal insufficiency. Stroke-like deterioration of the condition is frequent, characterized by the appearance of new focal symptoms and an increase in previously existing signs of cerebrovascular insufficiency.

Discirculatory myelopathy also has a progressive course, in which three stages can be roughly distinguished. Stage I (compensated) is characterized by the appearance of moderately severe fatigue of the muscles of the limbs, less often weakness of the limbs. Subsequently, in stage II (subcompensated), weakness in the limbs progressively increases, sensory disturbances of the segmental and conduction type, and changes in the reflex sphere appear. In stage III, paresis or paralysis, severe sensory disturbances, and pelvic disorders develop.

The nature of focal syndromes depends on the localization of pathological foci along the length and diameter of the spinal cord. Possible clinical syndromes are poliomyelitis, pyramidal, syringomyelic, amyotrophic lateral sclerosis, posterior columnar, transverse spinal cord lesions.

Chronic venous circulation disorders include venous stasis, causing venous encephalopathy and myelopathy. It is a consequence of cardiac or pulmonary-heart failure, compression of extracranial veins in the neck, etc. Difficulties in venous outflow from the cranial cavity and spinal canal can be compensated for a long time; with decompensation, headaches, seizures, cerebellar symptoms, dysfunction cranial nerves. Venous encephalopathy is characterized by a variety of clinical manifestations. Hypertensive (pseudotumor) syndrome, scattered small-focal brain lesion syndrome, and asthenic syndrome may be observed. Venous encephalopathy also includes bettolepsy (cough epilepsy), which develops in diseases leading to venous stagnation in the brain. Venous myelopathy is a particular variant of discirculatory myelopathy and clinically does not differ significantly from the latter.

Symptoms of circulatory disorders in the vessels of the brain

In the early stages, the disease is asymptomatic. However, it progresses quickly and gradually its symptoms completely incapacitate a person, performance is seriously impaired, the person loses the joy of life and cannot live fully.

So, the symptoms of cerebrovascular accident include:

Headache is the main alarm bell, but people often ignore it, believing that the pain is caused by fatigue, weather or other reasons
pain in the eyes - its peculiarity is that it noticeably intensifies during the movement of the eyeballs, especially in the evening
dizziness - when such a phenomenon is observed regularly, it should in no case be ignored
nausea and vomiting - usually this symptom manifests itself in parallel with the above
stuffy ears
ringing or noise in the ears
convulsions - this symptom appears less frequently than others, but still occurs
numbness - when blood circulation in the vessels of the brain is impaired, it occurs absolutely for no reason
tension in the head muscles, especially pronounced in the occipital muscles
weakness in the body
fainting
pale skin
decrease heart rate

Also noted various disorders consciousness, such as:

Changes in perception, such as feeling dazed
memory impairment - a person remembers his past perfectly, but often forgets about plans, about where things are
absent-mindedness
rapid fatigue and, as a consequence, decreased performance
short temper, easy excitability, tearfulness
constant drowsiness or vice versa insomnia

Causes of cerebrovascular accidents

Causes of this disease very diverse. They are usually associated with other abnormalities in the cardiovascular system, for example, vascular atherosclerosis or hypertension. Atherosclerosis is the blockage of blood vessels with cholesterol plaques, so it is simply necessary to monitor the concentration of cholesterol in the blood. And for this you should monitor your daily diet.

Chronic fatigue also often causes poor circulation in our brain. Unfortunately, people often do not realize the seriousness of their condition and end up dire consequences. But chronic fatigue syndrome can lead not only to disruption of blood circulation, but also to disruptions in work endocrine system, central nervous system and gastrointestinal tract.

Various traumatic brain injuries can also cause disorders. These can be injuries of any severity. Injuries with intracranial hemorrhage are especially dangerous. It is quite natural that the stronger the hemorrhage, the more serious consequences it can lead to.

The problem of modern man is regularly sitting in front of a computer monitor in an uncomfortable position. As a result, the muscles of the neck and back are greatly overstrained and blood circulation in the vessels, including the vessels of the brain, is disrupted. Excessive exercise can also be harmful.

Problems in blood circulation are also closely related to diseases of the spine, especially its cervical region. Be careful if you are diagnosed with scoliosis or osteochondrosis.

The main cause of cerebral hemorrhage is high blood pressure. With a sharp rise, a vessel may rupture, resulting in the release of blood into the brain substance and the development of an intracerebral hematoma.

More rare reason hemorrhage - rupture of an aneurysm. An arterial aneurysm, usually a congenital pathology, is a saccular protrusion on the wall of a vessel. The walls of such a protrusion do not have such a powerful muscular and elastic framework as the walls of a normal vessel have. Therefore, sometimes only a relatively small jump in pressure, which is observed in completely healthy people during physical activity or emotional stress, is enough for the wall of the aneurysm to rupture.

Along with saccular aneurysms, other congenital anomalies of the vascular system are sometimes observed, creating the threat of sudden hemorrhage.
In cases where an aneurysm is located in the walls of vessels located on the surface of the brain, its rupture leads to the development of not intracerebral, but subarachnoid (subarachnoid) hemorrhage, located under the arachnoid membrane surrounding the brain. Subarachnoid hemorrhage does not directly lead to the development of focal neurological symptoms (paresis, speech impairment, etc.), but it causes general cerebral symptoms: a sudden sharp (“dagger”) headache, often followed by loss of consciousness.

A cerebral infarction usually develops as a result of blockage of one of the cerebral vessels or a large (main) vessel of the head, through which blood flows to the brain.

There are four main vessels: the right and left internal carotid arteries, which supply most of the right and left hemispheres of the brain, and the right and left vertebral artery, which then merge into the main artery and supply blood to the brainstem, cerebellum and occipital lobes cerebral hemispheres.

The causes of blockage of the main and cerebral arteries may be different. Thus, during an inflammatory process on the heart valves (with the formation of infiltrates or the formation of a parietal thrombus in the heart), pieces of the thrombus or infiltrate can break off and travel with the bloodstream to a cerebral vessel, the caliber of which smaller size piece (embolus), and as a result clog the vessel. Particles of disintegrating atherosclerotic plaque on the walls of one of the main arteries of the head can also become emboli.

This is one of the mechanisms for the development of cerebral infarction - embolic.
Another mechanism for the development of a heart attack is thrombotic: the gradual development of a thrombus (blood clot) at the location of the atherosclerotic plaque on the vessel wall. An atherosclerotic plaque filling the lumen of a vessel leads to a slowdown in blood flow, which contributes to the development of a blood clot. The uneven surface of the plaque in this area favors the adhesion (aggregation) of platelets and other blood elements, which constitutes the main framework of the resulting thrombus.

As a rule, local factors alone are often not enough for the formation of a blood clot. The development of thrombosis is facilitated by factors such as a general slowdown in blood flow (therefore, thrombosis of cerebral vessels, as opposed to embolisms and hemorrhages, usually develop at night, during sleep), increased blood clotting, and increased aggregation (gluing) properties of platelets and red blood cells.

Everyone knows from experience what blood clotting is. A man accidentally cuts his finger, blood begins to pour out of it, but gradually a blood clot(thrombus) and the bleeding stops.
Blood clotting - essential biological factor, contributing to our survival. But both decreased and increased coagulability threatens our health and even our very lives.

Increased coagulability leads to the development of thrombosis, while decreased coagulability leads to bleeding from the slightest cuts and bruises. Hemophilia, a disease accompanied by reduced blood clotting and of a hereditary nature, suffered from many members of the reigning families of Europe, including the son of the last Russian emperor, Tsarevich Alexei.

Disruption of normal blood flow can also be a consequence of spasm (strong compression) of the vessel, which occurs as a result of a sharp contraction of the muscle layer vascular wall. Several decades ago, spasm was given great importance in the development of cerebrovascular accidents. Currently, spasm of cerebral vessels is mainly associated with cerebral infarctions, which sometimes develop several days after subarachnoid hemorrhage.

With frequent increases in blood pressure, changes can develop in the walls of small vessels that supply deep structures of the brain. These changes lead to narrowing and often closure of these vessels. Sometimes, after another sharp rise in blood pressure (hypertensive crisis), a small infarction develops in the circulatory system of such a vessel (called a “lacunar” infarction in the scientific literature).

In some cases, cerebral infarction can develop without complete blockage of the vessel. This is a so-called hemodynamic stroke. Let's imagine a hose from which you water a garden. The hose is clogged with silt, but the electric motor, lowered into the pond, works well, and the stream of water is enough for normal watering. But a slight bend in the hose or a deterioration in the performance of the motor is enough, and instead of a powerful stream, a narrow stream of water begins to flow out of the hose, which is clearly not enough to water the ground well.

The same thing can happen under certain conditions with blood flow in the brain. For this, the presence of two factors is sufficient: a sharp narrowing of the lumen of the main or cerebral vessel by an atherosclerotic plaque filling it or as a result of its kinking, plus a drop in blood pressure occurring due to a deterioration (often temporary) in the functioning of the heart.

The mechanism of transient cerebrovascular accidents (transient ischemic attacks) is in many ways similar to the mechanism of development of cerebral infarction. Only compensatory mechanisms for transient disorders of cerebral circulation work quickly, and the developed symptoms disappear within a few minutes (or hours). But one should not hope that compensation mechanisms will always cope so well with the violation that has arisen. Therefore, it is so important to know the causes of cerebrovascular accidents, which allows us to develop methods for preventing repeated disasters.

Treatment of cerebrovascular accidents

Various diseases of the cardiovascular system are the most common ailments among the world's population. And cerebrovascular accident is generally an extremely dangerous thing. The brain is the most important organ of our body. Its poor functioning leads not only to physical abnormalities, but also to impaired consciousness.

Treatment of this disease includes not only taking medicines, but also a complete change in your lifestyle. As mentioned above, cholesterol plaques contribute to the development of circulatory disorders in the vessels of the brain. This means that it is necessary to take measures to prevent an increase in blood cholesterol levels. And the main measures include proper nutrition. First of all, do the following:

Limit the amount you consume as much as possible. table salt
give up alcoholic drinks
if you have extra pounds, you urgently need to get rid of them, since they create extra stress on your blood vessels, and this is simply unacceptable for this disease
Some people's blood vessels, including capillaries, are fragile. Such people often have bleeding gums, and often have nosebleeds. How to get rid of this scourge?

Dissolve in a glass of water at room temperature a teaspoon of well-cleaned (food grade) and finely ground sea ​​salt. Inhale the cool saline solution through your nostrils and hold your breath for about 3-4 seconds. Repeat the procedure every morning for 10-12 days, and nosebleeds will stop.

This method also works well: prepare a saturated salt solution (five tablespoons of coarse sea salt per glass of warm water). Make two cotton swabs, soak them in the prepared solution and insert them into your nose. Lie with your head thrown back for 20 minutes. It is also useful to rinse your mouth with the same solution: your gums will stop hurting and bleeding.

Take two tablespoons of dry mustard, two pods of chopped hot pepper, a tablespoon of sea salt. Mix all ingredients and add two glasses of vodka. Leave the mixture in a dark place for 10 days. Actively rub your feet with the resulting tincture at night. After rubbing, put on wool socks and go to bed.

Treatment of age-related changes in the circulatory system in old age

Age-related changes in blood vessels and the heart significantly limit adaptation capabilities and create the preconditions for the development of diseases.

Changes in blood vessels. The structure of the vascular wall changes with age in each person. Gradually atrophies and decreases muscle layer each vessel, its elasticity is lost and sclerotic compactions of the inner wall appear. This greatly limits the ability of blood vessels to expand and narrow, which is already a pathology. Large arterial trunks, especially the aorta, are primarily affected. In older and older people, the number of active capillaries per unit area decreases significantly. Tissues and organs stop receiving the amount they need nutrients and oxygen, and this leads to their starvation and development various diseases.

As each person ages, small vessels become more and more “clogged” with lime deposits and peripheral vascular resistance increases. This leads to a slight increase in blood pressure. But the development of hypertension is significantly hampered by the fact that with a decrease in the tone of the muscular wall of large vessels, the lumen of the venous bed expands. This leads to a decrease in cardiac output (minute volume is the amount of blood ejected by the heart per minute) and to active redistribution of peripheral circulation. Coronary and cardiac circulation usually suffers little from a decrease in cardiac output, while renal and hepatic circulation are greatly reduced.

Decline contractility heart muscle. The older a person gets, the more muscle fibers of the heart muscle atrophy. The so-called “senile heart” develops. Progressive myocardial sclerosis occurs, and in place of the atrophied muscle fibers of the cardiac tissue, non-working fibers develop connective tissue. The strength of heart contractions gradually decreases, metabolic processes are increasingly disrupted, which creates conditions for energetic-dynamic heart failure under conditions of intense activity.

In addition, in old age, conditioned and unconditioned reflexes of blood circulation regulation appear, and the inertia of vascular reactions is increasingly revealed. Research has shown that with aging, the effects of various brain structures on the cardiovascular system change. In turn, the feedback also changes - the reflexes coming from the baroreceptors of large vessels are weakened. This leads to dysregulation of blood pressure.

As a result of all the above reasons, the physical performance of the heart decreases with age. This leads to a limitation of the range of reserve capabilities of the body and a decrease in the efficiency of its work.

Points of influence for circulatory disorders

In case of weak blood flow and blockage of blood vessels, you should use the index finger and thumb of one hand to grab the middle finger of the other hand. Perform acupressure by pressing with medium force with your thumbnail on a point located under the nail bed. The massage should be done on both hands, spending 1 minute each.

Points of influence for thirst. When a feeling of thirst occurs, you should act on a soothing point. The peculiarity of this BAT is that it is still in human body It was not possible to identify other points associated with the mucous membrane. The point is located at a distance of approximately 1 cm from the tip of the tongue. The massage consists of lung shape biting this point with the front teeth (incisors) with a rhythm of 20 times per 1 minute.

Points of intervention for sleep disorders. For insomnia, acupressure of the lower part should be performed. auricle. The massage should be carried out with the index and thumb, clasping the earlobe on both sides. Biologically active point located in the middle of the lobe. Sleep will come faster (or massage more often with right side than with the left.

Drawing. Points of influence for influenza, runny nose, catarrh of the upper respiratory tract

Acupressure does not replace the necessary medical treatment, especially if surgical intervention is urgently needed (for example, with appendicitis, its purulent stage).

Even a small, but frequently repeated change in blood pressure leads to the development of cerebral ischemia, and the affected areas try to continue to perform their functions. A chronic disruption of the blood supply to the brain develops—dyscirculatory type encephalopathy.

It does not progress quickly, due to insufficient blood circulation, while developing in the brain tissue small lesions necrosis, which will inevitably lead to loss of brain function. Symptoms of cerebrovascular accidents are treated with methods traditional medicine, the goal of treatment is to restore the blood supply deficit and alleviate the symptoms of hypertension.

Lack of blood supply to brain tissue causes metabolic and subsequently destructive changes in brain cells. Years of progression of the disease, even with proper treatment, aggravate it both in the quality and number of affected cells.

When the disease is at the very beginning of its development, the main symptoms are cerebrosthenic:

• increased fatigue;
• prevalence of emotional instability;
• anxiety from sleep disorders;
• suffering from frequent headaches;
• memory loss.

Symptoms of cerebrovascular accidents are treated with injections and droppers, that is, methods when the medicine penetrates directly into the blood and begins to work faster in the body.

Non-children's problems

Circulatory disorders in the brain are observed much less frequently in children than in adult patients. Children do not have age-related vascular deformations, and the outflow of blood from the brain is not impaired. If circulatory disorders occur, their causes differ significantly from the factors that cause cervical cerebrovascular accidents in adults.

The most common causes of circulatory disorders in children are:

• blood diseases;
• vascular injuries;
• cardiac pathology;
• vasculitis;
• symptoms of arterial hypertension;
• dystonia of vasomotor type;
• endocrine system disease;
• hypertension;
• atherosclerosis of blood vessels in the children's brain.

Different factors predominate at different times age periods children's growth. Treatment of symptoms of cerebrovascular accident in children depends on their age and physiological factors.

The 1st year of life shows that the main factor of NMC is anomalies in the formation of cerebrospinal fluid. Preschoolers and schoolchildren give such causes of cerebrovascular accidents as blood and heart diseases.

Occurrence of signs and symptoms

Most vascular disorders are based on hypoxia - lack of oxygen. Neurons are unusually sensitive to a decrease in oxygen supply. Even a five-minute cessation of blood supply to the brain can lead to irreparable consequences.

The development of hypoxia leads to disruption of:

• brain functions,
• functions of the center responsible for vascular movements,
• regulation of vascular tone.

When hypoxia of brain cells is at a reversible level, transient ischemia develops. If irreversible changes occur, then a cerebral infarction occurs, expressed in white or red softening of the tissue. While cerebrovascular accidents are at a transient level, their symptoms can be treated, amenable to medication, and restoration of motor and facial functions.

NMC manifests itself in an acute and chronic nature, including the passage of crises or strokes. Reversible disorders usually indicate vascular crises, but it should be noted that they are clear signals of strokes.

Clinical symptoms are common to all vascular diseases:

• consciousness is briefly lost and confused;
• facial symmetry is disrupted;
• nystagmus appears;
• speech becomes confused and difficult to understand;
• epilepsy-type seizures occur.

Vegetative signs appear:

• increased sweating when the hands and feet get cold;
• paleness or redness of the skin;
• changes in heart rate and respiratory rhythm;
• blurred vision;
• nausea;
• instability in movements and in a static state.

If at least several of the above symptoms are present, the doctor prescribes an examination in which the following are of particular diagnostic value:

• development of vascular diseases over several years - hypertension, diabetes;
• appropriate presentation of complaints by the patient;
• research indicators medical psychologist, the MMSE scale that identifies mental abilities is most often used here;
• duplex scanning, which provides information about the location of affected vessels, the presence of malformations, and the development of venous type encephalopathy;
• MRI indicators are the most informative in modern medicine examination that detects the smallest lesions;
• blood tests - clinical, sugar;
• blood test for lipid profile, coagulogram.

Therapeutic measures

Treatment is aimed at stabilizing blood flow in brain tissue and stimulating neural metabolism. At the same time, the underlying vascular disease is actively treated, which in the sum of complexes provides neurons with effective protection from oxygen starvation.

An important area of ​​treatment is taking antihypertensive drugs; the same courses effectively prevent the formation of all kinds of blood circulation disorders in the brain. Non-medicinal methods of preventing and treating symptoms of cerebrovascular accident in adults are lowering blood pressure, reducing the amount of salt in the diet, losing excess weight, and a calm lifestyle.

Medicines from the glycoside group normalize the functioning of blood vessels: Korglykon, Digoxin. Their intake must be combined with potassium complexes and diuretics. Doctors pay particular attention to normalizing blood pressure.

A sharp increase in blood pressure is relieved by Eufillin and Dibazol. The decrease in blood pressure is corrected with vasotonic drugs and glucocorticosteroid hormones. To prevent cerebral edema, in a patient’s crisis state it is necessary to take dehydrates - Lasix, Mannitol.

Ischemic stroke - serious symptom cerebrovascular accidents; if the causes are identified, the doctor prescribes targeted treatment:

• taking drugs that dilate blood vessels - Complamina, No-shpy;
• exposure to anticoagulants - Heparin, Warfarin;
• regular use of antiplatelet agents – Curantil, Plavix.

At the recovery stage after active drug therapy traditional physiotherapeutic procedures are carried out to resolve the issue of rehabilitation of lost functions. Here, physiotherapy, massage, exercise therapy come first. Doctors do not deny the complex rehabilitation treatment and traditional medicine, recommend ancient recipes that have been tested for centuries.

Grandma's recipes to help doctors

In addition to medications, which the therapist selects individually for each patient, constant use of light herbs is prescribed hypotensive effect in a minimal dosage. This is done in order to constantly maintain normal blood pressure.

Symptoms of cerebrovascular accident are treated with folk remedies. Herbalists recommend drinking an infusion of hawthorn with rose hips every day: pour boiling water into 11 large rose hips and 7 hawthorn berries in a thermos. Leave overnight. Drink ¼ glass before meals. Dried hawthorn flowers are also used and brewed like tea so that the drink does not become bitter.

Valerian extract also belongs to herbal preparations. Herbalists do not recommend drinking complex mixtures so that the patient knows exactly the effect of each medicinal plant, in order to exclude allergic reaction on herbs.

• 3 equal parts each of motherwort herb, cudweed herb, hawthorn flowers,
• 1 part chamomile flowers.

A mixture of dry herbs is made, and 1 tbsp is brewed with boiling water. l. mixture in 1 glass of boiling water for 8 hours. Then the finished infusion is filtered, divided into 2 equal parts, drink 2 r. per day 1 hour after meals.

Folk remedies include vitamins and sedatives. herbal teas, climate therapy, aromatherapy, hirudotherapy, oxygen and pine baths, set up on fresh or sea ​​water, depending on the location of the resort area. For aromatherapy, you can create all the conditions at home, you can buy an aroma lamp at the pharmacy, choose the right aroma for yourself, and enjoy traditional treatment in the comfort of home, not forgetting a cup of herbal tea.

A condition called cerebrovascular accident acute form, is one of the leading causes of death in developed countries. According to statistics, more than 6 million people suffer a stroke every year, a third of whom die as a result of the disease.

Causes of cerebrovascular accidents

Doctors call a circulatory disorder in the brain when blood moves through its vessels. Damage to the veins or arteries responsible for the blood supply causes vascular insufficiency.

Vascular pathologies that provoke cerebrovascular accidents can be very different:

• blood clots;
• formation of loops, kinks;
• narrowing;
• embolism;
• aneurysm.

We can talk about cerebral vascular insufficiency in all cases when the amount of blood actually transported to the brain does not coincide with what is necessary.

Statistically, most often blood supply problems are caused by sclerotic vascular lesions. Formation in the form of a plaque interferes with the normal passage of blood through the vessel, impairing its throughput.

If treatment is not prescribed on time, the plaque will inevitably accumulate platelets, due to which it will increase in size, ultimately forming a blood clot. It will either block the vessel, preventing blood from flowing through it, or it will be torn off by the blood flow and then be delivered to the cerebral arteries. There it will block the vessel, causing an acute cerebrovascular accident called a stroke.

Human brain

Hypertension is also considered one of the main causes of the disease. For patients suffering from hypertension, a frivolous attitude towards their own pressure, including ways to normalize it, is noted.

If treatment is prescribed and the doctor’s instructions are followed, the likelihood of vascular insufficiency is reduced.

Osteochondrosis of the cervical spine can also cause difficulty in blood flow, as it compresses the arteries that supply the brain. Therefore, treatment of osteochondrosis is not only a matter of getting rid of pain, but more of an attempt to avoid serious consequences, even death.

Chronic fatigue is also considered one of the reasons for the development of circulatory problems in the brain.

Head injuries can also be a direct cause of the disease. Concussions, hemorrhages or bruises cause compression of the centers of the brain, and as a result - cerebrovascular accidents.

Types of violations

Doctors talk about two types of cerebral blood flow problems: acute and chronic. Acute is characterized by rapid development, since we can talk not only about days, but even about minutes of the course of the disease.

Acute disorders

All cases of acute cerebral circulation problems can be divided into two groups:

1. stroke . In turn, all strokes are divided into hemorrhagic, in which hemorrhage occurs in the brain tissue due to rupture of a vessel, and ischemic. With the latter, the blood vessel is blocked for some reason, causing brain hypoxia;
2. transient cerebrovascular accident. This condition is characterized by local vascular problems that do not affect vital areas. They are not capable of causing real complications. A transient disorder is distinguished from an acute one by its duration: if the symptoms are observed for less than a day, then the process is considered transient, otherwise - a stroke.

Chronic disorders

Difficulties in cerebral blood flow that are chronic in nature develop over a long period of time. The symptoms characteristic of this condition are very mild at first. Only over time, when the disease progresses noticeably, do the sensations become stronger.

Symptoms of cerebral blood flow obstruction

The clinical picture for each type of vascular problem may vary different kind. But all of them are characterized by general signs, indicating loss of brain functionality.

In order for treatment to be as effective as possible, it is necessary to identify all significant symptoms, even if the patient is confident in their subjectivity.

The following symptoms are characteristic of cerebrovascular accident:

• headaches of unknown origin, dizziness, crawling sensations, tingling sensations not caused by any physical reasons;
• immobilization: both partial, when motor functions are partially lost in one limb, and paralysis, causing complete immobilization of a part of the body;
• a sharp decrease in visual acuity or hearing;
• symptoms indicating problems with the cerebral cortex: difficulty speaking, writing, loss of reading ability;
• seizures resembling epileptic;
• sharp deterioration of memory, intelligence, mental abilities;
• sudden onset of absent-mindedness, inability to concentrate.

Each of the problems of cerebral blood flow has its own symptoms, the treatment of which depends on the clinical picture.

Thus, with an ischemic stroke, all symptoms manifest themselves very acutely. The patient will definitely have subjective complaints, including severe nausea, vomiting or focal symptoms signaling violations of those organs or systems for which the affected area of ​​the brain is responsible.

A hemorrhagic stroke occurs when blood from a damaged vessel enters the brain. The fluid can then compress the brain cavity, causing various damages, often resulting in death.

Transient disorders of cerebral circulation, called transient ischemic attacks, may be accompanied by partial loss motor activity, drowsiness, visual impairment, speech impairment, and confusion.

Chronic problems of cerebral blood supply are characterized by a slow development over many years. Therefore, patients are most often elderly, and treatment of the condition necessarily takes into account the presence of concomitant diseases. Frequent symptoms are a decrease in intellectual abilities, memory, and ability to concentrate. Such patients may be more aggressive.

Diagnostics

The diagnosis and subsequent treatment of the condition is based on the following parameters:

• collecting anamnesis, including the patient’s complaints;
• concomitant diseases of the patient. Diabetes mellitus, atherosclerosis, high blood pressure may indirectly indicate circulatory problems;
• scan indicating damaged vessels. It allows you to prescribe their treatment;
• Magnetic resonance imaging, which is the most reliable way to visualize the affected area of ​​the brain. Modern treatment cerebral circulation difficulties are simply impossible without an MRI.

Treatment of cerebral circulation difficulties

Cerebral circulation disorders that are acute in nature require immediate medical attention. In case of strokes, emergency care is aimed at maintaining vital human organs and systems.

Treatment of cerebrovascular problems consists of ensuring the patient normal breathing, blood circulation, relieving cerebral edema, correcting blood pressure, and normalizing water and electrolyte balance. To carry out all these procedures, the patient must be in the hospital.

Further treatment for stroke will consist of eliminating the cause of the circulatory difficulties. In addition, the general blood flow of the brain and the restoration of its affected areas will be corrected.

According to medical statistics, timely and correct treatment increases the chances of full restoration of functions affected by a stroke. Approximately a third of able-bodied patients can return to their jobs after rehabilitation.

Chronic cerebrovascular accidents are treated with medications that improve arterial blood flow. At the same time, treatment is prescribed to normalize blood pressure and cholesterol levels in the blood. In case of chronic disorders, independent training of memory, concentration, and intelligence is also indicated. Such activities include reading, memorizing texts, and other intellectual training. It is impossible to reverse the process, but the patient can prevent the situation from worsening.

With this disease, general cerebral signs are detected (headache, dizziness, vomiting, tinnitus, decreased hearing, vision, impaired consciousness) and focal symptoms of cerebral circulatory disorders (motor and sensory disorders), impaired coordination of movements, extrapyramidal disorders, cortical dysfunctions.

There are 4 periods in the clinical picture of the disease:

acute period (from days to 4 weeks depending on severity),

recovery period (from 4-6 weeks to 12 months)

and residual, characterized by the presence of persistent residual effects.

The following syndromes are typical for patients with acute disorders:

• encephalopathic,
• motor disorders,
• sensory disorders,
• disturbances in motor coordination,
• hyperkinetic syndrome
• and syndrome of cortical dysfunctions (psycho-emotional disorders),
• hypertensive-hydrocephalic
• and arterial hypertension,
• disorders of cerebral angiohemodynamics and metabolism.

Types of pathologies of cerebral circulation and their symptoms

Currently, there are several classifications of cerebrovascular accidents. The most common classification of vascular lesions of the brain in our country is the classification proposed by the Institute of Neurology of the Academy of Medical Sciences of Russia. It is compiled in accordance with the criteria of the international classification.

According to it, violations by their nature are divided into the following types.

Initial (early) signs of cerebrovascular insufficiency.

Acute disorders:

• acute hypertensive encephalopathy;
• cerebral stroke,
• hemorrhage, which, in turn, can be parenchymal, subarachnoid, epi- or subdural;
• cerebral infarction.

Slowly progressive disorders of the blood supply to the brain.

Consequences of a previous stroke.

Forms of cerebrovascular accidents

The classification of acute cerebrovascular accidents according to the International Classification of Diseases, Tenth Revision, is also widely used in clinics in our country:

Transient transient ischemic attacks and similar syndromes:

• vertebrobasilar arterial system syndrome;
• carotid artery syndrome (hemispheric);
• multiple and bilateral cerebral artery syndromes;
• transient blindness;
• transient global amnesia;
• other transient cerebral ischemic attacks and related syndromes;
• transient cerebral ischemic attack, unspecified.

Vascular brain syndromes in cerebrovascular diseases (160–167+):

• middle cerebral artery syndrome (166.0+);
• anterior cerebral artery syndrome (166.1+);
• posterior cerebral artery syndrome (166.2+);
• brainstem stroke syndrome (160–167+);
• Millard-Jublay syndrome, cerebrovascular accidents;
• Wallenberg syndrome;
• Weber syndrome;
• cerebellar stroke syndrome (160–167+);
• purely motor lacunar syndrome (160–167+);
• purely sensitive lacunar syndrome of cerebrovascular accidents (160–167+);
• other lacunar syndromes (160–167+);
• other vascular syndromes of the brain in cerebrovascular diseases;
• cerebrovascular diseases.

Subarachnoid hemorrhage:

• subarachnoid hemorrhage from the carotid sinus and bifurcation of the internal carotid artery;
• subarachnoid hemorrhage in cerebrovascular accidents from the middle cerebral artery;
• subarachnoid hemorrhage from the anterior communicating artery;
• subarachnoid hemorrhage from the posterior communicating artery;
• subarachnoid hemorrhage from the basilar artery;
• subarachnoid hemorrhage from the vertebral artery;
• subarachnoid hemorrhage from other intracranial arteries;
• subarachnoid hemorrhage in cerebrovascular accidents from an unspecified intracranial artery;
• other subarachnoid hemorrhage;
• subarachnoid hemorrhage, unspecified;

Intracerebral hemorrhage in cerebrovascular accidents:

• intracerebral hemorrhage in the subcortical hemisphere;
• intracerebral hemorrhage in the cortical hemisphere;
• intracerebral hemorrhage in the hemisphere, unspecified;
• intracerebral hemorrhage in the brain stem;
• intracerebral hemorrhage due to cerebrovascular accidents in the cerebellum;
• intracerebral intraventricular hemorrhage;
• intracerebral hemorrhage of multiple localization;
• other intracerebral hemorrhage;
• intracerebral hemorrhage, unspecified.

Other non-traumatic intracranial hemorrhage for cerebrovascular accidents:

• subdural hemorrhage (acute) (non-traumatic);
• non-traumatic extradural hemorrhage;
• intracranial hemorrhage (non-traumatic) unspecified.

Cerebral infarction due to cerebrovascular accidents:

• cerebral infarction caused by thrombosis of the precerebral arteries;
• cerebral infarction caused by embolism of the precerebral arteries;
• cerebral infarction caused by unspecified occlusion or stenosis of the precerebral arteries;
• cerebral infarction caused by thrombosis of cerebral arteries;
• cerebral infarction caused by embolism of cerebral arteries;
• cerebral infarction due to cerebrovascular accidents caused by unspecified blockage or stenosis of cerebral arteries;
• cerebral infarction caused by cerebral vein thrombosis, non-pyogenic;
• other cerebral infarction;
• cerebral infarction, unspecified.

Stroke not specified as hemorrhage or infarction.

Stages of chronic cerebrovascular insufficiency

Along with the described classifications, there are others accepted in a number of clinics. Thus, according to the classification of N.K. Bogolepov, there are two types of cerebral circulatory disorders -

• acute
• and chronic.

Acute cerebral circulatory failure includes: paroxysms, crises and strokes (hemorrhagic and ischemic) and subarachnoid hemorrhages.

Chronic cerebral circulatory failure (represented by discirculatory encephalopathies of hypertensive origin and atherosclerotic discirculatory encephalopathies) is divided into 4 stages.

Stroke as a sign of cerebrovascular insufficiency

In turn, strokes are classified according to the nature of the changes occurring in the brain into:

hemorrhagic stroke (rupture of a vessel and hemorrhage into the substance of the brain and under the membranes of the brain);

ischemic stroke (blockage of a blood vessel), which can be:

Thrombotic and embolic develop due to complete blockage of an extra- or intracranial vessel, which can be caused by thrombosis or embolism, obliteration of the vessel by an atherosclerotic plaque. Non-thrombotic stroke in cerebrovascular accidents is a stroke that occurs in the absence of complete occlusion of the vessel; this condition most often occurs with atherosclerotic damage to the vessel by occlusion, angiospastic condition, vascular tortuosity, cerebrovascular insufficiency.

Mixed forms of stroke as a manifestation of cerebrovascular accident

Mixed forms of stroke can also occur - a combination of hemorrhagic and ischemic foci. According to severity, ischemic stroke can be divided into two:

moderate severity - a stroke without clinical manifestations of cerebral edema, without impairment of consciousness, while the clinical picture of the pathology is dominated by focal brain symptoms;

severe stroke - manifested by severe general cerebral symptoms with depression of consciousness; examination reveals signs of cerebral edema, vegetative-trophic disorders, severe focal symptoms, often with dislocation manifestations (herniation of brain formations into the large foramen magnum and/or tentorium cerebellum).

Severity of stroke in cerebrovascular accidents

Depending on the duration of the appearance of signs of neurological disorders and the severity of the condition, ischemic stroke is divided as follows.

1. Transient disorders are acutely occurring disorders of cerebral circulation, manifested by focal or general cerebral symptoms and lasting about 24 hours. IN foreign literature transient neurological disorders with signs of focal symptoms, which developed as a consequence of short-term local cerebral ischemia, are more often called transient ischemic attacks, because these conditions are based on transient ischemia in the basin of one of the cerebral vessels. The diagnosis in this case is often made retrospectively. Transient disorders include not only transient ischemic attacks, but also hypertensive cerebral crises, as well as some rare forms of cerebral vascular disorders with variable symptoms.

“Minor stroke” (reversible neurological deficit) is a neurological syndrome that develops as a consequence of an acute cerebrovascular accident, accompanied by restoration of impaired functions during the first 3 weeks of the disease. Unlike transient disorders, strokes are characterized by persistent impairment of brain functions, expressed to varying degrees.

Massive stroke, in which focal neurological symptoms persist for more than three weeks.

Hemorrhagic stroke includes hemorrhage into the substance of the brain or under its membranes - this is the so-called sub-arachnoid hemorrhage. Sometimes a combination of these two types of strokes occurs.

• transient cerebrovascular accidents;
• cerebral infarction;
• cerebral hemorrhage;
• cerebral embolism;
• subarachnoid hemorrhage.

Features of the treatment of cerebrovascular disorders

Treatment of patients with cerebrovascular disorders includes diet therapy, adherence to a certain motor regimen and drug therapy (hypotensive, cardiovascular, dehydration agents, nootropics, mediators, B vitamins, etc.).

The goal of physiotherapy is the complete (or partial) restoration of impaired functions of the central nervous system and the return of the patient to active work and everyday life.

Physical methods are used to restore liquor dynamics (decongestant methods), rheological properties of blood (hypocoagulating methods), metabolism of nervous tissue (enzymatic stimulating methods), cortical functions (psychostimulating methods), bio-electrogenesis of the brain (trophostimulating methods), preventing the progression of motor disorders (neurostimulating methods). These tasks help to implement the following physiotherapy methods:

Psychostimulating methods: long-term aerotherapy, oxygen baths, non-selective chromotherapy.

A tonic method for the treatment of cerebrovascular disorders: therapeutic massage.

Trophostimulating methods: diadynamic therapy, amplipulse therapy, electrical stimulation, local darsonvalization.

Neurostimulating method of treatment: neuro-electric stimulation.

Enzyme-stimulating treatment methods: infrared laser therapy, transcerebral UHF therapy.

Hypocoagulating method: low-frequency magnetic therapy.

Psychostimulating methods of cerebral circulation therapy

24-hour aerotherapy. Excitation of mechanoreceptors and thermosensitive structures of the skin and mucous membranes of the upper respiratory tract with cool air leads to an increase in tidal volume and alveolar ventilation with a subsequent increase in the partial pressure of oxygen in the alveoli, an increase in the rate of its transfer into the blood and delivery to brain tissue, its oxygenation, activation of metabolism, processes excitation in the cerebral cortex, and improvement of compensatory mechanisms of the cardiovascular system leads to an increase in patients’ tolerance to physical activity and restoration of cerebral hemodynamics. Long stay in an open area with a picturesque landscape promotes the formation of positive psycho-emotional reactions ("landscape reflex"), effectively restores the disturbed balance of inhibitory-excitatory processes in the cerebral cortex. The procedures are carried out in a climatic pavilion or on a veranda at an air temperature of at least 15 °C ( day rest), time 2-3 hours (mode I), daily; course of treatment 20 procedures.

Oxygen baths increase oxygen saturation of the blood and brain. Strengthening the processes of oxygen utilization by the myocardium and brain, along with an increase in volumetric blood flow, leads to the activation of excitation processes in the cerebral cortex. The procedures are carried out with incoming oxygen under pressure kPa, at water temperature °C, min, daily; course of treatment of cerebral circulatory disorders 10 procedures.

Non-selective chromotherapy- therapeutic use of visible radiation. It accounts for up to 15% of radiation from artificial sources. Visible radiation represents a range of different color shades that selectively excite cortical and subcortical nerve centers and modulate psycho-emotional processes in the body. White color is necessary for normal human life and performance. Duration from 30 minutes to 2 hours, daily; courseprocedures.

Tonic method of cerebral circulation physiotherapy

Massotherapy with dosed mechanical irritation of superficial and deep-lying tissues of the body (skin, muscles, ligaments, periosteum, internal organs) it reflexively leads to activation of the somatosensory zone of the cortex. The formation of a new focus of excitation leads to a blockade of the ascending afferent flow from the affected organs and tissues, and also activates the central mechanisms that regulate activity internal organs. This significantly improves functionality, helps reduce fatigue and increase performance. Effect on the sympathetic nerve fibers leads to activation of the adaptive-trophic function of the sympathetic department of the autonomic nervous system, adrenergic structures, pituitary-adrenal system, which in turn increases immunogenesis and resistance of the body.

The dosing of procedures occurs according to the area of ​​influence on the tissues, their localization, the number of massage manipulations and the duration of the procedure. It is customary to take 10 minutes for one conventional massage unit (the minimum duration of the procedure for one zone). Therapeutic massage of the collar area - 15 minutes (1.5 units), daily; number of procedures - 10; repeat course of treatment for cerebrovascular accidents after 1 month. Massage of the collar area must be alternated with a back massage (20 minutes, i.e. 2 units), in this case the course of treatment is increased to 20 procedures.

Trophostimulating methods of treating pathologies of cerebral circulation

Transcutaneous electrical nerve stimulation- rhythmic impact of impulses electric current, the duration and frequency of which are commensurate with the duration nerve impulses and the frequency of their passage in vegetative efferent conductors (B-fibers), leads to an increase in the afferent flow in them and regulates the metabolism of innervated tissues. At the same time, increased local blood flow activates cellular respiration and the protective properties of tissues. The segmental reflexogenic zones are exposed to mono- and biopolar current pulses, rectangular and triangular in shape, with an amplitude of up to 50 mA, a duration of 0.1-0.2 ms, followed by a frequency of 2-40 pulses/s, daily or every other day; course of treatment is 8-10 procedures.

Diadynamic therapy. Due to the coincidence of the frequency of modulations with the frequency of action potentials along B-type nerve fibers, the current rhythmically excites them and activates the trophic influences of the sympathetic nervous system, local protective humoral mechanisms. A therapeutic effect is applied to the segmental reflexogenic zones with a half-wave wave current - bursts of a half-wave continuous current with a frequency of 50 Hz, duration 4-8 s, with a gradual increase and decrease in amplitude, with pauses lasting 2-4 s, daily; course of treatment procedures.

Local darsonvalization causes severe irritation of unmyelinated nerve fibers of the skin (C-fibers), which leads to a “blockade” of the flow of afferent impulses from the pain focus, reduces increased tone arterioles not only of the skin, but also of deep-lying tissues, increasing blood flow, microcirculation and metabolism in tissues, and the resulting foci of micronecrosis in the skin stimulate phagocytosis and the release of biologically active substances (heparin, prostaglandins, cytokines and histamine), as well as their inhibitors in the underlying tissues. Using the segmental-reflex technique, the peripheral part of the sympathetic nervous system is stimulated, which leads to activation of the body's sympathetic-adrenal system, central circulatory mechanisms and improvement of tissue trophism. A spark discharge with an output voltage of kV is used, the current in the discharge is 0.02 mA, the duration of the procedure is one field, total time for all fields, daily or every other day; course of treatment of cerebrovascular disorders procedures.

Amplipulse therapy. Sinusoidal modulated currents excite nerve fibers predominantly of skin and muscle efferents. The neurostimulatory effect of these currents depends on the frequency and depth of their modulation. It is more pronounced than in direct current, but less than that of the diadynamic one. The most pronounced neurostimulating effect is possessed by a constant modulation current (CM), a current with various modulation and a pause (AP), and a less pronounced one by currents with an alternating frequency of 150 Hz and modulated Hz (MHz) with a pause between their cycles and a current with an alternating frequency (IF) - alternating current with a frequency of 150 Hz and modulated with a frequency of Hz. SMT has a mild neurostimulating and trophic effect. The strength of the PM current increases with decreasing frequency and increasing depth, and the PP, PFC and IF currents, in addition, depend on the difference in frequencies and modulated oscillations, as well as the sending-pause periods. The stimulating effect of SMT increases when switching from an alternating mode of influence (1st mode) to a straightened mode (2nd mode). When exposed to segmental reflexogenic zones, SMT activates the central mechanisms of blood circulation, which improves microcirculation, tissue metabolism and oxygenation.

Activation of the central nervous system (sympathetic-adrenal system) during the treatment of cerebrovascular accidents significantly improves the trophism and rheological properties of blood, immunogenesis. SMT on the collar area (or affected limb), 1st mode, sequential exposure to currents I RR (PM) Hz and V RR (PPP) Hz, with a modulation depth of % from the 5-6th procedure of 100%, current strength - according to feeling of vibration. The duration of the procedure is 5-10 minutes for one field (zone), but not more than one minute for all fields (zones); daily or every other day; course of treatment of cerebral circulatory disorders 10 procedures.

Neurostimulating treatments for circulatory disorders

Neuroelectric stimulation. Under the influence of pulsed currents of various shapes and amplitudes, selective stimulation of fiber types in nerve conductors occurs, which leads to local changes in microcirculation and tissue trophism, developing due to local (according to the axon reflex mechanism) and segmental reflex reactions. Electrical stimulation of motor nerve conductors (Aa- and Ap-fibers) causes passive contraction of the muscles innervated by them and enhances their weakened contractile function. A series of pulses with a frequency of Hz and a duration of 0.5-100 mV are used. The duration of the procedure is 10 minutes daily; course of treatment of cerebrovascular disorders procedures.

Enzyme-stimulating methods of cerebral circulation therapy

Infrared laser therapy. As a result of selective absorption of energy, the systems of membrane organization of biomolecules in tissues (photobioactivation), the processes of immunogenesis and metabolism are activated. Under the influence of radiation, the enzyme systems of red blood cells are activated, which leads to an increase in the oxygen capacity of the blood. In addition, there is a decrease in platelet aggregation, an increase in the level of free heparin and fibrinolytic activity of the blood serum, and a slowdown in thrombus formation (hypocoagulation). Radiation power 4 W, frequency 50 Hz, procedure time - 4 minutes per area, contact technique, stable, daily or every other day; course of treatment of cerebral circulatory disorders 10 procedures; repeat course after 2-3 months.

Transcerebral UHF therapy. The UHF electric field activates the central links of neuroendocrine function, cerebral blood flow, microcirculation and metabolism in nervous tissue, and reduces the excitability of the nerve conductors of the somatosensory system, eliminates spasm of vascular smooth muscles, leading to a decrease in blood pressure. The brain structures are affected by the electrical component of the electromagnetic field UHF (27.12 MHz), with a power of 30 W, for 5-10 minutes, daily; course of treatment is 6-10 procedures.

Hypocoagulating methods of physiotherapy for cerebrovascular disorders

Low frequency magnetic therapy. The spatial heterogeneity of magnetic fields causes the formation of magnetic dynamic forces that activate blood circulation and microcirculation in tissues, reduce platelet aggregation and the activity of the blood coagulation system, and enhance metabolic processes in tissues. With segmental impacts (on collar area) sympathicotonia decreases, cerebral angiohemodynamics improves. The induction of magnets is mT, duration min, daily or every other day; course of treatment of cerebrovascular disorders procedures.

Contraindications to the treatment of cerebrovascular accidents using physical methods:

acute period of the disease,

disorders of consciousness, psyche (reactive psychoses) and cortical functions (aphasia, agnosia),

extrapyramidal (hyperkinesis) and cerebellar (ataxia) disorders,

inability to self-care,

dysfunction of the pelvic organs,

cardiovascular and respiratory failure in the stage of decompensation.

Sanatorium-resort method of treating circulatory disorders in the brain

Patients with transient ischemia, without repeated crises, with stage I-II hypertension one month after an attack, with transient cerebrovascular accidents, angiodystonic cerebral crises, occurring with focal organic symptoms that regressed within 24 hours, no earlier than 2 weeks after the attack, are sent to local sanatoriums. development of the disease, with consequences intracerebral hemorrhage(hemorrhagic stroke) no earlier than 4-6 months with the possibility of self-care and independent movement without a decrease in intelligence, aphasia and not requiring surgical intervention, with the consequences of blockage or stenosis of the cerebral main arteries, cerebral arteries (cerebral infarction) in the recovery period no earlier than 4-6 months with the possibility of self-care and independent movement and without a decrease in intelligence, aphasia, with forms of ischemic strokes with moderately and mildly expressed focal organic neurological symptoms, which regressed completely or partially within 1-2 weeks.

Contraindications to sanatorium-resort treatment are severe strokes with loss of motor functions, diseases of the nervous system with mental disorders.

Improvement in the condition of patients with the consequences of a cerebrovascular accident during self-care of patients without pronounced intellectual-mnestic disorders is ascertained by improvement in general condition, stabilization of hemodynamic parameters, normalization and improvement of sleep, restoration of cranial nerve function, increase in muscle strength of previously affected limbs by 1-2 points , increasing the rate of active movements in them, normalizing muscle tone, restoring coordination of movements, improving gait, restoring or significantly reducing the intensity of sensitivity disorders, autonomic-vascular reactions such as intellectual-mnestic disorders (according to REG, ultrasound, EEG). Persistent improvement is characterized by the preservation or tendency to further restoration of impaired brain functions and stabilization of hemodynamic parameters. Deterioration occurs when the underlying disease worsens ( hypertonic disease, atherosclerosis, rheumatism), deepening signs of focal brain damage, the addition of general cerebral symptoms, repeated cerebrovascular accidents, and an increase in intellectual-mnestic disorders. According to REG, ultrasound doppler examination indicates deterioration of cerebral circulation; according to EchoEG - increase in intraventricular hypertension; EEG shows foci of pathological brain activity; changes in blood clotting properties.

Causes of acute pathologies of cerebral circulation

The etiological factors that cause acute circulatory failure are:

atherosclerosis of cerebral vessels,

And the accompanying factors

obesity as a cause of cerebrovascular accidents,

blood diseases (anemia, hemorrhagic diathesis, hemophilia, leukemia),

hidden anatomical defects (cerebral aneurysms),

functional disease of the nervous system,

previous injuries to the central nervous system,

intoxication (alcoholism, substance abuse).

Etiological factors of cerebral circulatory disorders lead to disruption of cerebral normal hemodynamics, rheological properties of blood, cerebral hypoxia, cerebral metabolism with a predominance of catabolic processes, and the development of functional and organic signs of the disease. In the pathogenesis of stroke, changes in the reactivity of vessels with a tendency to dystonic reactions (angiospasm, angioparesis, stasis, venous congestion), morphological changes in blood vessels (atheromatosis, atherosclerosis, aneurysms), biochemical changes in the blood (increased coagulability, increased viscosity, erythrocythemia, thrombinemia) and other hemodynamic factors (sharp fluctuations in blood pressure - increase and decrease, slowdown of blood flow).

Cerebrovascular accident

Cerebrovascular accident is a pathological process that leads to obstructed blood circulation through the vessels of the brain. Such a violation is fraught with serious consequences, death is no exception. An acute process can become chronic. In this case, the risk of developing aneurysm, thrombosis and hemorrhage increases significantly. All these pathologies lead to fatal outcome.

If such a pathological process is present, you should urgently consult a doctor; treatment with folk remedies or medications at your own discretion is impossible.

Etiology

Poor blood circulation in the brain can be triggered by almost any pathological process, trauma, and even severe stress. Clinicians identify the following most common causes of cerebrovascular accidents:

• genetic predisposition;
• head injuries;
• previous serious illnesses affecting the brain, central nervous system and nearby organs;
• physical inactivity;
• increased emotional excitability;
• atherosclerosis;
• diabetes;
• hypertension;
• frequent changes in blood pressure;
• pathology blood vessels and blood;
• heart disease;
• thrombophlebitis;
• excess weight;
• alcohol and nicotine abuse, drug use;
• arrhythmia.

In addition, clinicians note that acute cerebrovascular accident may be due to age. In this case, people aged 50 years and older are at risk.

You need to understand that this disorder can be caused by frequent stress, severe nervous strain, and overwork of the body.

Classification

In international medical practice The following classification of cerebrovascular disorders has been adopted:

Chronic pathologies include the following subtypes:

• initial manifestations of insufficiency of blood supply to the brain;
• encephalopathy.

The last subform is divided into the following subtypes:

Acute cerebrovascular accidents (ACVA) are divided into the following subtypes:

Any of these forms is life-threatening, and at any time can provoke not only a serious complication, but also cause death.

In the chronic form, stages of development are also distinguished:

• The first is that the symptoms are vague. The person’s condition is more suggestive of chronic fatigue syndrome;
• second – significant memory deterioration, social adaptation is lost;
• the third is almost complete personality degradation, dementia, and impaired coordination of movements.

At the third stage of development of circulatory disorders, we can talk about an irreversible pathological process. However, the patient's age and general history should be taken into account. It is inappropriate to talk about complete restoration.

Classification according to morphological changes is also used:

Focal lesions include the following:

Diffuse morphological changes include the following pathological processes:

• small cystic neoplasms;
• minor hemorrhages;
• scar changes;
• the formation of small necrotic foci.

It should be understood that the disorder of any form of this pathological process can lead to death, so treatment must be started urgently.

Symptoms

Each form and stage of development has its own signs of cerebrovascular accident. The general clinical picture includes the following symptoms:

Transient cerebrovascular accidents are characterized by the following additional symptoms:

• numbness of the half of the body, which is opposite to the focus of the pathology;
• weakness of arms and legs;
• speech impairment – ​​the patient has difficulty pronouncing individual words or sounds;
• photopsia syndrome - visibility of luminous dots, dark spots, colored circles and similar visual hallucinations;
• drowsiness;
• stuffy ears;
• increased sweating.

Since there are symptoms such as speech impairment and weakness in the limbs, the clinical picture is often confused with a stroke. It should be noted that in the case of PNMK, acute symptoms disappear within a day, which is not the case with a stroke.

In the first stage of the chronic form, the following symptoms of cerebrovascular accident may be observed:

• frequent headaches;
• drowsiness;
• increased fatigue – a person feels tired even after a long rest;
• sudden mood swings, short temper;
• absent-mindedness;
• memory impairment, which manifests itself in frequent forgetfulness.

When moving to the second stage of development of the pathological process, the following may be observed:

• minor violations motor function, a person’s gait may be unsteady, as if drunk;
• concentration deteriorates, the patient finds it difficult to perceive information;
• frequent mood changes;
• irritability, attacks of aggression;
• almost constantly dizzy;
• low social adaptation;
• drowsiness;
• performance practically disappears.

The third stage of chronic cerebrovascular accident has the following symptoms:

• dementia;
• hand tremors;
• stiffness of movements;
• speech disorder;
• almost complete loss of memory;
• a person is unable to remember information.

At this stage of development of the pathological process, symptoms of almost complete degradation are observed; a person is not able to exist without outside help. In this case, we can talk about an irreversible pathological process. This is due to the fact that already at the initial stages the neurons of the brain begin to die, which entails severe consequences, if this process is not stopped in a timely manner.

Diagnostics

You cannot independently compare the symptoms and take treatment at your own discretion, since in this case there is a high risk of developing complications, including life-threatening ones. At the first symptoms, you should immediately seek emergency medical help.

To clarify the etiology and make an accurate diagnosis, the doctor prescribes the following laboratory and instrumental examination methods, if the patient’s condition allows them:

• general blood analysis;
• lipid profile;
• blood sampling for glucose testing;
• coagulogram;
• duplex scanning to identify affected vessels;
• neuropsychological testing using the MMSE scale;
• MRI of the head;

In some cases, the diagnostic program may include genetic studies if a hereditary factor is suspected.

Only a doctor can tell how to treat this disorder, after an accurate diagnosis and identification of the etiology.

Treatment

Treatment will depend on the underlying cause - depending on this, basic therapy is selected. In general, drug therapy may include the following drugs:

All drug therapy, regardless of etiology, is aimed at protecting brain neurons from damage. All funds are selected only individually. During drug therapy, the patient should constantly monitor blood pressure, as there is a high risk of stroke and heart attack.

Except drug treatment, the doctor can prescribe a course physical therapy. In some cases, such activities are used for rehabilitation. The standard program includes the following:

• a set of “balance” exercises, which is aimed at restoring coordination of movements;
• a set of reflex exercises according to Feldenkrais;
• microkinesitherapy;
• exercises according to the Voight system.

The recovery program also includes therapeutic massage and a course of treatment with a chiropractor.

Possible complications

Cerebrovascular accident is a symptom of a serious and life-threatening pathological process. Even a slight delay in treatment can cause serious complications. In this case, the following should be highlighted:

• total disability;
• dementia;
• development of pathologies of the cardiovascular system.

In the absence of timely medical care and correct treatment, death occurs.

Prevention

Unfortunately, specific methods There is no prevention for the manifestation of such a symptom. However, if you apply the elementary rules in practice healthy image life, you can minimize the risk of developing such a disorder. In addition, you need to systematically undergo preventive comprehensive medical examination. At the first symptoms of the clinical pictures described above, you should urgently seek emergency medical help.

“Impaired cerebral circulation” is observed in diseases:

Pheochromocytoma is a tumor of a benign or malignant nature, which consists of extra-adrenal chromaffin tissue, as well as the adrenal medulla. More often, the formation affects only one adrenal gland and has a benign course. It is worth noting that scientists have not yet established the exact reasons for the progression of the disease. In general, adrenal pheochromocytoma is quite rare. Typically, the tumor begins to progress in people aged 25 to 50 years. But the formation of pheochromocytoma in children, especially boys, is not excluded.

With the help of exercise and abstinence, most people can do without medicine.

Symptoms and treatment of human diseases

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