Vascular dementia is a deterioration in the functioning of the vessels of the brain. As a result of this disorder, brain cells die due to problems with blood supply. According to the nature of the course of changes and symptoms, several variants of dementia differ.
As a result of the pathology, there are significant deviations in the psyche, which are divided into emotional, behavioral and cognitive. The patient's behavior changes, unreasonable depressions are observed, and gradually the person begins to degrade.
Already at the initial stage of the course of vascular dementia, the violations are quite significant, which affects the patient's life. A person should always be under the control of relatives and friends.
Features of the disease
Acquired cognitive impairment that adversely affects a person's daily activities and behavior is called vascular dementia (ICD code 10 F01). This type of disease is associated with pathologies of blood circulation in the brain.
The patient is far fromcan immediately notice that he has dementia. Due to the deterioration of blood flow, certain areas of the brain begin to experience constant oxygen starvation, resulting in cell death.
The disease has several degrees of severity. It is important to recognize the existing symptoms in a timely manner, to carry out the treatment prescribed by the doctor.
What types can there be
Vascular dementia has an ICD code 10 F01, involves two forms of development, namely, total and lacunar. The partial form is characterized by the fact that there are dangerous deviations in the form of memory loss. There may be excessive sensitivity and tearfulness. The main type of lacunar dementia can be considered Alzheimer's disease, which occurs in the initial stage.
Complete vascular dementia according to ICD 10 is characterized by complete degradation of the personality. The patient is subject to intellectual impairment. In addition, the emotional sphere changes, as a result of which a person loses a sense of duty, shame, spiritual values and interests. From a medical point of view, there are such types of vascular dementia (ICD code 10 of which is F01), such as:
- atrophic;
- vascular;
- mixed type.
Atrophic lesion occurs mainly against the background of primary degenerative disorders occurring in the cells of the nervous system. Vascular disorders are formed as a result of pathologies of blood circulation in the vessels. Mixed type dementia is characterized by the fact that the mechanism of its development is similar to atrophic and vascular dementia.
Dementia mainly develops not due to pathologies that lead to the death or damage of brain cells, but can manifest itself as a complication of the disease.
Stages of the disease
Vascular dementia according to ICD 10 belongs to the group of mental disorders and is divided into several degrees. A mild degree is characterized by a restriction of labor activity. The patient is assigned a disability (depending on his age). At the same time, he may well perform the required hygiene procedures, cook food, and take walks. He is fully aware of the presence of the disease and independently controls the intake of medications.
The average degree implies that the disease proceeds in a complicated form. Man suffers from forgetfulness all the time. However, he is quite able to go to the toilet and eat on his own.
Severe degree is characterized by complete memory impairment and problems with coordination of movements. In this case, the patient should be under the constant supervision of relatives. If they are not, then the person is placed in a specialized medical institution for life.
If you start treatment at the initial stage of the course of the disease, you can maintain a mild degree for many years.
Disease in children
Vascular dementia can affect not only the adult population, but also children. Children's types of dementia are conventionally divided into residual-organic and progressive. The residual-organic type of the disease is characterized bythe fact that meningitis, craniocerebral trauma, as well as poisoning with medications lead to its development. Progressive type of dementia refers to a self-developing pathology. It refers to genetic abnormalities, vascular lesions and diseases of the nervous system.
Such a violation in a child may be a sign of mental pathology, in particular, oligophrenia or schizophrenia. Symptoms begin to appear very early. The child loses the ability to perceive and remember information. In addition, mental abilities are reduced.
Therapy in a child is based on the complete cure of the disease that provoked dementia, as well as taking into account the characteristics of the pathology. In any case, the treatment is carried out with medication. The doctor prescribes medications to improve cerebral circulation and cell metabolism.
Regardless of the type of dementia, families need to be understanding towards a sick child, as he does not realize what he is doing.
Features of lesions in the elderly
Vascular dementia in the elderly is caused by a sharp course with an increase in dangerous symptoms, since vascular pathology often accompanies it, and concomitant diseases only aggravate the patient's well-being. In especially dangerous cases, delusional states, psychoses, hallucinations can be observed all the time.
However, it is worth noting that vascular dementia rarely reaches a critical stage. A person often retains all available household skills, criticalself-respect.
Causes of occurrence
In many cases, vascular dementia results from vascular accidents such as heart attacks and strokes. When a cerebral artery ruptures, blood pours into the brain tissue, provoking massive death of neurons. The highest probability of developing the disease is if the neurons of the cortex and some areas of the subcortex of the brain die, since it is these departments that are responsible for the cognitive abilities of a person. If hemorrhage occurs in other areas, then mental impairment may not be observed, but only a deterioration in coordination of movements and orientation in space.
Another cause of mental disorders in patients is heart failure. This is explained by the weakening of blood circulation in the arteries of the brain, since a diseased heart cannot function normally. As a result, neurons also die, which negatively affects the psyche of a person suffering from heart failure.
Chronic ischemia plays an important role in the development of dementia, when brain tissue is deprived of a full supply of oxygen and blood. As a result, persistent and prolonged hypoxia develops, the consequences of which are expressed in the death of neurons and the subsequent occurrence of signs of dementia. The main reason for the weakening of mental activity are disorders of cerebral and cardiac circulation, provoked by constantly high or low blood pressure. There are also certain factors that in one way or another canaffect cognitive decline. These include such as:
- age;
- bad habits;
- gender;
- genetic predisposition.
In addition, chronic diseases are of great importance. These include, in particular, infectious vasculitis, diabetes mellitus and autoimmune disorders. It is worth noting that people who have a high level of intelligence and are well educated develop dementia much less frequently than those whose intelligence is not high enough. This is explained by the difference in the reserve capacity of the brain.
Main symptoms
Vascular dementia symptoms are often observed in patients who have recently had a stroke. Violations should be attributed to such signs:
- memory;
- speech;
- motor coordination;
- thought processes;
- abstract thinking.
In addition, it is possible to distinguish the concomitant symptoms of an acute form of pathology, namely, the following signs:
- weakening of the muscle tone of the limbs;
- different manifestation of the intensity of reflexes in the limbs;
- walking disorder.
In addition to the acute manifestation, there may be a gradual development of dementia. It is observed mainly in the ischemic form of the disease. Vascular dementia in this case is characterized by a gradual increase in symptoms. The gradual development of the disease occurs over about 3-5 years. The manifestation of such a violation begins with a changepersonality. In particular, the following signs may be observed:
- exacerbated manifestation of certain character traits;
- development of conservative judgment;
- deterioration of ongoing thought processes;
- loss of norms and rules of moral behavior.
Then, memory deterioration is gradually observed, and the person gradually ceases to navigate in time and space. At the same time, for a long time, the behavior does not change at all, and there are no violations of gestures and speech.
At the last stage there is trembling of the fingers and hands, exhaustion, impaired walking and coordination. The subsequent development of the disease is characterized by discontinuity of speech, as well as fragmentation of information about oneself. The patient cannot take care of himself and observe the basic rules of personal hygiene. Symptoms of manifestations largely depend on the area of the affected area of the brain.
Diagnostics
Symptoms and treatment of vascular dementia largely depend on the stage and characteristics of the course of the disease, which is why a comprehensive diagnosis must first be carried out. It is based on a psychodiagnostic study and neuroimaging techniques. Doppler studies and brain tomography are used as imaging techniques. Biochemical blood tests are also prescribed.
The patient, when the first signs appear, is placed in a hospital, a comprehensive examination is prescribed. At the initial stage, the doctor conducts an oral survey of the patient for an accurate statementdiagnosis. This is followed by a study of the existing diseases in the anamnesis.
Special tests are carried out to determine cognitive impairments, blood pressure is monitored, and blood is taken for sugar. Based on blood tests, cholesterol and lipid levels are determined. An electroencephalogram is shown to assess the electrical activity of the brain.
Ultrasound of the brain helps to analyze the state of blood vessels, and Dopplerography allows you to detect violations in the vascular system of the brain. Based on the diagnosis, the doctor assesses the patient's condition and prescribes appropriate treatment.
Features of treatment
Since there are many risk factors, the treatment of vascular dementia should be based on the elimination of the cause of the disease. In particular, if the disorder develops in patients with prolonged arterial hypertension, then therapy should be selected strictly individually. At the same time, you should not try to reduce pressure, as this can provoke insufficiently good blood supply to the brain, which will contribute to an even greater progression of disorders.
There are a number of principles for managing vascular dementia. The doctor prescribes antiplatelet agents that prevent platelets from sticking together, and also normalize blood circulation. In addition, drugs that improve the metabolism of brain cells and neuroprotectors are required. All these requirements are met by such medicinalfunds:
- Cerebrolysin;
- "Acatinol memantine";
- Cavinton.
The drug "Cerebrolysin" contributes to the normalization of metabolic processes, and also has a neuroprotective effect. This drug helps improve cognitive function and has virtually no side effects.
The Akatinol memantine drug helps to improve concentration, speeds up mental processes and improves memory. "Cavinton" reduces the resistance of spasmodic vessels, improves blood microcirculation and has antiaggregatory properties, contributing to a more rapid removal of glucose.
In addition, medications of other groups, the effectiveness of which has been clinically proven, may be prescribed. In particular, drugs such as Gingko Biloba and ergot alkaloids are prescribed.
Forecast
Many people who are diagnosed with this are interested in how long they live with vascular dementia, what kind of disorders can occur. Complete cure is possible only in 10-16% of cases. In the acute course of the disease, the prognosis is quite unfavorable. A significant percentage of mortality is observed mainly 4-5 years after the onset of the initial symptoms of the course of the disease.
In the presence of an ischemic form of the disease, it is very often possible to slow down the process of the pathology, especially if the complex treatment of diseases that provoked the violation is carried out in a timely manner.
Life expectancy largely depends on the attention of relatives andliving conditions of the patient. If the disease is detected at the initial stage and appropriate therapeutic measures have been taken, a person can live 10-20 years. Full recovery occurs mainly in young people, while the processes of brain activity can still be restored.
Prophylaxis
Special attention is paid to prevention. Among the main preventive measures, it is necessary to highlight the following:
- moderate exercise;
- proper nutrition;
- maintaining normal mental he alth;
- blood pressure control.
When forgetfulness appears, you should definitely consult a doctor for diagnosis and subsequent treatment.
