Vascular encephalopathy of the brain in adults

If emotional outbursts are noted, memory and intellectual sphere suffer, perhaps these are signs of circulatory disorders in the brain with the development of vascular encephalopathy.

What is vascular encephalopathy

Vascular encephalopathy, as noted neurologist Victoria Grigorenkо, is a slowly progressive disorder of the blood supply to the brain. As a result, diffuse multifocal lesions (areas where brain cells die or do not work well) form in the brain.

The main risk group is the elderly with atherosclerosis of the vessels and hypertension. Also at risk are people with diabetes, vasculitis, obesity, a sedentary lifestyle, smokers, and alcohol abusers.

Causes of cerebral vascular encephalopathy in adults

The brain is the main organ that controls the entire body. Therefore, it consumes a large amount of resources and must be continuously supplied with blood, bringing oxygen and nutrition. It is supplied by large arteries, which form a special system – the circle of Willis. It works in a unique way, normally evenly nourishes all parts of the brain, and with various deviations it can redistribute blood to those areas where it is especially needed.

If a person suffers from cerebral circulation due to various health problems, at first the brain tissue uses its reserves, but they are quickly depleted, which can lead to disruption of neurons. Then vascular encephalopathy develops – a condition in which brain cells suffer from hypoxia (chronic ischemia) due to insufficient blood flow to them, rich in oxygen and nutrients. Most often, vascular encephalopathy occurs when:

• atherosclerosis, if plaques form in the cerebral and cervical vessels;
• long-term arterial hypertension;
• lesions of the vertebral arteries (including if there are degenerative changes in the spine);
• metabolic pathologies that lead to disorders of capillary and arterial blood flow (obesity, endocrine disorders, diabetes);
• inflammatory lesions of small arteries (the so-called vasculitis);
• brain injuries;
• cardiac arrhythmias;
• prolonged persistent hypotension (very low blood pressure).

At the heart of the disorders is a long-term lack of oxygen in the brain tissues. Against this background, cells die, function worse, small foci of cerebral infarctions can form. The subcortical structures and nuclei of the brain suffer especially strongly – there are fewer vessels, the redistribution of blood is worse. The result – problems with the intellect, disorders of the emotional sphere and motor acts.

Symptoms of cerebral vascular encephalopathy in adults

Symptoms of vascular encephalopathy may develop slowly if this is its classic form. With a rapidly progressive form, symptoms may appear in a short period of time. Sometimes the course can be undulating – periods of exacerbation are replaced by improvements in the condition. Depending on the severity of changes in tissues during hypoxia and ischemia, several stages of encephalopathy are distinguished.

• The first stage – these are the initial changes in the work of the brain, they are minimal, often the changes are assessed very subjectively. Perhaps a slight deterioration in memory, absent-mindedness, fatigue. There are no neurological symptoms at this stage.
• The second stage – changes in the intellectual sphere and memory are more noticeable, there are disorders in the emotional sphere, movement disorders.
• The third stage – the most severe changes in the form of vascular dementia (dementia development), in which there are mental disorders, decreased intelligence, loss of ordinary household skills, problems with the pelvic organs, impaired motor function.

It is often difficult to determine the diagnosis at the initial stage, the complaints of patients are quite general, not typical. Depressive disorders, rapid fatigue, general weakness may occur. More precisely, you can determine the condition when more pronounced symptoms occur:

• bouts of dizziness;
• speech disorders;
• memory impairment;
• insomnia or excessive sleepiness;
• personality changes (egocentrism, capriciousness, suspiciousness);
• irritability;
• inappropriate actions;
• apathy.

These changes are beginning to disturb almost permanently. In addition, the risk of developing a stroke increases, which threatens with disability or death.

Treatment of cerebral vascular encephalopathy in adults

It is necessary to start therapeutic measures as early as possible – in the first stage of encephalopathy, in order to slow down its progression and disorders of the brain. In addition, the prevention of strokes, which are life-threatening, is important.

Diagnostics

Initially, a neurologist may suspect encephalopathy by examining the patient and asking a series of questions about the general condition and typical symptoms. In addition, the doctor prescribes a number of additional examinations – analyzes and instrumental tests:

• EEG, which determines the violation of brain activity in certain areas;
• EchoEG to assess the level of intracranial pressure;
• rheoencephalography or ultrasound of the vessels of the neck and head to assess the degree of cerebrovascular disorders;
• CT or MRI of the brain – they will allow you to evaluate changes in the brain that are provoked by blood flow disorders.

Additionally, consultations of a cardiologist, ophthalmologist and other doctors are necessary, depending on the causes of circulatory disorders.

Modern treatments

As neurologist Viktoria Grigorenko notes, given the variety of factors that cause encephalopathy, treatment is aimed at eliminating the causes of the disease and improving blood supply to the brain.

Correction of vascular risk factors includes:

• normalization of blood pressure,
• to give up smoking,
• weight loss,
• lowering cholesterol, homocysteine,
• increase in physical activity.

Antiplatelet agents and anticoagulants are used as part of antithrombotic prophylaxis of acute cerebrovascular accidents.

To improve cerebral blood supply, vasoactive, nootropic drugs, antioxidants, antihypoxants, correctors of cognitive disorders are used.

Given the chronic course of vascular encephalopathy, treatment can be provided in a polyclinic, day hospital.

Not only a neurologist is involved in the treatment of such patients, the help of specialized specialists is needed: a cardiologist, an endocrinologist, a nutritionist, an ophthalmologist, a rheumatologist.

Drug therapy can be in the form of intravenous jet or drip infusions, and in tablet form.

There is also inpatient surgical treatment – reconstructive operations on the vessels necessary to normalize blood flow. Emergency hospitalization of the patient is indicated for acute violation of cerebral blood supply, as a complication of vascular encephalopathy.

Prevention of cerebral vascular encephalopathy in adults at home

Prevention of vascular encephalopathy, notes neurologist Victoria Grigorenko, includes the following items:

• compliance with the regime of work and rest;
• normalization of sleep;
• maintaining a diet (with obesity, diabetes mellitus);
• blood pressure control;
• blood glucose control;
• drinking regime – at least 1,5 liters per day;
• dosed physical activity;
• Spa treatment.

Vascular encephalopathy is very insidious, since the onset of the disease is non-specific, insignificant for the quality of life, and patients do not seek medical help. Therefore, more often neurologists are already faced with stage 2-3 of the disease and with multifactorial brain damage. That is why early diagnosis, medical examinations, visits to doctors for preventive purposes are necessary.

Popular questions and answers

We talked about the possible consequences of vascular encephalopathy, its dangerous symptoms and the consequences of self-medication with neurologist Victoria Grigorenko.