Sometimes outwardly a person looks perfectly he althy, but feels constant weakness and experiences frequent dizziness. An experienced doctor in this case will suspect insufficient blood supply to the brain and suggest examining the brachiocephalic vessels. How is such an examination carried out and what threatens a person with such a condition?
What are brachiocephalic arteries?
We are talking about the main vessels involved in the blood supply to the soft tissues of the head and brain. In order for the brain to receive the necessary amount of blood, the carotid, brachiocephalic and left branches of the subclavian artery are involved in its supply. But it is the brachiocephalic vessels that play the main role in this important process. The other two arteries can be considered additional blood supply routes, but if the main one fails, they will not cope with the task.
What is the Wellisian Circle?
Carotid, brachiocephalic and left branch of the subclavian artery at the base of the brain form a vicious circle, it is calledWellisiev. The circle is responsible for the uniform supply of all parts of the brain with fresh blood. It includes arteries that supply blood to the right side of the shoulder girdle. If the patency of some part of the circle is disturbed, the entire system is forced to rebuild, as a result of which the even distribution of blood is disturbed. Such a violation of cerebral blood supply can have very serious consequences, for example, lead to a stroke.
What is atherosclerosis?
Very often brachiocephalic vessels suffer from atherosclerosis. This disease is classified as a chronic process. It is expressed in the deposition of cholesterol atheromatous plaques in the lumen of the vessel. Plaques lead to proliferation of connective tissue and calcification of elastic walls, as a result of which the vessel is deformed, narrowed, and sometimes completely clogged.
Medicine distinguishes between two types of disease:
- Neurostenosing, that is, atherosclerosis, in which cholesterol plaques grow in length without blocking the lumen of the vessel.
- Stenosing, that is, atherosclerosis with transverse growth of plaques. This type is more dangerous, as it can completely block the blood flow.
Treatment of atherosclerosis depends on the type and stage of the disease.
Diagnosis
To confirm or refute the cause of the patient's poor he alth, the doctor prescribes a study of the brachiocephalic vessels. For these purposes, modern equipment is used that is not associated with X-ray irradiation, for example, ultrasound and ultrasound or magneticresonance angiography, which uses a contrast agent and x-rays.
Surveying
Ultrasound of brachiocephalic vessels is considered the best research method. Ultrasonic waves make it possible to determine both the anatomical state and the degree of patency of the arteries. The procedure is extremely simple and does not require complicated preparation from the patient. The examination is carried out with a special apparatus. The patient is placed on the couch, a roller is placed under the neck. At the request of the diagnostician, the head must be turned in the direction opposite to the sensor.
UZDG
In the recent past, brachiocephalic vessels were examined only by dopleography. Doppler made it possible to determine the direction and speed of blood flow, but was not able to assess the structural changes in the vascular walls. The sensor sent a wave that was reflected from the blood elements. Even with its imperfection, the technique saved many human lives, allowing timely restoration of the blood supply to the brain. When performing ultrasound of brachiocephalic vessels, the display showed a graph and a spectrum, and not an image of the arteries. Thus, the diagnostician received incomplete information about the patient's condition.
Many doctors still use the method of "blind dopleography" today, because it does not require high costs from either medical institutions or patients. The method reveals only gross violations, but takes little time. If serious problems are detected during the examination of the brachiocephalic vessels, the patient receives an additional appointmentfor duplex or triplex scanning.
Duplex Scan
This type of examination of the vessels of the neck and head is also based on ultrasonic waves. The duplex method is called due to the fact that it combines two-dimensional ultrasound with Doppler mode. The technique allows you to see not only the graph and spectrum of motion, but also to get a two-dimensional picture of the brachiocephalic vessel. The screen shows the features of the structure of blood vessels and tissues. For convenience, the movement of blood through the arteries is shown in red, and venous blood in blue.
Duplex scanning of brachiocephalic vessels evaluates the following parameters:
- blood flow volume;
- the speed of its progress through the vessels;
- features of the structure of arteries and veins;
- obstacles to blood flow;
- condition of adjacent tissues.
The method allows you to determine a number of vascular pathologies of brachiocephalic arteries, which include: atherosclerosis, various vasculitis, angiopathy, structural anomalies, vascular deformities, aneurysms connecting fistulas between venous and arterial blood flow, thrombosis and much more.
Triplex Study
Do you think this is a revolutionary breakthrough in the study of blood vessels in the neck and head? In fact, the whole difference lies only in the number of evaluation modes. There are 2 assessment modes on the screen during a duplex examination, and 3 during a triplex examination. It may be more convenient for the doctor to view the image,but the quality of diagnostics from this increases slightly. If the cost of the procedure does not play a big role for the patient, then he can undergo a triplex examination. But if the price matters, then a duplex examination will be enough to make an accurate diagnosis.
Many modern triplex devices have a 3D modeling function. In fact, this is a beautiful expensive picture that can be made for complacency. This examination does not provide additional information to the doctor.
Preparatory period and contraindications
No special preparation is required the day before the procedure. Ultrasound examination of brachiocephalic vessels can be performed immediately after the appointment, since neither food nor the physical condition of the patient has a great influence on the result. The only thing worth giving up is the use of foods or drinks that cause vasospasm. These are ordinary tea and coffee, Pepsi or Cola drinks, all types of energy drinks, alcohol and cigarettes. If the patient is taking the drugs prescribed by the doctor, then there is no need to postpone the appointment.
Ultrasound of the main vessels supplying blood to the brain can be performed even for pregnant and lactating mothers. Contraindications for research can only be a fresh neck injury or pustular lesions in this area. This is due to the fact that the sensor will act on the neck and the gel will be applied. Such exposure may aggravate injury or spread infection through the skin.
What is issued forhands to the patient
The diagnostician is obliged to give the patient a conclusion describing the state of the examined vessels. The conclusion should contain a maximum of information useful for making a diagnosis. These are the sizes of vessels, and the speed of blood flow, and other parameters. It is advisable to attach pictures of problem areas found by the diagnostician.
