Cerebral atherosclerosis

Author Ольга Кияница

2019-02-02

Atherosclerosis is the result of local inflammation and fibrosis of the arteries. In cerebral atherosclerosis, the blood flow is limited by the vessels of the brain. The complication of this disease may be dementia, memory problems, and ischemic stroke.

erebral arteriosclerosis (CA) is a blockage of the arteries of the brain that occurs as a result of thickening and compaction of their walls. This is one of the causes of stroke, which can also cause aneurysms. Breaking an aneurysm in the brain can lead to hemorrhage (bleeding).

Atherosclerosis today is one of the most common causes of the formation of neurological disorders, especially in the elderly.

Symptoms of cerebral atherosclerosis include headache, facial pain, or vision impairment. For diagnostics, computer tomography (CT) and magnetic resonance imaging (MRI) are used. With their help it is possible to clarify the localization of cerebral atherosclerosis before the occurrence of stroke or hemorrhage.

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Description of cerebral vascular arteriosclerosis

Atherosclerosis is a disease, the essence of which is the formation of atherosclerotic plaques, consisting mainly of lipids (fats) and calcium. Then there is an inflammatory process in the walls of the arterial vessels. Inflammatory infiltration and concomitant fibrosis are precisely the basis of the formation of atherosclerosis.

As a result of pathological changes, the vessel is narrowed, normal blood circulation is disturbed. Due to the fact that the cells of the nervous system are particularly sensitive to hypoxia (lack of oxygen), cerebral arteriosclerosis can lead to neurological disorders. In particular, there may be a deterioration in the memory of the elderly.

Recently , the concept of atherosclerotic dementia has begun to be used , suggesting that neurological changes are caused by a decrease in blood flow through the vessels of the brain. However, the most unfavorable complication of atherosclerosis is a life-threatening ischemic stroke.

Atherosclerosis is part of a process that also affects other arteries in the human body. It is worth noting that in more than 90% of cases the narrowing of the sleep and vertebral arteries develops against the background of the atherosclerotic vascular damage.

Cerebral Atherosclerosis: Causes

The causes of atherosclerosis include so-called modifiable factors, which include:

  • Increase in total cholesterol and LDL ("bad" cholesterol).
  • Diabetes mellitus
  • Hypertension.
  • Obesity
  • Smoking

It should be remembered that these factors and how they are modified (modified) are also mentioned in the recommendations for the secondary prevention of stroke and many cardiovascular diseases.

To date, additional causes have been identified leading to atherosclerosis. These include genetic factors. These conditions are associated, in particular, with the metabolism of lipids.

Age and sex are also important. Many researchers note that after 40 years, the risk of atherosclerosis is markedly increased.

Symptoms of the disease often appear in men. On the basis of this it is worth noting that the male sex is also a risk factor for the development of atherosclerosis.

Additionally, patients with metabolic syndrome are more likely to develop the disease, so this condition should be diagnosed in a timely manner.

Cerebral Atherosclerosis: Symptoms

Atherosclerotic plaques located in the cerebral, cervical or vertebral arteries can cause brain blood vessel disorders. The first symptoms of cerebral hypoxia as a result of blood flow disorders in the blood vessels may be:

  • Headaches
  • Dizziness
  • Symptoms of ischemic stroke.

Also, signs of a psychoneurological disorder may be determined due to the developing vascular dementia. Symptoms are more common in men and become more pronounced with age.

Signs of atherosclerosis in the brain, cervical and vertebral arteries can be similar. In particular, they may be related to:

  • Transient ischemia of the brain (the so-called small stroke, TIA, microunit).
  • Ischemic stroke (ischemia caused by changes in the internal carotid arteries, usually caused by congestion).
  • Paresis, paralysis of the face and extremities.
  • Sensory disorder, numbness, paresthesia, speech impairment, visual impairment, temporary loss of vision on one eye, decreased hearing aids.
  • Disorder of maintaining balance, disturbance of gait, sudden, stinging and recurring lethargy of the lower extremities.

With age, cerebral atherosclerosis may be manifested by mental changes in the form of vascular dementia. Also, the disease is characterized by emotional and cognitive disorders. Patients have memory problems, and sometimes with short-term memory appear.

Video: Atherosclerosis: Types, Causes, and Symptoms

Diagnosis of cerebral atherosclerosis

To determine the degree of narrowing of the arteries and to determine the location of atherosclerotic lesions, anultrasound carotid examination and an ultrasound examination of the transcranial carotid artery should beperformed . These methods lie at the heart of the evaluation of brain vessels. They are non-invasive, absolutely safe and painless for humans.

Unfortunately, for some adults, especially the elderly, ultrasound scan transcranial doppler for the evaluation of cerebral arteries is contraindicated.

In such cases, angioplasty (CT scan) or angioplasty (magnetic resonance angiography) may be performed. These studies provide high-resolution images and a three-dimensional assessment of the arteries in the brain, as well as vertebras. However, arteriography is due to the high risk of complications only when other tests do not allow to assess the degree of stenosis of the arteries.

The magnetic resonance imaging of the head , performed by the classical method, allows you to detect changes in the brain that may have occurred earlier as a result of cerebral atherosclerosis after a stroke (for example, post-stroke attacks).

To determine whether a patient has dyslipidemia, the doctor may prescribe appropriate blood tests , including general and biochemical tests. Ideally, a lipidogram is recommended, the indicators of which allow the determination of total cholesterol, HDL, LDL, and triglycerides.

Complications and consequences of cerebral atherosclerosis

Atherosclerotic changes in brain tissues can lead to complications of varying severity. In particular, there are often problems with the memory described above. The most dangerous consequence of untreated cerebral artery atherosclerosis is an ischemic stroke. This, in turn, can cause long disturbance of movements as a result of paresis of extremities, speech and sensory disorders.

In patients with stroke, depressive disorders are more frequent than in the rest of the population. Sometimes, as a result of ischemia, there is a cerebral dysfunction and death of the patient.

Consequences of vascular dementia:

  • Failure to perceive new information.
  • Problems with everyday activities.

These patients are actually helpless. They can cry for a long time, as well as leave the apartment and wander without assistance, without recalling the road home.

Ischemic stroke

Cerebral Atherosclerosis: Treatment

In the asymptomatic course of cerebral atherosclerosis, pharmacological treatment is carried out with the aim of preventing possible complications. For this purpose, the drugs for atherosclerosis, which are statins and acetylsalicylic acid (in the case of contraindications to acetylsalicylic acid - clopidogrel), should be taken.

Additionally, it is important to follow the following guidelines:

  1. Arterial pressure should be monitored.
  2. Treat diabetes if necessary.
  3. Maintain normal body weight.
  4. Fully abandon smoking.

Dietary nutrition is also important. It should include a limited amount of animal fat, which allows you to maintain the amount of cholesterol within the normal range or to lower the high level of LDL. This will allow you to control the important risk factors for developing atherosclerosis.

In the event of a significant violation of the blood flow in the carotid arteries, surgical removal of the atherosclerotic plaque may be performed (this procedure is called endarterectomy ). Also, depending on the indications, the stent is implanted into the artery, for which intravascular plastic is used.

Prior to surgical intervention, the individual readings are always first and foremost studied. During preparation for the procedure, it should be remembered that this is a preventive operation that can prevent the occurrence of a stroke.

Conclusion

Cerebral atherosclerosis can lead to stroke and hemorrhage in the brain. Both states can be dangerous to human life.Survivors after stroke and hemorrhage often have long-term neurological and motor disorders. Therefore, diagnosis of cerebral atherosclerosis and timely treatment, pharmacological or surgical treatment is extremely important.

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