Chronic cerebral ischemia

Chronic cerebral ischemia refers to a particular form of cerebral vascular pathology. This kind of pathology is caused by diffuse insufficiency in the blood supply of the tissue. Insufficiency progresses slowly and leads to impaired brain functioning.

Diffuse decrease in intensity of blood flow in many cases is caused by arterial hypertension, atherosclerosis or a combination of them. Chronic cerebral ischemia is also accompanied by violations of the neurogenic regulation of cerebral and systemic hemodynamics.

The problem of morbidity is very relevant. Mental and neurological disorders accompanied by chronic cerebral ischemia often become the cause of severe disability.

The development of the disease is determined by various factors. The first include ischemic hypoxic brain damage, as well as a progressive decrease in energy processes, activation of lipid peroxidation processes. To provoking factors include the violation of ionic homeostasis, leading to the defeat of the functions of cells in the nerves. In particular, to the defeat of the biosynthetic function, which is necessary to ensure their vital activity and the ability to transmit, process and store information.

Chronic cerebral ischemia (depending on the clinical severity of the disorders) is divided into three stages.

With the manifestation of the first stage, there is a dominance of subjective disorders in the form of sleep disturbance, loss of attention and memory. In addition, there are headaches, a feeling of heaviness, dizziness. Neurological status is characterized by the presence of small-focal symptomatology of a neurological nature, which is not sufficiently pronounced to diagnose a clear neurologic syndrome.

In the second stage, chronic brain ischemia manifests itself with the same symptoms as the first. In this case, there is a sharp deterioration in memory. In addition, the symptoms of neurologic and organic brain damage are more pronounced.

With the appearance of the third stage, there is a decrease in the volume of patient complaints, combined with a decrease in his criticism to his condition. Neurological status is characterized by a combination of individual syndromes, indicating a multifocal cerebral lesion in combination with vascular dementia.

Modern correct diagnosis of the disease, mainly in the early stages of manifestation, includes paraclinical studies and methods of neuroimaging. The use of these measures plays an invaluable role in the diagnosis of the disease, since it is possible to confirm its vascular character and to reveal the connection of clinical disorders with vascular lesion. Instrumental diagnostic activities include computer tomography, electroencephalography, ultrasound dopplerography of intracranial and extracranial vessels, echoencephaloscopy.

Treatment. Chronic cerebral ischemia, accompanied by cognitive disorders, undergoes therapy without hospitalization of the patient. Therapeutic measures are aimed at stabilizing destructive processes. In addition, therapy involves the prevention of ischemic stroke.

To optimize blood flow, medicines are used. In this case, experts set the task to maintain a normal level of blood pressure. This causes the use of drugs that have an antihypertensive effect.

In the presence of atherosclerotic vascular lesions, hypolipidemic agents are also prescribed . Their action, among other things, is aimed at improving the functions of the endothelium and reducing the viscosity of the blood. The therapeutic course also includes antiplatelet agents.

Particularly severe cases involve surgical intervention.