Arteriosclerosis is a disease that is manifested by the replacement of trophic-capable and contraction of the muscular-type vessel wall with connective tissue. At the same time, the main property of the vessels, elasticity, is lost, which is fraught with a deterioration in the blood supply to the area where the affected vein or artery is located.
A special form of arteriosclerosis is atherosclerosis, also called metabolic. The cause of this condition is the dysfunction of fat metabolism in the body, which leads to their leakage through the basement membrane and the vascular endothelium.
The most dangerous cerebral atherosclerosis is the development of the pathological process in the main arteries that feed the brain. If a central organ is affected, the consequences can be very serious, so the treatment and prevention of the disease state should become a priority for the patient.
The main causes and mechanism of development
There are many reasons that contribute to the occurrence and development of the disease.
The starting mechanism of the disease is a violation of lipid metabolism.
Lack of oxidation of lipids, an imbalance of their transport forms and immense consumption underlie the development of cerebral atherosclerosis.
The main reasons for this condition include:
- Excess animal fat intake. Fats that are found in butter, eggs, meat, dairy products, are necessary sources of energy and endogenous water for the body. Cholesterol also participates in the synthesis of hormones, stabilizes cell membranes and is a cofactor in a number of biochemical transformations. But the enzyme systems of the body have limitations, besides many people suffer from diseases of the gallbladder or pancreas, which take a direct part in the breakdown of fat.
- Liver disease. The main synthetic processes in the body occur here, it is the largest organ of the human body with suitable heat and excellent blood circulation. When hepatocytes (functional units of the liver) are damaged, the following happens: fat oxidation reactions are disturbed, and they are transferred to free circulation through the bloodstream, and the balance of high and low density lipoproteins is disturbed, which is why cholesterol is retained in the cells of the vascular wall and can remain there forever . In addition, often cirrhosis and other liver diseases are the causes of hypertension.
- Hypodynamia. With a sedentary lifestyle, the frequency and strength of the contraction of the heart fall, the coronary circulation deteriorates, and blood flow slows down. The slower the blood moves in the most distant from the center of the vascular networks, the higher the chance of atherosclerosis arising there, because the blood will not wash away the infiltration from the cell surface.
- Smoking. Regular intake of nicotine into the blood causes the vessels to spasm, and then relax, and so after each breath, the bioactive components of cigarette smoke. Therefore, the wall begins to lose its properties by itself, and after the residual fat metabolites are included in the process, an atherosclerotic vessel will appear soon.
In addition, the causes of the development of the disease may be diabetes and congenital pathologies of carbohydrate metabolism. With massive violations of the metabolism of saccharides, there is an accelerated development of atherosclerosis.
Diabetes mellitus is one of the most common causes of lipid metabolism disorders and the appearance of atherosclerosis.
Main stages of the disease
The process is characterized by a clear staging.
Treatment and prognosis of the disease depends on the stage of the lesion of the vessel.
Modern classification is based on pathological changes in the wall.
It looks like this:
- Against the background of fat circulation and increased vessel permeability, the cells are “filled” with lipids and are reborn into large and fat foam cells, also called xantom cells. The fat inside them undergoes changes and turns into protein detritus. Such a cell can no longer fully fulfill its role, but the changes are noticeable only under a microscope and the affected area is scanty. At this stage, the prognosis is positive and you can get by with diet and exercise. However, atherosclerosis of the initial stage is observed even in children 15 years old.
- If characteristic fatty spots and stripes can be seen on the vessel, the diagnosis is “atherosclerosis of the first stage”. This condition is not critical, but the patient may complain of insomnia, irritability and high blood pressure.
- Fibrin and platelets stick to the fat deposits, a fatty plaque appears. Progressive vascular changes in the second stage of atherosclerosis consist in complications at the site of the formed plaque - their destruction, inflammation around the perimeter, or even small ulcers. Drug treatment is indicated at this stage.
- The arrival of the last stage will be marked by the introduction of calcium salts in the thickness of the plaque and their subsequent petrification. At the same time there is stenosis of the vessel (a significant reduction in its lumen) and circulatory disorders of the target organ.
Cerebral atherosclerosis is one of the most dangerous forms. This means that the pathological process develops in the vessels of the brain. Any pre-cerebral vessel subject to this multiplies the risk of ischemic stroke and subsequent disability. A feature of this type of disease is called the painlessness of the process, and the patient may not even be aware of the problem.
To find out about the presence of the atherosclerotic process and to prescribe treatment in time, one must know the key symptoms of cerebral atherosclerosis of the cerebral vessels.
Symptoms characteristic of the disease
If an atherosclerotic plaque forms in the pool of the carotid and vertebral arteries that feed the brain, then its growth begins and increases.
It grows until it closes the bloodstream or it does not form a thrombus, which can break off over time.
If there is suspicion of the development of the disease, the patient is obliged to monitor their psycho-emotional state over the past few months.
Very often, the progression of the disease is accompanied by the appearance of the following symptoms and abnormalities in the state of the human body:
- Problems with memory - a sign of impaired cerebral circulation. If the patient complains of short-term memory disorders, it should be sent for analyzes with suspicion of the atherosclerotic process. Often the inability to recall what happened a couple of minutes ago, such a phenomenon is not a distraction, but a symptom.
- A frequent complaint is fatigue, coupled with a violation of fine motor skills. Possible drowsiness, heaviness in the limbs, tremor. This is especially noticeable when the usual operations around the house or in the kitchen begin to take much longer than before.
- Insomnia and subsequent irritability indicate a multitude of diseases, but if you become anxious, restless not so long ago, even though you have never had any problems with sleep, this is a reason to consult a specialist.
- Launched forms are characterized by formidable symptoms - deterioration of vision and hearing, distortion of taste perception, motor function, ischemic attacks.
A dangerous complication is stroke, as a common outcome of the disease. Death does not occur from the metabolic arteriosclerosis itself, but from ischemic or hemorrhagic damage to important brain structures or from thrombosis.
A common cause of death for patients is myocardial infarction due to a similar process in the coronary arteries.
Basic diagnostic methods
The effectiveness of treatment depends on the correct diagnosis.
For this purpose, a number of examinations are prescribed - a biochemical blood test for lipid profile (high, low density lipoproteins, free and bound cholesterol, chylomicrons, free triglycerides), as well as immune markers for atherosclerosis.
Diagnosis of the disease involves some hardware research.
Apparatus research includes the following:
- Ultrasound with the use of the Doppler effect (while the specialist assesses blood flow velocity in various areas of the brain and pre-cerebral arteries, detects the localization of the plaque);
- EEG to check the electrical activity of the brain, which indicates the usefulness of thought processes and the integrity of the basic functions of the cortex.
If necessary, it is absolutely accurate to detect a stenotic vessel; invasive contrasting methods are used:
- MRI using a high resonance substance.
- CT scan with angiographic contrast.
In the latter methods, all vessels will be highlighted and clearly visualized in the resulting image, which may be necessary for surgical intervention.
Deciphering numerical data should be trusted to an experienced specialist, because they are very specific.
Treatment of cerebral atherosclerosis
Prevention of atherosclerosis consists in a strict diet with reduced intake of animal fats, increased physical activity, increased patient exposure to air and active walking, avoidance of stress on the body, quitting smoking, consuming therapeutic doses of alcohol for cleansing and widening the lumen of the vessels.
Doctors use a wide range of drugs when treating a disease.
At each stage of the disease there is a need for dose adjustment and the possibility of replacement therapy.
In general, the arsenal of drugs looks like this:
- Cholesterol absorption inhibitors. In this case, the intake of fat in the body decreases, which leads to a decrease in its atherogenic effects. But the cholesterol that has entered the body undergoes slow processing, so there is no need to wait for a quick effect. The drugs are used in the early stages in combination with diet therapy. The main tool - Cholestyramine.
- Inhibitors of cholesterol synthesis and transfer. These drugs inhibit the metabolic processes involved in the transportation of endogenous fat from food into the gastrointestinal tract, which slows down the development of atherosclerosis. These include Simvastatin, Zokor, Lovastatin, Atorvastatin.
Additionally, drugs that stimulate the excretion of cholesterol from the body are used.
Helping enzyme systems, medicines from this group (for example, drug Esentiale) metabolize fats much faster.
Mostly used means selectively lowering the content of blood triglycerides. Cholesterol is not the only atherogenic fat.
The progression of the disease is accelerated by ordinary triglycerides.
Fenofibrate and Nicotinic Acid (Vitamin PP) contribute to lowering their levels in the freely circulating pool.
In addition, the following means can be applied:
- Antioxidants of direct and indirect action. These cheap drugs are used more for general control and prophylaxis than for the treatment of a hyperlipidemic state, but their role cannot be underestimated. Tocopherol (vitamin E) and ascorbic acid (vitamin C) help to reduce oxidative processes in the affected wall and are an integral part of complex therapy in combination with other groups. Methionine and Glutamic Acid are also used.
- Angioprotectors. These modern drugs find their use in any dystrophic changes of blood vessels and related conditions. They enhance the natural resistance of the vascular wall to damage, return the regenerative function and produce a tonic effect. These include Parmidin (Prodektin, Anginin), Etamzilat (Ditsinon), Quercetin (Flavin, Quertin).
- Antihypertensive drugs. Supporting therapy throughout the treatment of cerebral atherosclerosis are blood pressure lowering agents. Due to the loss of elasticity, intracranial pressure increases, leading to worsening of symptoms and, in this case, pain due to damage to the membranes of the brain. Then the doctor may prescribe Furosemide to lower the BCC, ACE inhibitors in the form of Captopril and Lisinopril, beta-blockers Atenolol and Metoprolol.
Additional agents used during therapy are anticoagulants.
A frequent complication of atherosclerosis is the formation of a blood clot at the plaque site and its subsequent detachment, which leads to an embolism with organic lesions.
To prevent this, prescribe a means of reducing the activity of thrombin and the formation of prothrombin. These are Heparin, Hirudin, Dikumarin, Warfarin, Pelentan and their foreign counterparts.
An expert in the video in this article will tell you about cerebral atherosclerosis.