Ischemic disease of the brain
Ischemia is a local disruption of blood flow caused by narrowing of the arteries or complete obstruction. Inadequate blood supply leads to a persistent disruption of the accepted on. The consequences of starvation depend on the duration of illness, stage of the violations General condition and, of course, the sensitivity of the body to oxygen starvation.
Global cerebral ischemia refers to the most severe forms, as this body, along with the myocardium and kidneys, is the most sensitive to hypoxia.
The mechanism of the disease
The brain is perhaps the most main consumer of oxygen in the human body. When the small mass is around 3%, the brain consumes about 20% oxygen. Therefore, the violation of its blood supply has serious consequences, the disease develops very quickly.
This disease is a consequence of the reduction of the lumen of arteries and arterioles. The reasons for this are different, which complicates diagnosis and treatment. Cerebral ischemia is accompanied not only by tissue hypoxia - oxygen starvation, but also a change in metabolism due to the lack of nutrients.
The main causes of disease include the following factors.
- Morphological changes - that is, related to the shape of the vessel and its work section. This group includes the most common cause is atherosclerosis of brain vascular, i.e. the formation and growth of cholesterol plaques on the wall. As well as blood clots, aneurysms and prolonged spasms. Changes are caused by congenital abnormalities of the walls.
- Modify properties of the blood - increased clotting leads to the appearance of blood clots. No less dangerous change of electrolyte composition due to which blood loses its ability to carry oxygen and protein compounds.
- Circulatory disorders - both General and cerebral, such States are observed in cases of severe poisoning.
- Metabolic changes of neurons associated with age or individual characteristics.
Treatment for different cases offered range from medical to surgical. In addition to the true causes of the disease that matters and the stage of the disease, and the age and General condition.
Coronary artery disease: types
Cerebral ischemia can have both acute and chronic, occur with varying severity and with different speed, and striking as separate parts and the entire body.
The intensity of the condition of the ischemic brain disease is classified that way.
- Transient ischemic attack - a violation ofcirculation, lasts about a day. Symptoms are determined by the specifics of the affected area.
- Small stroke - attack for long periods. The disease develops long enough. The treatment is accompanied by a pronounced back symptoms, take 2 to 22 days.
- Progressive stroke - symptoms persist for several days or even hours. Treatment is complicated, complete restoration of function is not guaranteed.
- Total stroke - develops when the withering away of the meninges. This is the most severe form of the disease. To predict the consequences is almost impossible.
Depending on the cause of the disease ischemia is classified as follows.
- Atherothrombotic - the reason for this is atherosclerosis. This form develops gradually, the symptoms is varied, treatment is possible even in the later stages. Actually cerebral ischemia occurs as a result of a blood clot separation.
- Cardioembolism is the result of occlusion, develops rapidly and is associated with lesions of the cardiovascular system. The symptoms occur in the form of attack, very bright.
- Hemodynamic, occurs when blood circulation. Is observed both at rest and during physical activity.
- Lacunar - affects one of the small arteries of the hemisphere or of the trunk. This species is characteristic of patients with hypertension or diabetes
- Rheological - vascular disease are not observed, the reasons are different.
There are three stages according to severity
- Smile - a sign of a stroke is misalignment of the mouth, strong asymmetry of the face.
- Confusing vague answers slow speech and inability to pronounce complicated long words are a major reason for seeking help.
- The victim can't keep one hand on weight.
- Language - when you try to show the language of the latter is significantly shifted from the center line.
The presence of even two signs enough to call an ambulance. We must remember that the pain symptoms and also dizziness or nausea may not occur.
Diagnosis of ischemia and treatment
If the disease took an acute form, for its diagnosis conducted some research.
- Data collection for treatment is important not only characteristic of the state at the time of treatment, but the chronology of the onset of signs. Doctor must specify the information received from words of the patient, his relatives.
- Testing of the respiratory, cardiovascular and urinogenital systems, toto localize the damaged area.
- The survey includes analysis of blood and urine. Ischemic attack affects the composition of the blood.
- MRI allows to establish the cause of stroke - ischemic or hemorrhagic.
Treatment can be divided into two stages:
- In the first stage the aim is to restore respiratory functions until tracheotomy, and normalization of blood pressure. To prevent changes in brain tissue are assigned a neuroprotectant.
- The second stage - rehabilitation. Measures aimed at restoring the function of the brain. It all depends on the severity of the disease, age and body features.
Ischemia in infants
Unfortunately, neonates are at risk to this ailment. Fetal hypoxia - a phenomenon by no means rare, caused by many factors.
The causes of the disease
Manifested cerebral ischemia in the very first days of the appearance of the newborn to the light, but is formed during pregnancy.
Causes it is:
- diseases transferred during pregnancy. Any: respiratory, infectious, cardiovascular, to a greater or lesser degree they affect the blood supply to the fetus;
- Smoking, alcoholism, drug use, systematic failure mode;
- pathology premature childbirth, of late, oligohydramnios, or toxicosis in the last months. All of the above is a reason to further observe the newborn;
- heavy labor - stimulation, caesarean section, birth trauma and so on;
- complication can cause even age is less than 18 and more than 35 years at General good condition of the mother's body.
The children's symptoms of ischemia
Characteristic symptoms are pronounced enough that in combination with hardware study can quickly establish the diagnosis.
- The newborn may experience restless sleep, overreaction to stimuli - the kid shivers, cries for no apparent reason, trembling of the body parts.
- Observed reduced muscle tone with adequate nutrition, low activity, disorders of sucking and swallowing. Often found facial asymmetry and strabismus.
- Typical of newborns increase the size of the head, increased intracranial pressure.
- In the later stages, there are convulsions, coma. In the latter case, the completely lack of coordination, the child for long periods is unconscious.
At the slightest suspicion on disease of the baby should be tested further.
Stage of ischemia
Like adults newborns are observedthree stages of disease development.
- Light - is accompanied by excitation or low tone. Cured without consequences, if diagnosed in the first weeks. The baby should be observed by a neurologist.
- Middle stage characterized by convulsions. With timely therapy ischemic attack does not lead to serious consequences.
- Heavy - at this stage, the clumsiness, there is an obvious developmental delay, impaired vision and hearing. The treatment is carried out in the intensive care unit. Unfortunately, the forecasts are not so comforting, because in addition to restore the normal blood circulation is necessary treatment and the damaged areas of the brain.
Diagnosis and treatment
The correct diagnosis of the newborn does not differ almost from the examination of adult patients:
- blood test;
- is assigned to ECG, x-ray and other investigations of the cardiovascular and respiratory systems;
- Mr angiography and conventional allow to establish the reasons for violations of the aneurysm, narrowing of the artery, a clot;
- duplex study is assigned to assess circulation.
Treatment for mild and moderate is to restore blood flow.
- Massage - for babies this is the best of physiological methods as medications for infants - the extra stress.
- Medication prescribed with little effect from the massage. It is drugs that stimulate brain function and help restore normal circulation.
Is assigned treatment only after a complete examination, and only on an individual basis: responses of newborns to certain drugs unpredictable.
Cerebral ischemia is a serious disease. When it is ignored or delayed treatment to the doctor the consequences can be very destructive and neonatal and adult patients. When even individual symptoms to the doctor you need to apply immediately.