The term "atherosclerotic dyscirculatory encephalopathy" refers to a pathological process, the course of which is characterized by lesions of the cerebral vessels. The main reason for the development of the disease is poor cerebral blood flow and, consequently, oxygen starvation of tissues. These disorders are the result of the deposition of atherosclerotic plaques on the walls of blood vessels, and therefore the disease is most often diagnosed in the elderly.
Pathogenesis
Under the influence of various adverse factors, the concentration of "bad" cholesterol in the liquid connective tissue increases. It settles on the walls of blood vessels, due to which their lumen narrows. As a result, brain cells do not receive the required amount of oxygen and vital components. Over time ata person develops chronic ischemia of the white matter. The consequence of this is the disruption of the brain and the occurrence of structural changes in the nervous system.
In addition to atherosclerotic encephalopathy, it is customary to distinguish hypertensive and mixed. In the first case, the pathogenesis is based on persistent arterial hypertension. The mixed type combines the clinical manifestations of both hypertensive and atherosclerotic encephalopathy. Recently, doctors separately distinguish the venous form of the disease. It develops against the background of a violation of the outflow of blood from the cranial cavity.
In the International Classification of Diseases (ICD-10), atherosclerotic encephalopathy is assigned the code I67.
Etiology
The main cause of the development of the disease is atherosclerosis of the blood vessels responsible for the nutrition of the brain. The following diseases and conditions are provoking factors for increasing the level of "bad" cholesterol:
- Disorders of lipid metabolism.
- High blood pressure.
- Diabetes mellitus.
- Tobacco smoking.
- Frequent consumption of alcoholic beverages.
- Hereditary predisposition.
- Overweight.
- Unbalanced diet.
According to statistics, atherosclerotic encephalopathy is most often diagnosed in men. Doctors believe that this is due to the effect of hormones on cholesterol metabolism. In addition, age is a natural risk factor. The older the person, the more likely it is to developailment.
Degrees of severity
It is customary to distinguish the following forms of atherosclerotic encephalopathy:
- Easy. In this case, the symptoms are absent or mild. Characteristic signs are psychopathy of various kinds and cerebrosthenic syndrome.
- Subcompensated. At this stage, structural changes in the brain become more pronounced. The clinical picture is aggravated, there are focal symptoms.
- Decompensated. It is characterized by pronounced clinical manifestations. Organic changes can be detected in the brain, including atrophy of the cortex. Decreased white matter density.
Thus, the severity of symptoms of atherosclerotic encephalopathy depends on the severity of the disease.
Clinical manifestations
Characteristic signs of pathology are shown in the table.
| Stage | Symptoms of disease |
| Easy |
|
| Subcompensated |
|
| Decompensated |
|
At the initial stage of the development of the disease, the symptoms are not specific. Most people attribute their presence to banal fatigue. Thus, many patients go to a medical institution already at the stage of rapid progression of the disease.
Diagnosis
When the first signs of atherosclerotic encephalopathy occur, you should consult a doctor as soon as possible. The pathology is treated by a neurosurgeon, a neurologist and a vascular surgeon.
Primary diagnosis of the disease involves taking an anamnesis and conducting a physical examination. In addition, the doctor evaluates the state of the vestibular apparatus, checks muscle and tendon reflexes, and also tries to understand how clear speech and cognitive functions are preserved.
After the primary diagnosis, the doctor issues a referral for a comprehensive examination, including:
- MRI or CT with contrast.
- REG.
- Duplex vascular scanning.
- Fundus examination.
Based on the results of the diagnosis, the doctor chooses the tactics of managing the patient.
Treatment
The disease requires an integrated therapeutic approach. Inin all cases, the treatment of atherosclerotic encephalopathy involves taking medications.
The classic pathology therapy scheme consists of the following items:
- Taking antihypertensive drugs. The active components of the funds help to reduce the rate of blood pressure. As a rule, doctors prescribe Betaloc ZOK and Physiotens to patients.
- Taking lipid-lowering drugs. During treatment, the level of "bad" cholesterol in the blood is significantly reduced. Examples of funds: Atorvastatin, Crestor.
- Taking nootropics. The active components of these drugs have a positive effect on the functioning of the brain. As a result, patients increase the speed of thinking and improve memory. As a rule, doctors prescribe Phenibut and Nootropil.
- Reception of neuroprotectors and agents intended to normalize blood circulation. Examples of drugs: Vinpocetine, Cerebrolysin, Pentoxifylline.
Other conservative treatments for atherosclerotic encephalopathy:
- Acupuncture.
- Electrophoresis.
- Ozone therapy.
- exercise.
If the lumen of the vessel is almost completely blocked by large atherosclerotic plaques, the doctor evaluates the advisability of surgical intervention. During the operation, the affected blood vessel is stented.
Forecast
The outcome of the disease directly depends on the timeliness of the visit to the doctor. Upon detectionpathology at an early stage, it is possible to stop the progression of the disease.
In all other cases, the prognosis is less favorable. At the last stage, the patient is not able to serve himself. In this case, all therapeutic measures are aimed at stopping clinical manifestations and maintaining life.
Ignoring the disease leads to its rapid progression and, accordingly, the development of complications. Left untreated, it can lead to a stroke.
In conclusion
Encephalopathy of atherosclerotic genesis is a pathology, the development mechanism of which is based on an increase in the concentration of "bad" cholesterol in the blood and blockage of blood vessels with plaques. The brain ceases to receive the amount of oxygen and nutrients that it needs. As a result, structural changes of the body appear. The initial stage of encephalopathy has no specific signs. As the disease progresses, speech is disturbed, vision and hearing deteriorate, and a headache appears. In severe cases, paralysis and paresis occur.
