Discirculatory encephalopathy according to ICD 10. Features of the course of the disease. Causes of toxic encephalopathy

Disorders of blood circulation in the vessels of the brain have a very serious consequences. One of the diseases leading to this is discirculatory encephalopathy. When diagnosing it, it is imperative to carry out qualified treatment in order to avoid the disease progressing to a more severe degree, which often results in disability.

What it is?

Discirculatory encephalopathy is a disease in which, due to impaired blood supply, the brain does not function properly. The pathology is characteristic of both the cortex and subcortical brain regions, it requires compulsory treatment, which is prescribed based on the degree of the disease. The main symptoms are damage to motor and psychophysical function, which affects the general condition of the person, who, among other things, becomes susceptible to frequent emotional disorders.

The main cause of the disease is imbalance of oxygen supply, carried by the blood, into the vessels, since cerebral circulation is disrupted due to various factors. As a result, various lobes of the brain are in a state of oxygen starvation and do not receive vital substances. Subsequently, dyscirculatory encephalopathy constantly progresses, which gradually leads to the death of the brain areas susceptible to pathology. In such an area, a rarefaction center is formed, which has small size, its localization can vary significantly.

At the initial stage, discirculatory encephalopathy occurs with active resistance of the body, when it, at the expense of healthy cells, tries in every possible way to replace the functionality of dead ones. However, if treatment measures are not taken further, the disease becomes more severe, and the replacement cells themselves begin to experience oxygen starvation. Often, due to inferior brain activity, the result of the pathological process is disability of varying degrees.

Early stage of discirculatory encephalopathy, occurring without severe symptoms and signs, can last quite a long time, sometimes it lasts for several years.

ICD-10 disease classification code – G45 or I60 - I69

Causes

The disease of discirculatory encephalopathy does not happen out of the blue, there is always some initiator due to which the development of the disease begins, most often it is:

• Atherosclerosis
• Existence of traumatic brain or spinal cord injuries
• Diabetes
• Improper functioning of the vertebral vessels
• Excessive blood viscosity and other pathologies
• High cholesterol
• Prolonged stress and depression
• Over or underweight
• Physical inactivity and inactivity
• Bad habits

Kinds

Discirculatory encephalopathy in medicine is divided according to several criteria. First classification – by origin, based on this, the disease happens:

• Atherosclerotic
• Hypertensive
• Venous
• Mixed

According to the speed of development, there is a division into slow, when the transition from stages 1 to 2 or from stages 2 to 3 occurs over several years (4-5). In this case, remission and exacerbation of the pathology are often observed. The next one is fast, when progression from the first to the last degree occurs in just a couple of years.

Based on the consequences encephalopathy has for the patient’s health, it is divided into degrees:

1. The first is the degree at which only slight deviations in the way the brain functions are noticeable.
2. The second degree is characterized by increased symptoms, they become noticeable, but do not have a noticeable effect on the quality of life and ability to work.
3. At the third stage of development, the patient is assigned a disability, which will depend on the depth of physical and mental disabilities.

Symptoms

Let us describe the main manifestations and signs that dyscirculatory encephalopathy of various degrees will have.

First

• A person changes emotional background, the mood is increasingly bad, there is general depression and rapid irritability
• Periodically severe headache
• Difficulty concentrating on anything
• Intellectual ability regresses, especially with regard to memory, which is why facts from the past are confused. A phenomenon often arises when information from many years ago is remembered well, but fresh information is not retained in the head at all.
• During active movements, nausea may occur due to dizziness.
• Poor sleep with nightmares and anxiety

Second

With dyscirculatory encephalopathy of the second degree, there is a general worsening of the symptoms of the disease described above, as well as some new symptoms:

• Incessant pain in the head
• Serious memory difficulties
• Difficulty swallowing and speech disturbances are common
• There is noise in the ears, for this reason the patient begins to hear worse
• Yeast attacks of hands, head
• Cramps that periodically spread to the entire body
• Bright flashes of light in the eyes

At this stage, the manifestations of the disease already make adjustments to the normal course of the patient’s life, as a result of which its quality decreases and the ability to work suffers. Often, even this development of encephalopathy leads to the appointment of a 2nd or 3rd disability group.

Third

• Difficulty with orientation in space and time
• Severe disorders of the sensory organs, in which hearing, vision, touch, and coordination of movements can be severely impaired
• Apathy towards everything around you
• Lack of control over feces and urine excretion
• Convulsions
• Insomnia
• In some cases, complete immobility is observed

This set of symptoms of dyscirculatory encephalopathy leads to the inability to normally perform work duties and even care for oneself, which is why the patient is assigned first or second degree disability.

Diagnostics

It is very important that discirculatory encephalopathy is diagnosed as early as possible in order to begin treatment on time and prevent the serious manifestations described in the previous section. An accurate diagnosis requires examination by specialists in various fields of medicine:

• Neurologist
• Ophthalmologist
• Cardiologist
• Endocrinologist

Based on the results of the examination and medical history, various examinations are prescribed to help determine the presence of encephalopathy and its degree, usually these are:

• Ophthalmoscopy
• Electroencephalography
• Ultrasound examination of the vessels of the head and neck
• Checking the patency of the cerebral arteries

Additionally, a biochemical and general blood test is performed, checking for increased level sugar and cholesterol.

Treatment

How to treat such a complex and diverse disease? Considering the multiplicity of manifestations, as well as based on the causes of dyscirculatory disorder, a complex of procedures is used in treatment. Typically therapy is carried out:

• Special drugs, with the help of which it is possible to take control of blood pressure, keeping it normal, and improve metabolic processes in the body. In addition, they are used for treatment medicines, the task of which is to improve the nutrition of the brain by activating its blood supply.
• Physiotherapeutic procedures, including the use of laser therapy, therapeutic electrosleep, special oxygen and radon baths, massages, acupuncture, hirudotherapy.

Timely targeted treatment allows slow down significantly development of the initial stages. If one of the causes of the disease is high cholesterol, it is very important to change your diet to limit the intake of this substance. Surgery is not used as a method of treating discirculatory encephalopathy, so if the disease is in an advanced form, then most likely you will have to come to terms with it, and with the help of therapy you can only limit further progression.

ethnoscience

In addition, with the permission of the doctor, treatment is often supplemented with traditional methods and methods. Usually it consists of ingesting tinctures of:

• Clover
• hawthorn
• Leaves of strawberry, oregano, birch
• Chamomile with valerian and lemon
• Hops with motherwort and mint

Preventive measures

Prevention consists of constant monitoring of those factors and diseases that lead to encephalopathy due to impaired blood circulation in the brain. For this it is important:

• Check your blood pressure periodically
• Know your blood sugar and cholesterol levels, and if the levels are elevated, then take the necessary actions
• Refuse bad habits
• Get involved in a light sport
• Watch your weight
• Attend regular clinical examinations

If left untreated, the disease progresses and over time leads to complete inability to self-care and disability.

ICD-10 does not have a separate code for dyscirculatory encephalopathy. The disease is classified in the class “Cerebrovascular diseases” with the assignment of codes I60-I69 depending on the cause of the development of the pathology and the manifested symptoms.

Discirculatory encephalopathy: degrees of disease

The disease develops gradually, and with each transition of dyscirculatory encephalopathy to a new stage, the nature of the symptoms worsens, and the patient’s well-being noticeably worsens. The following degrees of dyscirculatory encephalopathy are distinguished:

Stage 1 of the disease

The initial first degree of DEP is characterized by minor cerebral disorders, the symptoms of which are similar to neurological diseases, consequences of injury or poisoning. During this period, the patient is concerned about:

• moderate headache;
• changes in mood – tearfulness, irritability, apathy to what is happening, anxiety;
• dizziness;
• weakness, fatigue;
• noise in ears;
• insomnia;
• forgetfulness, absent-mindedness;
• uncertainty in movements when walking.

Stage 2 of the disease

The transition of discirculatory encephalopathy to the second degree is marked by a significant deterioration in both physical and emotional state. The patient begins to show aggravated signs of neurological disorders:

• almost persistent headache;
• violation of the swallowing reflex (pseudobulbar syndrome);
• difficulty perceiving speech;
• lethargy;
• depression;
• impaired coordination and motor skills;
• trembling, numbness, cramps of the limbs;
• hearing and visual disorders;
• decreased concentration.

Stage 3 of the disease

At the last stage extensive lesion brain cells leads to complete disorientation of the patient in space. In most cases, he becomes incapable of self-care, he shows signs of dementia and severe brain disorder:

• significant impairment or absence of motor functions;
• lack of thinking and complete lack of understanding of what is happening;
• loss of interest in life;
• Parkinson's syndrome;
• seizures;
• difficulty eating due to lack of a swallowing reflex;
• urinary incontinence.

The transition of dyscirculatory encephalopathy from one degree to another can be stopped if early stage start treatment. In the absence of such, the disease can develop slowly - from 5 years or more, and rapidly - over the course of 2 years, the passage of all stages.

Treatment of dyscirculatory encephalopathy of the brain

At an early stage, treatment of this type of encephalopathy is aimed at restoring the functioning of the vascular and nervous system. In advanced cases, the doctors’ task is to stop the processes of death of brain cells and restore lost vital functions to the maximum extent possible.

Treatment of dyscirculatory encephalopathy is carried out repeatedly conservative ways. In cases of rapid development of the disease or observation of at least one attack of acute circulatory failure, the patient may be recommended an operation to artificially restore the patency of blood vessels or replace them.

The course of drug treatment for dyscirculatory encephalopathy usually includes the following groups of drugs:

1. Antihypertensive drugs (Phentolamine, Clonidine, Enalapril) - prescribed to prevent sharp jumps blood pressure. Taken throughout the course of treatment.
2. Lipid-lowering drugs (Pentoxifylline, Piracetam, Lovastatin) - tablets are indicated for the treatment of atherosclerosis, which is one of the common causes of dyscirculatory encephalopathy.
3. Neuroprotectors (Actovegin, Cerebrolysin, Cortexin) are necessary to restore the functioning of neurons.
4. Vascular agents (Xanthinol nicotinate, Vinpocetine).
5. Blood thinners (Curantil, Heparin) - prevent the formation of blood clots and narrowing of the lumen of blood vessels.

To improve blood circulation, in combination with medications, the patient may be prescribed physiotherapeutic procedures:

• electrosleep;
• galvanotherapy on the neck and collar area;
• UHF vessels in the neck area;
• acupressure;
• medicinal baths;
• laser exposure;
• physiotherapy.

One of therapeutic measures with diagnosed discirculatory encephalopathy is to follow a diet. From daily diet High-calorie foods should be excluded, in particular eggs, fried and fatty foods. Instead, the menu should include seafood, raw vegetables, fruits, rice, corn, low-fat dairy products, onions and nuts.

During the treatment process, you should try not to limit physical and mental activity - regularly walk in the air and develop intellectually. This will help the brain in combination with drug treatment restore the affected cells and start the mechanism of their work.

Discirculatory encephalopathy - how long can you live with this diagnosis?

The favorable prognosis for a full life in dyscirculatory encephalopathy depends on several factors - the stage of the disease and the rate of its progression, the age criterion, as well as the degree of neglect of concomitant pathologies.

1. At the initial stage of the disease, the brain is still able to independently compensate for the affected cells, so during this period the prognosis for a complete recovery is the most favorable.
2. A less positive prognosis for recovery can be observed when the pathology moves into the 2nd stage. Signs of neurological disorders and disorders of brain activity become more pronounced, the patient cannot lead a full life, becomes partially dependent on the help of others, and is assigned a disability. Treatment during this period can only stop the course of the disease, but not cure it.
3. At the last third stage of discirculatory encephalopathy, irreversible changes occur in the brain structures, the patient loses self-care skills and becomes completely dependent on other people. A person in this state can live for decades. fatal outcome Moreover, it is possible in cases of development of complications of this disease - heart attack, stroke, attack of cardiovascular failure.

If self-care abilities are limited, a patient with dyscirculatory encephalopathy is assigned a disability, the group of which depends on the severity of the disease:

• Group 3 - with mild signs of disability and disability characteristic of the 2nd stage of the disease.
• 2nd group - prescribed in cases where the patient is diagnosed with the 2nd or 3rd degree of the disease, significant violations CNS and brain functions. In everyday life, a person cannot cope independently, in labor activity partially limited.
• 1st group - indicated for sharp progression of the 3rd stage of the disease. The patient has severe signs of dementia, mental and physical maladjustment and other neurological disorders.

If there is a risk of a disease, it is important to prevent its development and transition to an advanced form. To do this, you need to be regularly examined and, if possible, limit the impact of negative factors that provoke the appearance of dyscirculatory encephalopathy.

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Discirculatory encephalopathy 1, 2, 3 degrees, brain treatment, ICD-10

Disturbances in blood circulation in the vessels of the brain have very serious consequences. One of the diseases leading to this is discirculatory encephalopathy. When diagnosing it, it is imperative to carry out qualified treatment in order to avoid the disease progressing to a more severe degree, which often results in disability.

What it is?

Discirculatory encephalopathy is a disease in which, due to impaired blood supply, the brain does not function properly. The pathology is also characteristic of the cortex and subcortical parts of the brain; it requires mandatory treatment, which is prescribed based on the degree of the disease. The main symptoms are damage to motor and psychophysical function, which affects the general condition of the person, who, among other things, becomes susceptible to frequent emotional disorders.

The main cause of the disease is an imbalance in the supply of oxygen carried by the blood to the vessels, since cerebral circulation is disrupted due to various factors. As a result, various lobes of the brain are in a state of oxygen starvation and do not receive vital substances. Subsequently, dyscirculatory encephalopathy constantly progresses, which gradually leads to the death of the brain areas susceptible to pathology. In such an area, a rarefaction center is formed, which is small in size; its localization can vary significantly.

At the initial stage, discirculatory encephalopathy occurs with active resistance of the body, when it, at the expense of healthy cells, tries in every possible way to replace the functionality of dead ones. However, if treatment measures are not taken further, the disease becomes more severe, and the replacement cells themselves begin to experience oxygen starvation. Often, due to defective brain activity, the result of the pathological process is disability of varying degrees.

The early stage of dyscirculatory encephalopathy, which occurs without pronounced symptoms and signs, can last quite a long time, sometimes it lasts several years.

ICD-10 disease classification code – G45 or I60 - I69

Causes

The disease of discirculatory encephalopathy does not happen out of the blue, there is always some initiator due to which the development of the disease begins, most often it is:

• Atherosclerosis
• Vegetovascular dystonia
• Existence of traumatic brain or spinal cord injuries
• Hypertonic disease
• Diabetes
• Improper functioning of the vertebral vessels
• Excessive blood viscosity and other pathologies
• High cholesterol
• Prolonged stress and depression
• Over or underweight
• Physical inactivity and inactivity
• Bad habits

Discirculatory encephalopathy in medicine is divided according to several criteria. The first classification is by origin, based on this, the disease is:

According to the speed of development, there is a division into slow, when the transition from stages 1 to 2 or from stages 2 to 3 occurs over several years (4-5). In this case, remission and exacerbation of the pathology are often observed. The next one is rapid, when progression from the first to the last degree occurs in just a couple of years.

Based on the consequences of encephalopathy for the patient’s health, it is divided into degrees:

1. The first is the degree at which only slight deviations in the way the brain functions are noticeable.
2. The second degree is characterized by increased symptoms, they become noticeable, but do not have a noticeable effect on the quality of life and ability to work.
3. At the third stage of development, the patient is assigned a disability, which will depend on the depth of physical and mental disabilities.

Symptoms

Let us describe the main manifestations and signs that dyscirculatory encephalopathy of various degrees will have.

First

• A person’s emotional background changes, his mood is increasingly bad, there is general depression and rapid irritability.
• Periodically severe headache
• Difficulty concentrating on anything
• Intellectual ability regresses, especially with regard to memory, which is why facts from the past are confused. A phenomenon often arises when information from many years ago is remembered well, but fresh information is not retained in the head at all.
• During active movements, nausea may occur due to dizziness.
• Poor sleep with nightmares and anxiety

Second

With dyscirculatory encephalopathy of the second degree, there is a general worsening of the symptoms of the disease described above, as well as some new symptoms:

• Incessant pain in the head
• Serious memory difficulties
• Difficulty swallowing and speech disturbances are common
• There is noise in the ears, for this reason the patient begins to hear worse
• Yeast attacks of hands, head
• Cramps that periodically spread to the entire body
• Bright flashes of light in the eyes

At this stage, the manifestations of the disease already make adjustments to the normal course of the patient’s life, as a result of which its quality decreases and the ability to work suffers. Often, even this development of encephalopathy leads to the appointment of a 2nd or 3rd disability group.

Third

• Difficulty with orientation in space and time
• Severe disorders of the sensory organs, in which hearing, vision, touch, and coordination of movements can be severely impaired
• Apathy towards everything around you
• Lack of control over feces and urine excretion
• Convulsions
• Insomnia
• In some cases, complete immobility is observed

This set of symptoms of dyscirculatory encephalopathy leads to the inability to normally perform work duties and even care for oneself, which is why the patient is assigned the first or second degree of disability.

Diagnostics

It is very important that discirculatory encephalopathy is diagnosed as early as possible in order to begin treatment on time and prevent the serious manifestations described in the previous section. An accurate diagnosis requires examination by specialists in various fields of medicine:

Based on the results of the examination and medical history, various examinations are prescribed to help determine the presence of encephalopathy and its degree, usually these are:

• Ophthalmoscopy
• Electroencephalography
• Ultrasound examination of the vessels of the head and neck
• Checking the patency of the cerebral arteries

Additionally, biochemical and general analysis blood, checking for high sugar and cholesterol levels.

Treatment

How to treat such a complex and diverse disease? Considering the multiplicity of manifestations, as well as based on the causes of dyscirculatory disorder, a complex of procedures is used in treatment. Typically therapy is carried out:

• Special medications that help bring blood pressure under control, keeping it normal, and improve metabolic processes in the body. In addition, medications are used for treatment, the task of which is to improve nutrition of the brain by activating its blood supply.
• Physiotherapeutic procedures, including the use of laser therapy, therapeutic electrosleep, special oxygen and radon baths, massages, acupuncture, hirudotherapy.

Timely, targeted treatment can significantly slow down the development of the initial stages. If one of the causes of the disease is high cholesterol, it is very important to change your diet to limit the intake of this substance. Surgery is not used as a method of treating discirculatory encephalopathy, so if the disease is in an advanced form, then most likely you will have to come to terms with it, and with the help of therapy you can only limit further progression.

ethnoscience

In addition, with the permission of the doctor, treatment is often supplemented with traditional methods and methods. Usually it consists of ingesting tinctures of:

• Clover
• hawthorn
• Leaves of strawberry, oregano, birch
• Chamomile with valerian and lemon
• Hops with motherwort and mint

Preventive measures

Prevention consists of constant monitoring of those factors and diseases that lead to encephalopathy due to impaired blood circulation in the brain. For this it is important:

• Check your blood pressure periodically
• Know your blood sugar and cholesterol levels, and if the levels are elevated, then take the necessary actions
• To refuse from bad habits
• Get involved in a light sport
• Watch your weight
• Attend regular clinical examinations

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Coding of dyscirculatory encephalopathy in the ICD

Such dangerous pathology as discirculatory encephalopathy according to ICD 10 has the code “I 67”. This disease belongs to the category of cerebrovascular diseases - a general group of pathological conditions of the brain that are formed as a result of pathological transformations of cerebral vessels and disorders of normal blood circulation.

Features of terminology and encoding

The term "encephalopathy" refers to organic disorders of the brain due to necrosis of nerve cells. Encephalopathy in ICD 10 does not have a special code, since this concept unites a whole group of pathologies of various etiologies. In the International Classification of Diseases, tenth revision (2007), encephalopathies are divided into several headings - “Other cerebrovascular diseases” (heading code “I - 67”) from the class of diseases of the circulatory system and “Other brain lesions” (heading code “G - 93” ) from the class of diseases of the nervous system.

Etiological causes of cerebrovascular disorders

The etiology of encephalopathic disorders is very diverse and different factors can cause different types pathologies. The most common etiological factors are:

• Traumatic brain damage (severe blows, concussions, bruises) causes a chronic or post-traumatic version of the disease.
• Congenital malformations that may occur due to a pathological pregnancy, complicated childbirth, or as a consequence of a genetic defect.
• Chronic hypertension (high blood pressure).
• Atherosclerosis.
• Inflammatory vascular diseases, thrombosis, dyscirculation.
• Chronic poisoning with heavy metals, drugs, toxic substances, alcohol, drug use.
• Venous insufficiency.
• Excessive radiation exposure.
• Endocrine pathologies.
• Ischemic conditions of the brain and vegetative-vascular dystonia.

Classification of cerebrovascular diseases according to ICD 10

According to the ICD, the encephalopathy code can be encrypted under the letter “I” or “G”, depending on the prevailing symptoms and etiology of the disorder. Thus, if the cause of the development of pathology is vascular disorders, when setting clinical diagnosis the code used is “I - 67” - “Other cerebrovascular diseases”, which includes the following subsections:

• Dissection of the cerebral arteries (CB) without the presence of their ruptures (“I – 0”).
• Aneurysm of cerebral vessels without their rupture (“I – 1”).
• Cerebral atherosclerosis (“I – 2”).
• Vascular leukoencephalopathy (progressive) (“I – 3”).
• Hypertensive damage to the brain (“I – 4”).
• Moyamoya disease (“I – 5”).
• Thrombosis of the intracranial venous system is non-purulent (“I – 6”).
• Cerebral arteritis (not classified elsewhere) (“I – 7”).
• Other specified vascular lesions GM (“I – 8”).
• Unspecified cerebrovascular disease (“I – 9”).

In ICD 10, discirculatory encephalopathy does not have a special code, it is a progressive disease that arises due to vascular dysfunctions, it belongs to the headings “I – ​​65” and “I – ​​66”, as it is encrypted with additional codes that clarify the etiology, symptoms or absence thereof.

Classification of encephalopathic lesions of a neurogenic nature and unspecified etiology

If encephalopathy is a consequence of dysfunction of the nervous system, then the pathology is classified under the heading “G - 92” (Toxic encephalopathy) and “G - 93” (Other brain lesions). The last category includes the following subsections:

• Anoxic lesion of the brain, which is not classified in other sections (“G – 93.1”).
• Encephalopathy, unspecified (“G – 93.4”).
• GM compression (“G – 93.5”).
• Reye's syndrome (“G – 93.7”).
• Other specified lesions of the brain (“G – 93.8”).
• GM violation, unspecified (“G – 93.9”).

Clinical symptoms

Manifestations of pathology may be different, depending on the etiology and type, but there are a number of symptoms that are necessarily present in the presence of a cerebrovascular disorder: intense headaches, frequent dizziness, memory disorders, disturbances of consciousness (apathy, persistent depression, desire to die), absent-mindedness and irritability, insomnia. Indifference to others, lack of interests, and difficulty in communication are also noted. Depending on the etiology, emotional disorders, dyspeptic disorders (nausea, vomiting, stool disorders), jaundice, pain in the extremities, obvious weight loss up to cachexia, signs of metabolic disorders (rashes, changes in the skin, swelling) may also be observed.

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Encephalopathy of mixed origin

Encephalopathy of mixed origin is a condition of the brain in which several pathological factors act on it and lead to negative manifestations.

Pathological factors can be completely various diseases and their consequences. Thus, most often dyscirculatory processes (hypertension, atherosclerosis of cerebral vessels, etc.), dysmetabolic processes ( diabetes, toxic goiter, hyperandrogenism, etc.), consequences of injuries, strokes and other factors.

Information for doctors: according to ICD 10, encephalopathy of mixed origin is coded under the code G 93.4. The diagnosis must indicate the factors that led to the disease and the severity of the syndromes.

Reasons for the development of the disease

There are many reasons for the development of mixed encephalopathy. It should be highlighted various groups and briefly describe each of them:

• Discirculatory processes. Described in detail in the article. They are almost always one of the factors leading to the disease.
• Dysmetabolic processes. Includes any endocrine and other metabolic disorders that pathologically affect brain tissue. Diabetes mellitus is the most common endemic goiter. The word toxicodismetabolic can also refer to alcohol abuse.
• Consequences of traumatic brain injuries. Most often, the consequences remain after a brain contusion, however, multiple concussions can also be included when making a diagnosis.
• Residual encephalopathy, meaning any birth defects development of the central nervous system.
• Hypoxic, this factor is set in the presence of severe obstructive pulmonary disease, uncontrolled bronchial asthma, lung tumors, including those operated on with existing insufficiency of external respiration.
• Consequences of ischemic and hemorrhagic strokes, especially in the presence of severe pyramidal insufficiency.
• Consequences surgical interventions on the brain, carried out for any indication (cancer process, etc.).
• Toxic factors. Any poisoning, including alcohol substitutes, metals, carbon monoxide.

Symptoms

Symptoms can be combined into several syndromes, which are similar for any pathological process of the brain. This is cephalgic syndrome (headaches), vestibular disorders(dizziness, throwing to the sides when walking), mood disorders, including neurasthenic syndrome, memory impairment, speech impairment, memory loss. In each case, the symptoms are unique, a lot depends on specific factors which led to a pathological condition.

Diagnostics

Diagnosis is made by identifying factors that can lead to encephalopathy, the presence of complaints, objective and neurological examination. In some cases, neuroimaging studies and other instrumental methods are required.

MR signs include identified consequences of severe pathological conditions of the brain (stroke, head injury, etc.), identification of hydrocephalus. MRI may also reveal focal glial changes, including leukoaraiosis.

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Treatment

Treatment of encephalopathy of mixed origin should, first of all, be aimed at eliminating all pathological influences. It is necessary to control the level of blood pressure, sugar, and monitor the lipid profile. In case of toxic brain damage, the effect of the substance should be eliminated and, if possible, detoxification of the body should be carried out.

Also, all patients in the treatment of encephalopathy of mixed origin are shown neuroprotective and metabolic drugs. Also, depending on the severity of the syndromes, drugs are prescribed that affect dizziness, metabolic processes, and nootropic drugs for decreased cognitive functions.

Disease is a complex problem. All patients should be under the supervision of neurologists or therapists at their place of residence. It is also recommended that all patients undergo inpatient treatment at least once a year, because a complete cure is impossible, but a long period without treatment can lead to a significant increase in all manifestations.

Discirculatory encephalopathy grade 2 ICD 10

The health of your head Miscellaneous Dyscirculatory encephalopathy of the brain: symptoms and treatment

Dyscirculatory encephalopathy of the brain: symptoms and treatment

Discirculatory encephalopathy (Latin prefix “dis-” #8212; disorder, “circulatio” #8212; blood supply, circulation, circulation; and also from Latin “encephalos” #8212; brain, “-pathia” #8212; pathology, dysfunction) is a pathological, gradually developing process in the brain, manifested by nonspecific cerebral symptoms and ultimately leading to irreversible changes in brain tissue. Russian doctors abbreviate this diagnosis in medical histories with the abbreviation “DE”.

Causes

1. Atherosclerosis. The disease occurs most often as a result of damage to cerebral (brain) vessels by atherosclerosis.
2. Hypertension (HTN). It is a risk factor and goes in the background (one might say, hand in hand) with DE. If blood pressure high, it means that the vessels are in increased tone, therefore there is a decrease in blood flow in the brain. The combination of “atherosclerosis + hypertension” is not uncommon.
3. Osteochondrosis cervical spine spine with degeneration bone tissue, osteophytes (bone growths) and disc herniations. Vertebral arteries are compressed by the named structures, so it does not reach the brain required amount blood.
4. Post-traumatic complications – with injuries to the head and cervical spine (especially the upper vertebrae).
5. Consequences of other cerebrovascular diseases: cerebral infarctions. non-traumatic hemorrhages, etc.
6. Periodic spasms. In this case, the disease is associated with the characteristics of the autonomic nervous system of a particular person. If the sympathetic (excitatory) component predominates, then the vessels often and quickly contract, sometimes to a pathologically narrow lumen.

Pathogenesis

Atherosclerosis of the cerebral arteries is the formation of pathological lipid deposits - plaques (atheromas) in the inner lining (intima) of the vascular wall. As the size of the plaques increases, the lumen of the vessel decreases and, accordingly, the blood flow to the brain tissue decreases. The process is further aggravated by the fact that platelets begin to “sit” on the atheromas, causing thickening of the blood in a certain area of ​​the vessel and the risk of blockage.

In fact, DE and cerebral infarction (the outdated name is stroke) are one and the same thing, only cerebral infarction occurs quickly, and DE lasts for years.

Complications

• Brain swelling.
• Cerebral infarction caused by complete occlusion of the lumen of a vessel by an atherosclerotic plaque and/or thrombus.
• Vessel rupture (less commonly).
• Vascular dementia is a mental and behavioral pathology caused by many years of progressive dyscirculatory encephalopathy.
• Transient ischemic attacks (TIA) - in this case, there is a combination of cerebral atherosclerosis with increased spasm. The latter can occur due to congenital (predominance of the sympathetic) or acquired (traumatic brain injury) characteristics of the autonomic system.

Symptoms and characteristic signs

• Headaches – caused by decreased blood flow to the head as a result of constriction cerebral arteries. Hypoxia and slight cerebral edema occur.
• Dizziness occurs for the same reason as a headache, only this requires a sharp and almost complete spasm of blood vessels.
• Reaction to changes in weather - usually occurs when dyscirculatory encephalopathy is combined with hypertension.
• Disturbances in the emotional and behavioral sphere. It is on this basis that the degrees of DE are classified: 1st, 2nd and 3rd.
• The first degree is characterized by periodic headaches, fatigue and fatigue (this is caused by hypoxia of brain cells). Sometimes dizziness and insomnia occur.
• The second degree is characterized by the beginning of changes in behavioral characteristics. A person may become more aggressive, suspicious, withdrawn, irritable, and easily “explode.” However, self-criticism still persists, because such a patient himself understands that “something is wrong” with him, therefore, he needs to consult a neurologist.
• The third degree is the most severe, which results in disability. It manifests itself in a person’s complete loss of self-criticism, behavioral oddities (for example, kleptomania or dragging various rubbish from garbage dumps into the apartment), an inadequate reaction to external factors and people (loud swearing without knowledge and good reason or lack of emotional manifestations), serious “lapses” in memory. Often such a patient becomes like a child who needs constant supervision and care.

Dyscirculatory encephalopathy in the international classification of diseases (or abbreviated as ICD-10)

According to ICD-10, there is one four-digit code that can be used to encrypt DE - this is I67.2. Literally it means cerebral atherosclerosis. Since 90% of the cause of DE is cerebral vascular atherosclerosis, this classification is considered correct and justified.

There is another option - hypertensive encephalopathy (combination “DE + GB”), coded as I67.4.

Diagnosis and treatment

The first is complaints, anamnesis. neurological status. The second is MRI. Zones of clearing (leukoaraiosis) are identified, and with contrast it is clear that the contrast agent does not reach these areas. The third is Doppler ultrasound (ultrasound) of the neck vessels. The locations and degrees of narrowing of the vertebral arteries are identified.

Treatment includes several groups of pharmacological drugs:

• Agents that improve metabolism (metabolism) in neurons - Mildronate, Mexicor, Cortexy.
• Nootropic drugs to improve interneuron connections - Nootropil, Piracetam.
• B vitamins to support redox processes in the nervous system - Milgamma.
• Prevention of progression of atherosclerosis - Atorvostatin, Lovastatin.
• Reduced thrombosis - Thrombo ACC, Aspirin cardio.

Other brain lesions (G93)

Acquired porencephalic cyst

Excluded:

• periventricular acquired cyst of the newborn (P91.1)
• congenital cerebral cyst (Q04.6)

Excluded:

• complicating:
  • abortion, ectopic or molar pregnancy (O00-O07, O08.8)
  • pregnancy, labor or delivery (O29.2, O74.3, O89.2)
  • surgical and medical care(T80-T88)
• neonatal anoxia (P21.9)

Excludes: hypertensive encephalopathy (I67.4)

Benign myalgic encephalomyelitis

Compression of the brain (trunk)

Infringement of the brain (brain stem)

Excluded:

• traumatic compression of the brain (S06.2)
• focal traumatic compression of the brain (S06.3)

Excluded: cerebral edema:

• due to birth trauma(P11.0)
• traumatic (S06.1)

Radiation-induced encephalopathy

If it is necessary to identify an external factor, use an additional code external reasons(Class XX).

In Russia International classification of diseases of the 10th revision (ICD-10) was adopted as a single normative document for recording morbidity, reasons for the population’s visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

ICD 10 ICD dyscirculatory encephalopathy

Encephalopathy

Discirculatory encephalopathy is a diffuse or focal lesion of the brain substance due to pathological changes in blood vessels. As you know, the DEP code according to ICD 10 belongs to the extensive IX class - “Diseases of the circulatory system”.

The International Classification of Diseases is valid in all medical institutions and is necessary to obtain the most important statistical data. Thanks to this system, we have an idea of ​​the structure of mortality and morbidity among huge masses of the population.

In ICD 10, DEP is located in the heading I60-I69, but there is no diagnosis of “Dyscirculatory encephalopathy” itself, so it is encrypted in accordance with the characteristic symptoms:

For many reasons, such as atherosclerosis, arterial hypertension, bad habits, dysmetabolic processes, etc., blood vessels cannot fully supply the brain tissue with sufficient oxygen and nutrients.

Nervous tissue gradually atrophies, foci of necrosis and sclerosis appear - diffuse and focal damage occurs, which leads to loss of mental, emotional, and motor activity. A cerebrovascular syndrome occurs, which according to the ICD is encrypted in section I69 - “Consequences of cerebrovascular diseases.”

All symptoms are constantly progressing and with decompensation it is possible acute complication in the form of ischemic or hemorrhagic stroke. In accordance with the etiology of origin, the following types of DEP are distinguished:

• associated with arterial hypertension;
• atherosclerotic origin;
• inflammatory genesis;
• toxic damage;
• other systemic diseases with vascular damage.

To slow the progression of discirculatory encephalopathy and prevent complications, it is necessary to prescribe appropriate therapy as early as possible.

Post-traumatic encephalopathy, ICD 10: symptoms, treatment

Post-traumatic encephalopathy of the brain is any change in the structure and function of an organ caused by mechanical impact. The insidiousness and danger of this condition lies in the fact that its symptoms can appear and begin to develop after what seems to be a complete recovery.

ICD 10

Post-traumatic encephalopathy is most often coded T90.5 as a consequence of intracranial injury. Additionally, G93.8 (other specified brain pathologies) is also used. In the diagnosis in mandatory the damage and its type are indicated. For example, according to ICD 10, post-traumatic encephalopathy can be caused by a bruise of varying severity, diffuse axonal damage, and so on. The diagnosis also indicates the date, and the syndromic part describes the manifestations. It must be said that a concussion does not provoke consequences. In this case, post-traumatic encephalopathy can only be described in the presence of necessarily documented multiple concussions. It can manifest itself as the only or leading syndrome. In this case, according to the ICD, post-traumatic encephalopathy is coded under G91.

Causes and development of pathology

Post-traumatic encephalopathy is usually a consequence of TBI. If we talk about the development mechanism, then we should distinguish 5 stages:

• Direct damage to nerve tissue(usually temporal and frontal lobes) at the moment of impact.
• Change in blood supply to the brain due to swelling.
• Disturbances in the circulation of cerebrospinal fluid (CSF) due to compression of the ventricles.
• Replacement of nerve cells with connective tissue due to lack of regeneration, adhesions and scars form.
• Pathological response protective system organism, as a result of which the immune system begins to perceive its own nerve cells as foreign (autoneurosensitization).

Clinical picture

Symptoms mainly depend on the size of the lesion and location. If post-traumatic encephalopathy is accompanied diffuse changes, then the manifestations will be more pronounced. Typically, the following symptoms are observed:

• Neuro-asthenic syndrome caused by weakening of the nervous system.
• Involuntary rapid twitching of the pupils (nystagmus).
• Pulsating constant pain in the head, caused by disturbances in lymph circulation. Conventional analgesics do not help.
• Dizziness, especially during physical overexertion.
• Sleep disorder. Post-traumatic encephalopathy is accompanied by insomnia or interrupted sleep. In this regard, there is a need to take sleeping pills daily, which, in turn, adversely affects the nervous system.
• Emotional lability is a violation of control over behavior. A person may experience unreasonable aggression towards others.
• Decreased intellectual level, memory impairment. These symptoms are especially characteristic of those who engage in mental work.
• Depressive states. As a rule, they develop as a result of a person’s awareness of his powerlessness over the disease.
• Epileptic seizures. They are caused by damage to certain brain areas and the formation of foci of painful activity.

It should be noted that the above symptoms appear several months or years after the incident.

Diagnostic measures

They are based on a very careful collection of anamnestic data that may indicate the presence of a TBI in the past. Post-traumatic encephalopathy is confirmed by CT or MRI. During these studies, the specialist receives detailed information about diffuse or focal changes medulla. At the same time, differentiated diagnostics are carried out to exclude other pathologies of the central nervous system, which are accompanied by similar symptoms. Electroencephalography can be used as an additional study. It allows you to identify the localization of the pathological focus of epileptic activity.

Post-traumatic encephalopathy: treatment

Therapeutic measures should be aimed at neuroprotection - ensuring the protection of nerve cells from various negative factors. Treatment should also help normalize blood circulation processes, restore brain cell metabolism and cognitive functions. Nootropic therapy is used for this. It is also important symptomatic treatment, especially in the presence of hydrocephalus syndrome. In this case it is necessary to use special means that help eliminate swelling. These, in particular, include drugs such as Diacarb, a glycerin mixture. Antiepileptic drugs are prescribed if necessary (in case of seizures). Courses of this complex therapy should be carried out once or twice a year. As a rule, Gliatilin (Cerepro), Mexidol, Actovegin are used among neuroprotective drugs. Nootropic therapy uses racetams (Piracetam for example), as well as drugs such as Pantogam, Phenotropil and others. In addition to the main (traditional) medicinal effects, exercise therapy and massage are used. Special meaning during the rehabilitation period, the patient’s lifestyle, sleep patterns, and nutrition. Any stressful situations, adversely affecting the state of the nervous system. You should also give up bad habits.

Forecast and consequences

Despite the treatment, brain tissue continues to be destroyed under the influence of its own immunity. In this regard, the prognosis for this pathology is very unfavorable. The methods used today can only slow down the development of the pathological process, alleviate the symptoms of the disease, relieve acute conditions, but not completely stop it.

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Residual encephalopathy is a pathological condition of the central nervous system, expressed in the death of its brain cells. This pathology is a rather serious brain lesion and has been studied in detail in the medical and scientific sphere.

According to the ICD 10th revision, residual encephalopathy is classified by different codes according to the nature of its manifestation and general pathogenesis. In today’s article we will pay attention to the general essence of this pathology, the signs and causes of its occurrence, as well as available methods therapy. Interesting? Then be sure to read the material below to the end.

Representation of residual encephalopathy according to ICD-10

As noted above, residual encephalopathy is a lesion of the central nervous system, which is expressed in the death of brain cells and the consequences that follow this process.

Diagnoses with the name of this disease are not very uncommon in neurological practice, so its consideration has always been relevant to the general public. Factors in the development of pathology can be completely different phenomena - from injuries to birth defects, but in any case, cell death will be of a residual nature (that is, persistent).

ICD-10, the basic international classifier of human diseases, considers residual encephalopathy rather controversially, providing doctors with ordinary people the ability to characterize this disease with different codes.

In general, the pathology is assigned the coding “G93.4”, which equates it to any encephalopathy of unspecified pathogenesis.

However, if certain factors are present, the diagnosis of “residual encephalopathy” can be considered under other codes, namely:

• G93.8 (damage to central nervous system cells in the brain under the influence of radiation)
• T90.5 (traumatic pathogenesis of nerve cell death)
• T90.8 (traumatic pathogenesis of nerve cell death)

In most medical institutions, neurologists assign the described coding to residual encephalopathy. In addition to the classification according to the ICD, when making a diagnosis of the disease in question, doctors must indicate the reasons for its development and the nature of its manifestation.

Main causes of pathology

Since residual encephalopathy refers to versatile lesions of the central nervous system that persist for a long time in the brain, there are many causes for this disease.

To the main causal factors pathologies should include:

1. generic and congenital anomalies(for perinatal lesions)
2. brain injuries (for traumatic lesions)
3. pathologies of brain development - Arnold-Chiari malformation or hydrocephalus, for example (with dysontogenetic lesions)
4. previous neuroinfection (with neuroinfectious lesions)
5. previous neurosurgical operations (for acquired lesions)
6. row serious illnesses body and brain in particular (diabetes mellitus, liver or kidney dysfunction, etc.)

It should be noted that the reasons discussed above are only a relatively small part of the factors that can provoke the development of residual encephalopathy.

This disease, under certain circumstances, can also arise under the influence of other factors traumatic to the central nervous system, which, after the end of their effect on the human body, leave corresponding neurological symptoms.

Signs and symptoms of brain damage

The severity and nature of the symptoms of residual encephalopathy directly depend on the severity of the damage to the central nervous system. Since the reasons and types of this disease There is a huge amount, then the signs of its manifestation can be varied.

The main and most common symptoms of persistent encephalopathy include:

• chronic headaches
• dizziness and other disturbances in coordination of movements
• increased weakness
• severe fatigue when doing normal activities
• frequent mood swings
• sleep problems
• memory impairment
• weakening of thinking abilities
• increased frequency of limb spasms

With severe brain damage, the signs of the disease are often supplemented by:

• Parkinson's syndrome
• increased arterial and intracranial pressure
• epileptic seizures
• pseudobulbar syndrome

Assessing the symptoms manifested when identifying residual encephalopathy plays an important role, but in the absence of other diagnostic methods it is often meaningless.

As practice shows, it is almost impossible to accurately identify this disease solely at the stage of collecting an anamnesis.

For a high-quality and most accurate diagnosis, it is also important to identify a neurological deficit through instrumental methods research. IN otherwise, the patient’s complaints are only indirect signs of residual encephalopathy, which are definitely not enough to start therapy for this particular pathology.

Methods for diagnosing encephalopathy

If residual encephalopathy is suspected, a high-quality diagnosis from a specialist is important. In this case, the specialized doctor is a neurologist, and it is advisable to contact him at the first manifestation of symptoms of neurological damage to the body.

In most cases, further examination of the patient will include alternating changes in the following types of diagnostics:

1. Taking an anamnesis, during which the nature of the manifestation of disorders and their potential relationship with brain damage is determined.
2. Neurological studies and tests aimed at primary diagnosis residual encephalopathy.

Instrumental examination methods, which necessarily include:

• Electroencephalography (determination of central nervous system lesions).
• (clarification of the nature of existing pathologies).
• CT scan, skull x-ray and craniography (used to confirm the final diagnosis).

In addition to carrying out the diagnostic methods discussed, patients with suspected residual encephalopathy also take several types and a urine sample. Such an approach in terms of organizing diagnostic procedures is necessary to neutralize all possible risks of making an inaccurate diagnosis and correct definition further vector of therapy. In many ways, the success of future treatment of residual encephalopathy depends on the literacy and quality of the diagnosis.

Treatment of the disease and its prognosis

Treatment of residual encephalopathy is a complex procedure, the implementation procedure of which is determined for each patient individually. As a rule, therapy is medicinal in nature.

Depending on the characteristics of a particular patient, he may be prescribed:

• non-steroidal anti-inflammatory drugs
• anticonvulsants
• nootropic drugs to improve blood supply to the brain
• hormonal medications
• vitamin complexes

The method of taking medications is also individual. For some patients, tablet medications are sufficient, while for others, only intravenous administration medicines. In addition to the basis of treatment - drugs, the following are also prescribed:

• antisymptomatic therapies
• massages
• physiotherapy
• acupuncture procedures
• cranial osteopathy

Surgical intervention for residual encephalopathy is extremely rarely required, due to its pointlessness. The main and, perhaps, the only significant indications for brain surgery are the presence of intracranial tumors or severe traumatic brain injuries. In other cases, only drug and procedural therapy methods are used.

It should be noted that for the majority of patients with residual encephalopathy, a positive prognosis for treatment of the disease is made. However, in this regard, the severity of the ongoing pathology and the pathogenesis of its development play an important role. Naturally, in extremely complex and advanced cases, no one will give a favorable prognosis to anyone. Under other circumstances, well-organized therapy is quite capable of completely or partially overcoming residual encephalopathy.

Possible complications and preventive measures

Unfortunately, if there is a delay in seeing a doctor or improperly organized therapy, residual encephalopathy often provokes the development of complications.

The main consequences of the disease are considered to be:

1. cerebral paralysis
2. hydrocephalus
3. residual brain dysfunction
4. Parkinson's disease
5. cerebral hypertension
6. development of epilepsy
7. to whom

It is not difficult to reduce the risks of developing both complications and irreversible consequences in the brain. It is enough to organize therapy in time and adhere to some preventive measures.

Among the latter it is worth highlighting:

• Periodic examinations in the neurologist's office.
• Maintaining healthy image life.
• Restriction from strong emotional shocks and stress.
• Timely treatment of all diseases of the body.
• Frequent walks in the fresh air.

Naturally, prevention is not a guarantee of residual encephalopathy or its complications, but if implemented correctly, it is quite capable of helping. At a minimum, taking the above measures will speed up the process of treating neurological lesions and reduce the nature of their manifestation.

You can learn more about the pathology from the video:

Since a considerable number of diagnoses with residual encephalopathy are made to newborn children, special attention to the importance of giving up bad habits and a healthy lifestyle should be given to expectant mothers. Do not forget that compliance with such measures is of enormous importance for the health of the fetus, so abandoning them, at least during pregnancy, is unacceptable.

Perhaps this is where the most important provisions on the topic of today’s article have come to an end. We hope that the material presented was useful to you and provided answers to your questions. Good health to you!

Excludes: hypertensive encephalopathy (I67.4)

Benign myalgic encephalomyelitis

Compression of the brain (trunk)

Infringement of the brain (brain stem)

Excluded:

• traumatic compression of the brain (S06.2)
• focal traumatic compression of the brain (S06.3)

Excluded: cerebral edema:

• due to birth trauma (P11.0)
• traumatic (S06.1)

Radiation-induced encephalopathy

If it is necessary to identify an external factor, use an additional code of external causes (class XX).

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Help-Alco.ru

Alcoholic encephalopathy of the brain: symptoms, treatment, ICD-10 code

Alcoholic encephalopathy refers to a group of brain diseases combined general symptoms and the cause of its occurrence. At its core, the disease is severe alcoholic psychosis associated with the process of brain cell death.

In the history of alcoholic encephalopathy, psychosis is the first factor - mental manifestations and symptoms. The disease is characterized by compatibility of mental symptoms, somatic and neurological manifestations. The reason for the development of pathology is always the same - systematic alcohol abuse and chronic alcoholism.

Encephalopathy of combined genesis is a collective concept that combines a number of pathological conditions that lead to suffering in the brain. The word encephalopathy in the diagnosis indicates suffering of the brain (encephalon - brain, pathos suffering, disease). The words of combined genesis in the formulation of the diagnosis indicate the presence of a combination of factors that can lead to brain suffering. Most often, such factors include a combination of a vascular component (a history of stroke), and a dysmetabolic process (diabetes mellitus, decompensated conditions from the thyroid gland), also such genesis can participate pathological conditions such as traumatic brain injury, the consequences of toxic brain damage (including long-term chemotherapy for cancer), the consequences of brain surgery, chronic and acute hyposkic conditions (bronchial asthma, carbon monoxide poisoning, COPD, etc.) . Sometimes (although, in the author’s opinion, this is not the best approach) the terminology used is encephalopathy of mixed origin, or, which is clearly incorrect terminology, mixed encephalopathy or encephalopathy of complex origin.

Information for doctors. According to ICD 10, the diagnosis is encrypted with code G93.4 - encephalopathy, unspecified. Although the term encephalopathy of combined genesis and as such a diagnosis are not used in foreign practice. In our country, there are no clear standards for the management and approach to diagnosing patients with this condition. The diagnosis must indicate all the factors that led to the development of the pathological condition; after these factors are indicated, there is a list of syndromes, for example, vestibulo-coordinator syndrome, indicating the degree of its severity.

A little about encephalopathy of combined genesis

Encephalopathy of combined genesis, as mentioned above, develops due to various factors. One of the main ones is a chronic discirculatory process, leading to chronic cerebral circulatory failure. The cause of these conditions are conditions such as cerebral atherosclerosis, as well as hypertension, which leads to micro- and macroangiopathy of blood vessels.

Often some other process, including multiple ones, is no less important and has a predominant nature. previous injuries brain, and sometimes there is a combination of 3 or more factors leading to brain suffering. That is why it is important to identify all risk factors and pathological conditions of a systemic nature (for example, diabetes mellitus).

Symptoms and diagnosis of encephalopathy of combined origin

The symptoms of encephalopathy are varied. The disease may cause such syndromes as cephalgic (that is, headache), asthenic (general weakness), cognitive impairment (memory loss), sleep disturbances, symptomatic epilepsy, hemiparesis and many other disorders. Dizziness to one degree or another occurs in more than half of patients with this diagnosis, ranks first in importance among all manifestations and will be considered separately.

There are no clear diagnostic criteria for making a diagnosis. The diagnosis is initially made mainly on the basis of complaints, anamnesis (identifying risk factors, the presence of chronic diseases, traumatic brain injuries, etc.), data from a neurological examination. In the neurological status, reflexes of oral automatism, anisoreflexia, and the presence of pathological reflexes, coordination violations.

For differential diagnosis It is important to conduct a neuroimaging study (MRI, MSCT of the brain) to exclude oncological lesions of the brain, determine the size of the defect after injury, etc., duplex scanning of the vessels of the neck and head, and electroencephalographic studies.

Dizziness with encephalopathy of combined origin

Dizziness with encephalopathy can usually be non-systemic in nature and is expressed more in the form of feelings of instability and weakness. The time of occurrence and provoking factors can be very diverse. There are no clear criteria for diagnosing this syndrome; often dizziness with this disease is completely psychogenic in nature.

Objectification of the presence of dizziness due to pathological processes is complex process. The most important symptoms The procedures tested for dizziness are fairly routine (but no less important) procedures: conducting cordinatory tests, identifying instability, and gait disturbances.

Treatment of encephalopathy of combined origin

Therapy for encephalopathy of combined origin should be directed, first of all. To eliminate factors leading to brain damage, if possible. It is necessary to correct blood sugar levels, normalize cholesterol metabolism, and correct changes in blood pressure. This part represents basic therapy and is also often equally important symptomatic therapy, which is selected taking into account the existing manifestations, as well as the individual characteristics of each person.

At cognitive deficit nootropic drugs are used (Pronoran, Gingko preparations and others). In the presence of symptomatic epilepsy, adequate anticonvulsant therapy is used. For headaches, it makes sense to use courses of “vascular” or neuroprotective drugs. It is important to conduct rational psychotherapeutic conversations in which it is necessary to explain the causes of the disease, as well as available methods correction of disorders with the elimination of modifiable risk factors.

It makes sense to carry out a course of treatment of encephalopathy of combined genesis in an outpatient setting, because There is usually no need for injectable drugs and long-term correction of risk factors and patient education are required the right image life.

Video material by the author

Therapy of dizziness in encephalopathy of combined origin

Treatment of dizziness in encephalopathies of combined genesis is sometimes challenging task. Classically used drugs (,), vinpocetine (), gingko biloba (,). The effectiveness of each of them is a matter of long-term analysis, because there is no drug that is ideal in any case of dizziness. Non-drug methods are also very important, in particular.

Dizziness due to encephalopathy is usually quite well corrected, although regular repeated courses of treatment are often required.