Vascular diseases of the brain: description of the disease, causes, symptoms, cost of treatment in Moscow

According to statistics, vascular diseases of the brain account for about 42% of all abnormalities of the nervous system. In the field of neurology, cerebrovascular accidents are recognized as one of the most common ailments. Affecting a significant number of elderly people and patients of older working age, these diseases pose a serious threat not only to normal life activities, but also to the patient’s life itself. Vascular pathologies require great attention from specialists and timely and effective treatment.

When it comes to vascular pathologies, they most often mean discirculatory encephalopathy. This is a slowly progressive vascular lesion of the brain. The course of the pathology is divided into three stages in accordance with the severity of the clinical picture. At the initial stage, the symptoms are not clearly expressed, so problems arise with making a diagnosis. Some symptoms indicate mental disorders, so errors in the anamnesis often occur. As a rule, an accurate diagnosis is made after a prolonged presence of the main symptoms (dizziness, impaired coordination and cognitive functions).

Classification of vascular diseases of the brain

There are two main groups of vascular pathologies: acute and chronic cerebrovascular accidents. The first group is divided into three subgroups: transient cerebrovascular accidents, cerebral strokes, mixed strokes. Transient disorders of cerebral circulation include transient ischemic attacks and hypertensive crises. Brain strokes are ischemic and hemorrhagic. Hemorrhagic strokes are divided into subarachnoid hemorrhage, parenchymal-subarachnoid hemorrhage, and ventricular-parenchymal-subarachnoid hemorrhage. Ischemic strokes, in turn, are divided into lacunar, atherothrombotic, cardioembolic and hemodynamic stroke.

The second group includes: chronic subdural hematoma, initial manifestations of cerebrovascular insufficiency, subcortical vascular dementia, discirculatory encephalopathy. The initial manifestations of cerebrovascular insufficiency are divided into two stages. The first stage is characterized by the absence of neurological manifestations. At the second stage, neurological manifestations are clearly expressed. Discirculatory encephalopathy is the most common among chronic cerebrovascular accidents. It is divided into three main stages:

The first stage is moderately severe, characterized by diffuse symptoms. The patient may complain of short-term headaches, periodically suffer from sleep disorders and increased irritability.
The second stage is more pronounced; clinical manifestations form in it. The person often experiences surges in blood pressure, loss of space, and cognitive impairment. As a rule, at this stage the disease is most often diagnosed.
The third stage is pronounced, during which irreversible changes occur in the body. Serious disturbances in memory and cerebral circulation in general appear. In rare clinical situations, complications in the form of strokes are observed (in the absence of timely consultation with a doctor).

How does a hemorrhagic stroke occur?

Vascular rupture can occur at any time of the day. This is usually preceded by physical or emotional stress. The person suddenly falls, sometimes with a loud cry, and loses consciousness.

Approximately 30% of patients have warning signs that develop within a few minutes to several days. On the eve of a rupture of blood vessels, there may be severe headaches - ones that the person has never experienced. There is a feeling of a rush and a sharp reddening of the face. Sometimes the sensations of numbness in the limbs, muscle weakness, and facial asymmetry appear.

The main symptoms of hemorrhagic stroke are:

Contralateral hemiplegia	The nerve pathways intersect, so the paralysis is located on the side opposite to the hemorrhage. During a stroke, the left arm and leg stop moving in the right hemisphere, and the right ones in the left hemisphere.
Contralateral hemianesthesia	In paralyzed limbs, sensitivity disappears on the side opposite to the rupture.
Aphasia	Loss of speech occurs when the dominant (dominant) hemisphere is damaged. For right-handers - right, for left-handers - left.
Spatial hemiagnosia with damage to the non-dominant hemisphere	If a right-hander's left hemisphere is affected, and a left-hander's right hemisphere is affected, then the person behaves as if half of the real space does not exist for him. A person does not realize that he has two halves of the body, that food can be eaten from the entire plate, and not from half. Half of everything that is located around a person is not perceived by him.
Facial asymmetry	One half of the face does not receive innervation and cannot contract. One nasolabial fold is smoothed out, the smile becomes one-sided, the tongue deviates to one side, water and food flow out of the mouth.

From the moment these symptoms appear, there is only 3 hours to help the person as much as possible. After 3 (sometimes 6) hours, irreversible changes will occur, then nothing can be corrected.

Causes of pathology

Vascular diseases of the brain can occur for a number of reasons. As a rule, several reasons lead to the appearance of pathology. The most common ones include:

● genetic predisposition;

● narrowing and hardening of intracerebral arteries (with hypertension);

● multiple focal and/or diffuse brain lesions;

● long-term somatic diseases of the expectant mother (and during pregnancy);

● atherosclerosis of cerebral vessels;

● rheumatic lesions;

● disturbances in the functioning of the respiratory system (for example, pulmonary edema);

● abuse of alcohol and tobacco products during pregnancy;

● disturbances in metabolic processes;

● increased blood viscosity;

● fractures of the skull bones;

● heart rhythm disturbance (with atrial fibrillation, blood hemodynamics are disrupted);

● serious abnormalities in the nervous system (increased anxiety, chronic stress);

● serious abnormalities of the endocrine system (diabetes mellitus, obesity);

● development of intrauterine infections;

● difficult long labor (with injuries);

● hypertension;

● hypercholesterolemia;

● various anomalies of the cardiovascular system (for example, hypoplasia of cerebral vessels, mitral valve prolapse).

Risk group

The risk group includes people with infectious pathologies during the neonatal period. The likelihood of developing vascular diseases of the brain increases significantly with hemolytic anemia, surgery and head injuries. The mother’s poor lifestyle (abuse of alcohol and tobacco products) can also negatively affect the condition of the child’s brain. A family history of cardiovascular pathologies (for example, myocardial infarction or arterial hypertension in close relatives) doubles the risk of developing cerebrovascular diseases.

How to help a stroke victim?

Recovery largely depends on how the people around the patient behave. First of all, you need to call an ambulance, and until it arrives, try not to move the person. You need to place a cushion or pillow under the shoulders and head, carefully turn the person on the right side, and place a basin or bag in case of vomiting. It is advisable to measure blood pressure. Anti-pressure pills should not be given before the ambulance arrives: there is a possibility of a sharp drop in blood pressure. Only specially trained medical personnel know the rules for lowering blood pressure when it rises above 150/100 mmHg. If respiratory depression occurs, you need to start resuscitation - chest compressions, mouth-to-mouth breathing.

The best prevention is timely treatment of hypertension, atherosclerosis, identification of malformations and aneurysms before they rupture.
Our neurologists see patients every day, and every patient at the clinic can find out their risk for developing a hemorrhagic stroke. Visit your doctor while you still have time.

Make an appointment through the application or by calling +7 +7 We work every day:

Monday—Friday: 8.00—20.00
Saturday: 8.00–18.00
Sunday is a day off

The nearest metro and MCC stations to the clinic:

Highway of Enthusiasts or Perovo
Partisan
Enthusiast Highway

Driving directions

Diagnosis of pathology

If the symptoms described above appear, it is recommended to immediately consult a cardiologist or neurologist. During the initial examination, the specialist collects an anamnesis of the patient’s life, asks in detail about his complaints (how long ago and under what circumstances they appeared), about diseases of the cardiovascular system of his closest relatives. Based on these data, further examination is prescribed.

To diagnose vascular diseases of the brain, they resort to laboratory and instrumental diagnostics. First of all, the patient is prescribed a general and biochemical blood test to determine the level of cholesterol, glucose, triglycerides, lipoproteins and prothrombin index (PTI). These substances affect the functioning of the heart and blood vessels. Biochemical indicators are very important in making a diagnosis. An increased level of leukocytes indicates the presence of an inflammatory process in the body. Among the instrumental diagnostic methods, the following are in particular demand:

● electrocardiography (ECG). This is a simple technique that does not require additional preparation. The essence of an ECG is to record the electrical potentials of the heart, due to which it is possible to detect changes in rhythm, electrolyte deficiency and other initial signs of cardiovascular pathologies;

● Doppler ultrasound of the vessels of the neck and brain (USDG). This is a modern, highly informative diagnostic method. It is used to determine damage to the arteries and indicates insufficient blood supply to the brain. With its help, it is possible to assess blood flow in the vessels of the neck and head;

● duplex scanning of blood vessels. Thanks to color contrast of flows during duplex scanning, it is possible to more clearly distinguish between moving and stationary objects (blood and vessels, respectively);

● ultrasound examination of the heart (ultrasound). This technique makes it possible to visually view the contractions of the heart muscle, assess the condition of its valves, and diagnose heart failure;

● echocardiography (EchoCG). Sometimes specialists prescribe echocardiography in addition to an ECG. This is a highly accurate examination method, with its help it is possible to assess the condition and determine the size of the valves;

vascular magnetic resonance imaging (MRI). This is a completely safe technique for the body (there is no radiation), it shows the lumen and patency of large vessels, and makes it possible to detect abnormalities in vascular development.

Features of treatment

Treatment of hemorrhagic stroke today is more in the purview of neurosurgeons than neurologists. The blood has already been shed, and the possibilities of medical assistance are limited. Removal of an intracerebral hematoma can save lives and maintain an acceptable level of health. Surgical removal is more successful the earlier it is performed. Optimally, the patient should be operated on on the first or, in extreme cases, on the second day after the incident.

The main intervention is aspiration (suction) of the hematoma and clipping of the aneurysm. It is only possible when the artery is in an accessible place. There is no way to help with an aneurysm deep in the medulla. In a typical case, the blood is aspirated, a clip is placed at the base of the aneurysm, and the aneurysm is isolated from the bloodstream.

Malformations are excised whenever possible. These are complex operations that require not only the skill of a specialist, but also first-class equipment.

Prevention of vascular diseases of the brain

Vascular diseases of the brain are easier to prevent than to cure. To do this, experts recommend leading a healthy lifestyle: engaging in moderate sports, drinking about 1-1.5 liters of water per day (to avoid dehydration), eating properly and following a diet. The diet involves limiting table salt and foods containing large amounts of animal fats (for example, sour cream and fatty meats). Fresh vegetables and fruits should prevail in the daily diet. A split diet is recommended (4-5 meals per day).

The intake of alcoholic beverages should be minimized (or completely abandoned). The emotional component is the key to good health, so you should not be exposed to stressful situations. Sleep should be complete (at least 7 hours of sleep per day are required). Moderate physical activity should be regular; it significantly improves the condition of the body. These include: swimming, yoga, Pilates, cycling.

Exercising and proper nutrition help prevent the appearance of excess weight, while they train the cardiovascular system. At least once a year it is required to undergo a study of the state of cerebral circulation (especially for those who are at risk). This will allow timely detection of pathology.

In order to prevent the progression of multi-infarction conditions, patients are prescribed combination therapy (antiplatelet and anticoagulant). The most suitable anticoagulants are selected depending on blood clotting parameters. If any signs of bleeding appear, it is important to contact a specialist promptly.

Vascular diseases of the brain are often accompanied by dizziness. To prevent them, doctors prescribe medications that affect the autonomic nervous system. To prevent cognitive impairment (memory deterioration, increased inattention), drugs that improve metabolism are prescribed. In the presence of movement disorders, therapeutic exercises, physiotherapy, massage and other methods of rehabilitation therapy are useful.