Tuesday 5 June 2012

The vessels of the brain. Stages of violations

In chronic cerebral vascular diseases (doctors often use the term "encephalopathy"), the symptoms of his defeat develop slowly, gradually and at first invisible to the patient and others. The most frequent cognitive disorders - disorders of attention and intelligence. In the early stages there is forgetfulness: it's hard to remember to put the right thing (keys, book, etc.), hard to recall a familiar phone, name and patronymic of his colleagues, the details of scanned before a television movie. It becomes harder to concentrate for a long time: if you have previously read books voraciously, and now, after reading a few pages of attention is scattered and difficult to focus on the content of the text. At this stage the ability to work largely preserved due to professional experience, but the ability to assimilate new (theories, skills) are significantly reduced.In the second stage of cognitive impairment begin to interfere with normal professional activities, and patients are often forced to leave work. However, loss of memory and attention have not impede the implementation of domestic duties: it is possible to run the household, including the necessary financial calculations, to go shopping, go out of town, to communicate with family and friends, interested in others. Some work for some time, but on a more simple, not requiring much attention and memory positions.If left untreated, can come the third stage, when the increasing violations of memory and attention joins progressive decline in intelligence. Patients gradually lose many of the skills: can not count how many you have to pay in a store for goods purchased with the apartment. Previously, good cooks can not cook dinner, including the most simple dishes, walking down the street, they can not find a way back home. They're becoming more and more helpless in the home and dependent on others.Another common symptom of chronic disease of the brain disorders are walking. In the early stages of the gait becomes festinating, shuffling, resembling gait of old people, even though a patient there may be a fairly young age. In the future, it becomes uncertain, the patient must constantly monitor to do the right thing when distractions occur fall. This gait is similar to walking man walking on the ice field, where every misstep threatens to fall.In the latter stages of walking without assistance becomes practically impossible, and then impossible, and with assistance. In this patient no paralysis and paresis of the legs (strength in the legs is good), there are no disturbances of balance and coordination associated with lesions of the cerebellum. These disorders are associated with walking disorder automatism of walking, which is formed during the first two or three years of life.In patients with chronic vascular disease of the brain may be other, as a rule, not very coarse symptoms of brain damage: Slight paresis of the arms and legs, blurred speech, choking when swallowing, dizziness, slowness of movement.The main causes of chronic disease of the brain are the same as that of stroke: high blood pressure (BP) and atherosclerosis. In patients with hypertension with frequent sharp increases in blood pressure at night, conditions are created for the sclerosis of small cerebral arteries, narrowing of the lumen, resulting in reduced blood supply to large areas of normal brain. Atherosclerosis - the deposition of plaques on the walls of blood vessels - is not directly connected with arterial hypertension and affects large blood vessels that supply blood to the brain - the internal carotid and vertebral arteries.A role in the development and progression of chronic disease of the brain is a metabolic disorder: lipid (primarily high cholesterol in the blood - hypercholesterolemia - and obesity) and glucose (diabetes). Hypercholesterolemia promotes the deposition of atherosclerotic plaques on the walls of blood vessels, diabetes leads to the defeat of the small vessels of the brain and lower extremities.Unfavorable factor is smoking, which causes loss of vessel walls toxic products contained in tobacco smoke. On the walls of blood vessels affected by atherosclerotic plaques are deposited more easily than normal. Smoking reduces the anticoagulant potential of the vascular wall that leads to the development of blood clots and blockage of the lumen of the vessel.Many patients with chronic vascular disease of the brain, a tendency to increased aggregation (agglutination), platelets (thrombocytes), which also contributes to blood clots and deepens the chronic insufficiency of blood supply to the brain.All these factors should be considered when treating chronic disease of the brain and prevent their progression.Below are the main required for this event.A normalization of blood pressure.First of all, regular use of funds, reduce blood pressure, under his constant supervision. The patient must own (or with relatives) daily or several times a week to measure blood pressure and keep a diary that you want to show the doctor regularly. Currently, there are several classes of drugs, a positive influence on blood pressure: ACE inhibitors, calcium channel blockers, beta-blockers, diuretics (diuretics), etc.2 Normalization of lipid metabolism:• a diet with restriction of caloric intake, animal fat, salt, easily digestible carbohydrates (sugar, pastries, white bread, pasta, cereals), with the inclusion in the diet of fresh fruits and vegetables, vegetable oil, brown bread, dairy products;• reduction of body weight;• feasible exercise, swimming, hiking;• reduction in low cholesterol levels, despite the implementation of all the above recommendations, receipt holesterinsnizhayuschih (lipid lowering) drugs.3 Normalization of carbohydrate metabolism - diabetes treatment:• Diet;• receiving glucose-lowering drugs under the control of blood glucose (possibly independent regular research with individual meter).4 Smoking cessation.5 Acceptance of antiplatelet therapy - drugs that reduce elevated levels of platelet aggregation.6 Application of funds, improve cerebral blood flow and metabolism in the brain.Some patients with severe narrowing of large arteries that supply blood to the brain, shown reconstructive vascular surgery.

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