Atherosclerosis of cerebral vessels is a chronic disease, one of the most common forms of atherosclerosis, in which lipid plaques are deposited in the walls of the arteries of the brain, followed by their replacement with connective tissue. Growing, plaques constrict the lumen of blood vessels, leading to malnutrition of brain tissue.
Most often, cerebral atherosclerosis occurs in middle-aged and elderly people: in men after 50 years and in women after 60 years.
Causes of cerebral atherosclerosis
The main reason for the development of atherosclerosis is a violation of lipid (fat) metabolism, as a result of which cholesterol begins to penetrate the vascular wall, forming atherosclerotic plaques.
Risk factors for cerebral atherosclerosis are the same as for any other form of atherosclerosis:
- arterial hypertension;
- sedentary lifestyle;
- alcohol abuse;
- increased blood clotting;
- genetic predisposition;
- frequent stressful situations.
The clinical picture, symptoms of cerebral arteriosclerosis
Atherosclerosis of cerebral vessels is manifested in the form of progressive chronic cerebral insufficiency, transient disorders of cerebral circulation or stroke.
The main manifestation of progressive cerebral insufficiency – mental disorders. In this case, it is possible to allocate 3 periods:
- pronounced clinical manifestations;
- period of dementia.
Initial stage of the disease
At the initial stage of development of cerebral vascular insufficiency, asthenic-like, neurosis-like and psychopathic-like disorders appear.
Asten-like disorders – rapid fatigability, poor memorability, reduced working capacity, difficulty concentrating, difficulty in switching from one activity to another. Patients are also worried about general weakness, headaches, bouts of dizziness, feeling of heaviness, pressure in the head, there may be a feeling of goosebumps on the body. In the initial stages of the disease, it is difficult only to remember the new information, but problems gradually appear with the reproduction of previously stored information. As the disease progresses, memory deteriorates, it becomes especially difficult to memorize names, numbers.
Neurosis-like manifestations – depressive symptoms (low mood, lack of desire for any type of activity, lethargy), tearfulness. In some patients, on the contrary, unmotivated euphoria appears.
Psychopathic manifestations – hot temper, nastiness, hysterical reactions. In the presence of psychopathic features (hysteria, obsession, etc.), their sharpening is possible. Also, there are such features as stinginess, pettiness, grumbling, negligence. The circle of interests is gradually narrowed to its own needs, especially physiological ones (to eat, sleep).
The period of pronounced clinical manifestations
This period is characterized by anxiety-delusional, anxiety-hypochondric and anxiety-depressive syndromes, atherosclerotic encephalopathy.
Such patients are anxious, concerned about their complaints and the existing (even insignificant) diseases, are not confident in their abilities. Often these patients begin to “suspect” the symptoms of cancer, visit various doctors to confirm this diagnosis. Although in fact they have no such pathology.
In patients at this stage of the disease, delusional inclusions can join. The delusions of damage are especially characteristic (“neighbors, relatives constantly steal something”), persecution, influence (“neighbors are pouring something, wanting death”).
Patients also complain of various unnatural sensations in the body: “bakes the back of the head”, “pricking the feet”.
The period of dementia (dementia)
Patients at this stage are practically incapable of memorizing new information, although the memory of past events is relatively preserved. Completely lost critical assessment of their behavior. Patients find it difficult to serve themselves. They can leave gas, water, electricity on and go for a walk. Inaccuracy with urination, feces appears. Patients are disoriented in time and place (they don’t know what year it is, where they are). Such patients seem to be returning to the past (they are considered to be 35 years old, and not 70). They require constant supervision and care.
Transient ischemic attacks manifest as transient paresis of various parts of the body, disturbances in their sensitivity, speech disorders, visual disorders (loss of visual fields).
There may also be an acute violation of cerebral circulation in the form of strokes with appropriate symptoms.
Diagnosis of cerebral arteriosclerosis
Suspect the disease can be on the characteristic clinical picture, the patient’s age.
If you suspect cerebral atherosclerosis, the patient must be examined by a neurologist, and he also prescribes the necessary additional methods of examination.
Ultrasound duplex scanning of the extracranial vessels will help assess their condition, the presence of atherosclerotic plaques, narrowings.
To assess the state of the intracranial arteries will help transcranial Doppler.
They can also prescribe magnetic resonance imaging of the brain, angiography of various vessels.
Complications of cerebral arteriosclerosis
Frequent complications of this disease are transient ischemic attacks and strokes.
Dementia is a no less dangerous disease, a consequence of atherosclerosis of the brain. After all, with dementia, the patient loses criticism, actually loses human likeness.
Treatment of cerebral atherosclerosis
For effective treatment of cerebral atherosclerosis, it is necessary, first of all, to minimize the impact of existing risk factors. It is necessary to stop smoking, limit the consumption of foods rich in cholesterol (fatty meats, creams), normalize blood sugar and blood pressure.
In the treatment of this disease using medical and surgical methods.
If an ultrasound examination revealed the presence of a narrowing (more than 70%) in the cerebral artery, it is necessary to consult a vascular surgeon with a subsequent decision on the question of surgical intervention on the vessel. The most common method for this is carotid endarterectomy. During this operation, cut through the wall of the affected vessel, remove the plaque (thrombus), and then with the help of seams restore the vessel wall.
Drug treatment is the use of symptomatic agents.
- If there are symptoms of depression, antidepressants (amitriptyline) are prescribed.
- When anxiety occurs, tranquilizers are prescribed (diazepam, phenazepam).
- Also used vitamin, vascular drugs.
Prevention of cerebral arteriosclerosis
To prevent the development of this disease, you need to adhere to a diet rich in vegetables and fruits.
It is necessary to carefully monitor your health, maintain optimal weight, give up bad habits.
A healthy lifestyle, sufficient physical activity – and talk about atherosclerosis of cerebral vessels is not necessary.
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