Small focal changes in brain matter treatment. Focal changes in the brain of a dystrophic nature. Causes of focal changes in the brain

Relevance. In recent years, widespread implementation the latest methods neuroimaging has expanded the possibilities of studying neurological processes that are manifested by multifocal changes in the brain. Differential diagnosis such changes present significant difficulties. High tissue contrast, the possibility of multi-planar imaging, lack of radiation exposure, and non-invasiveness make magnetic resonance imaging (MRI) the method of choice. However, a number of vascular, inflammatory, infectious and hereditary diseases may have a similar MRI picture.

The term “demyelinating diseases” (DD) of the central nervous system usually refers to primary, usually idiopathic, pathological processes that cause destruction of normally developed myelin. Processes such as vascular (dyscirculatory, hypertensive) encephalopathy, vasculitis, a number of infectious diseases, neurotrauma, degenerative diseases nervous system and many others also cause loss of myelin pathways, which is accompanied by corresponding changes in signal characteristics on MRI. But these processes have a different etiology and pathogenesis, which does not allow them to be included in the group of DD.

Multiple sclerosis(MS) is a chronic, progressive disease of the central nervous system, manifested by diffuse neurological symptoms and, in typical cases, having initial stages relapsing course (Adams R., 1993). MRI has high sensitivity in identifying lesions of MS, significantly exceeding the capabilities of both clinical examination and other neuroimaging methods. However, the specificity of MRI in diagnosing MS is no more than 80%, which is due to the fact that lesions in the white matter, similar to lesions in MS, can be observed both in healthy individuals and in patients suffering from vascular encephalopathy, migraine, vasculitis, bacterial and viral infection and a number of other diseases.

Currently international group Experts in the field of MS have accepted the following for relapsing-remitting MS:

Diagnosis requires the presence of at least three of the listed criteria. These criteria allow some patients to be diagnosed with multiple sclerosis earlier than standard methods for diagnosing clinically significant multiple sclerosis. In many patients, already in the early stages of the disease, MRI of the brain reveals multiple foci confirming “in situ” dissemination. These may include hyperintensity lesions on T2-weighted images (especially with FLAIR) in the white matter and black holes on T1-weighted images associated with atrophy. nerve fibers. When contrast enhancement is used, active lesions can be identified on T1-weighted images, since paramagnetic contrast accumulates in areas of increased BBB permeability and active inflammation. Typical localization of lesions, usually 0.2 - 1.0 cm in size, are:

Sometimes it is possible for the process to spread to the gray matter - to the subcortical nuclei. The lesion is often asymmetrical and bilateral. Periventricularly located RS plaques are oval in shape and located perpendicular to the lateral ventricles (“Dawson’s fingers”). The perifocal reaction in the form of edema can be weak, only in the “active” phase. MS lesions may accumulate contrast agent, reflecting impaired permeability of the blood-brain barrier. There are 3 types of contrasting plaques in MS (Pronin I.N. et al., 2003):
Hypoxic encephalopathies. In patients over 40 years of age, small focal brain lesions occur due to hypoxic encephalopathies (dyscirculatory encephalopathy, Binswanger's disease). This is due to atrophy of the myelin sheaths caused by atherosclerotic damage to the arterioles and the resulting chronic hypoxia. This process occurs asymmetrically bilaterally with localization in both deep and subcortical white matter. There is no perifocal reaction. With contrast enhancement, the intensity of the MR signal on T1 VI does not change (there is no accumulation of contrast agent).

With discirculatory encephalopathy, hydrocephalus often develops, both external (manifested by expansion of the subarachnoid spaces) and internal (enlargement of the ventricular system), due to atrophy of the brain substance.

In contrast to demyelinating processes, in hypoxic encephalopathies there are similar changes in the basal ganglia, zones of glial-atrophic changes after ischemic cerebrovascular accidents or lacunar infarctions, and expanded perivascular Robin-Virchow spaces are visualized. Leukoaraiosis is often detected periventricularly (areas of diffuse increased MR signal on T2 VI in FLAIR mode around the lateral ventricles, often bordering the horns of the ventricles) [to contents].

Migraine. Migraine is typical for young patients. An MRI examination reveals multiple, small (up to 0.5 cm) rounded lesions localized in the white matter of the hemispheres, sometimes in the subcortical nuclei, and are not found subtentorially. There is no perifocal reaction, no accumulation of contrast agent. The occurrence of such glial changes is associated with the development of vasculopathy of small arterioles [to contents].

Traumatic brain injury. With traumatic brain injury, multiple focal changes in the brain substance can be observed. More often, such foci are identified in mild trauma such as a concussion, but sometimes in severe neurotrauma such as DAP (diffuse axonal damage). The lesions can have different sizes and are most often localized in the splenium of the corpus callosum, pons, and midbrain. IN acute period injuries are characterized by the presence of a hemorrhagic component. IN long term There is no swelling of the brain substance around post-traumatic lesions, no accumulation of contrast agent [

All types of circulatory disorders in the human body also affect the substance of the brain, which ultimately affects its integrity and the ability to function normally.

And “starvation” of cells, which is provoked by a violation or complete cessation of blood supply (in medicine, this process is called ischemia), causes a change in the brain substance of a dystrophic nature. That is, degeneration, and sometimes, although very rarely, even the disappearance of tissues and a significant deterioration in their function.

More about this pathological condition we'll talk about it in the article.

Types of changes

In medicine, dystrophic manifestations in the brain substance are divided into two types:

Diffuse.
Focal.

In the first case, pathological changes spread evenly to the entire brain, and not to its individual areas. They are caused either by general disturbances in the functioning of the blood supply system or by infections (meningitis, encephalitis, etc.).

Diffuse changes are manifested mainly by a decrease in a person’s performance, a dull headache, difficulty switching to another type of activity, a narrowing of the patient’s range of interests, apathy and sleep disorders.

And what a focal change in the brain substance of a dystrophic nature is can be understood by the fact that it can be caused by various minor pathologies:

cysts (small cavities that form in the brain),
small foci of necrosis (tissue death in certain areas caused by lack of nutrients);
gliomesodermal (intracerebral) scars that occur after injuries and concussions;
minor changes in the structure of the brain matter.

That is, these are pathologies that cause disturbances in the blood supply in a small area. True, they can be either single or multiple.

Causes of dystrophy

The full picture of the appearance of dystrophic changes is not yet clear to researchers. But numerous observations have led to the conclusion that most cases of this pathology have a genetic predisposition. The action of provoking factors only accelerates the development of the process or enhances its manifestation.

Therefore, the reasons that cause focal changes in the brain substance of a dystrophic nature can be safely divided into genetic abnormalities and acquired ones. Although it should be noted that acquired causes are still a very conditional definition in this case, since they begin their destructive effect only if the patient is predisposed to the specified pathology.

Focal changes in the brain substance of a dystrophic nature: symptoms of disease development

Symptoms of changes in the substance of the brain of a dystrophic nature most often appear quite clearly, but, unfortunately, this happens when the disease has already progressed significantly. Therefore, it is important to pay attention to the appearance of even small deviations in health.

Is there an age limit for the disease?

It should be noted that single focal changes in the brain substance of a dystrophic nature occur not only in older people, but also in people under fifty years of age.

Stress, injuries, stressful situations, hypertension and other provoking factors can trigger the development focal changes. The constant overstrain that many able-bodied citizens experience also plays its unseemly role.

Increased brain function against the background of what is present in youth, as well as ischemia in old age, can equally lead to the emergence of foci of dystrophic changes with all the ensuing consequences. And it follows from this that timely and properly organized rest is a very important part of the prevention of the described pathology.

What diseases are accompanied by dystrophic changes in the brain?

Focal changes in the substance of the brain of a dystrophic nature, as a rule, are provoked by very common disorders of the functioning of blood vessels. These include:

vasomotor dystonia,
atherosclerosis,
arterial hypertension,
aneurysm of blood vessels in the brain and
cardiocerebral syndrome.

The diseases are also accompanied by the described irreversible changes in the brain - everyone knows the problems caused by Parkinson's, Alzheimer's or Pick's disease.

How is the diagnosis made?

The diagnosis of “focal changes in the brain substance of a dystrophic nature” is quite difficult to establish. This requires identifying the signs of the pathologies listed above and excluding other somatic diseases and possible neuroses. By the way, people with diabetes and rheumatism are also at risk.

The doctor must assess the patient’s condition and conduct the necessary examinations. The most accurate indications are provided by an MRI study, where lesions can be identified, as well as their size and location. Tomography makes it possible to determine changes in the density of brain tissue even in the initial stage of the disease. Correctly reading the MRI results is an important step in starting treatment for the problem described.

Focal changes in the brain substance of a dystrophic nature: treatment

As mentioned earlier, the exact cause of the appearance of this pathology, unfortunately, has not yet been established. And the diseases diagnosed along with it are more likely to be factors that only provoke the onset of its development or intensify processes that have already begun, and not the main cause of the disease.

Therefore, its treatment consists mainly of normalizing the patient’s daily routine and a proper diet, including foods that contain organic acids (baked and fresh apples, cherries, sauerkraut), as well as seafood and walnuts. The use hard cheeses, cottage cheese and milk will have to be limited, since excess calcium causes difficulty in oxygen metabolism in the blood, and this supports ischemia and isolated focal changes in the brain substance of a dystrophic nature.

In addition, the patient cannot do without symptomatic therapy, which involves prescribing drugs that affect cerebral circulation and reduce blood viscosity, taking analgesics, sedatives and B vitamins. However, this is a separate and rather extensive topic.

anonymously

Hello! Today my mother underwent an MRI examination of the brain, after which the clinic gave the conclusion: “On a series of T1 and T2 weighted MRI scans in three projections, sub- and supratentorial structures are visualized. The lateral and third ventricles of the brain are slightly dilated. The fourth the ventricle is not changed, the basal cisterns are of normal caliber. The chiasmal region is without features, the pituitary tissue has a normal signal. The subarachnoid convexital spaces and grooves are slightly expanded in the area of the parietal lobes and Sylvian fissures with moderately pronounced atrophic changes brain substances. The midline structures are not displaced. The cerebellar amygdala is located usually. In the white matter of the parietal and temporal lobes, multiple hydrophilic foci of different sizes, small areas of gliosis, and enlarged Virchow-Robin spaces are detected. CONCLUSION: MR picture of moderately expressed mixed replacement hydrocephalus. Multiple focal-dystrophic substances of the brain." My mother is 41 years old. Recently she began to complain of: - "swings as if on waves"; - Nausea; - Dizziness; - Periodic severe headaches (in the occipital region); - Stuffed ears ; - Memory deterioration; - Unable to concentrate on anything; - Sleep disturbance; - Weakness; - Nervousness. Please explain the situation, diagnosis, treatment... Thank you in advance! P.S.: Before the study, I completed a course of treatment prescribed by a neurologist: "1) Actovegin 2.0 IV in saline solution; 2) "Mexidol" 2.0 IM; 3) Platiphylline 1.0 IM." During the course of treatment, the health situation worsened. At the end of treatment positive results did not have.

Hello! Focal changes in the substance of the brain of a dystrophic nature - this is literally - as a result of a local (local) disruption of the blood supply (age-related, toxic or other nature) there are atrophied (dead) areas of brain tissue. This is how encephalopathy manifests itself. Treatment usually includes vasoactive drugs, so-called “cerebral circulation optimizers”: trental, cinnarizine, stugeron, etc. vascular insufficiency In the vertebrobasilar system, preference is given to stugeron and sibelium. betserku. If the patient has a combination of atherosclerotic lesions of the blood vessels of the brain and extremities, a prescription is indicated. Nootropics (gliatilin, cortexin, ceraxon). Decongestants (diacarb, veroshpiron).

A consultation with a neurologist on the topic “Please explain the conclusion of an MRI of the brain” is given for informational purposes only. Based on the results of the consultation received, please consult a doctor, including to identify possible contraindications.

About the consultant

Details

Neurologist, Candidate of Medical Sciences, medical experience: more than 17 years.
Author of more than 50 publications and scientific works, an active participant in conferences, seminars and congresses of neurologists in Russia.

Sphere of professional interests:
-diagnosis, treatment and prevention of neurological diseases (vegetative-vascular dystonia, dyscirculatory encephalopathy, consequences of strokes, arterial and venous disorders, memory impairment, attention, neurotic disorders and asthenic conditions, panic attacks, osteochondrosis, vertebrogenic radiculopathies, chronic pain syndrome).
- Patients with complaints of migraines, headaches, dizziness, tinnitus, numbness and weakness of the limbs, disorders of the autonomic nervous system, depressive and anxiety states, panic attacks, acute and chronic back pain and herniated discs.
- Functional diagnostics of the nervous system: electroencephalogram (EEG), ultrasound Dopplerography of the carotid and vertebral arteries (USDG), transcranial Dopplerography (TCD), rheoencephalography (REG), echo-encephalography (ECHO-EG).
- Anti-stress back mesotherapy.
- Shock wave therapy.
- Hirudotherapy.
- Mistletoe therapy.

Ask a Question

What is this pathology?

Before you begin to consider treatment methods for any disease, it is very important to understand the causes of its occurrence. Otherwise, the recovery process can be considered impossible. Focal changes in the brain substance of a dyscirculatory nature are a disease that affects the brain in several places at once. At the same time, the disease is considered chronic, since it develops very slowly, and its consequences are extremely severe.

Stages of development

Like any other pathology, focal changes in the brain substance of a dyscirculatory nature can have several stages of development. Each of them has its own characteristics and differences, so it is very important for the doctor to understand exactly what stage your disease is at in order to choose the optimal treatment for you.

So, at the very first stage it is extremely difficult to notice the presence of pathology. After all, cerebral circulation has just begun to be disrupted. In this case, the specific symptoms of the disease are not yet expressed, so it is almost impossible to diagnose it, and the patient does not have any special complaints.

In the second stage, the patient’s condition worsens as nerve cells and brain tissue begin to die. Such processes are associated with significant disturbances of cerebral circulation.

The third stage of this disease is the last. In this case, most of the brain matter has died, so the brain stops functioning normally. Moreover, the signs of the disease can be very diverse and manifest differently in each patient.

The main reasons for the development of pathology

Actually exists great amount reasons due to which focal changes in the brain substance of a discirculatory nature may occur. We will consider the consequences of this pathology below, and now we will understand what reasons influence its development.

As mentioned above, this condition occurs due to the fact that the blood supply to the brain is disrupted. Very often this is observed due to the fact that the cervical spine is injured or is susceptible to osteochondrosis and other diseases. The disease can also occur against the background of the presence of certain cardiovascular diseases. vascular system or after receiving a brain injury. People who are obese and lead an unhealthy lifestyle are also susceptible to the disease. Sometimes the disease can manifest itself in patients suffering from diabetes, cancer and inflammatory diseases. People who are often in stressful situations and prone to depression are no exception.

Focal changes most often occur in older people, but recently young patients are increasingly turning to neurologists, which indicates that the disease is beginning to actively become younger.

Focal changes in the brain substance of a discirculatory nature: symptoms

Despite the fact that at the first stage it is not easy to recognize the type of pathology, some symptoms will still indicate its presence. Typically, at the earliest stage, patients complain of insomnia, constant fatigue, lethargy, inability to work, pain in the head, as well as inability to cope with stressful situations.

But when the pathology begins to actively progress, it becomes much easier to recognize it. Pain in the head is much more common and lasts longer. Mental activity is disrupted, and psychosomatic disorders occur. Some patients experience epileptic seizures, as well as cognitive impairment and strokes. Also suffers vestibular apparatus, organs of vision and hearing.

How does the diagnostic process work?

Signs of focal lesions are not always very easy to recognize. It is impossible to draw any conclusion based only on the patient's words. In order to understand what kind of disease is present in the patient, it is necessary to carry out full diagnostics. Of course, at the first stage it is difficult to determine the presence of focal changes in brain tissue, since the disease is just beginning to gain momentum. Therefore, it is very rare for patients to go to the hospital when they have constant feeling fatigue or insomnia.

Most often, patients turn to neurologists already in the second and third stages of the disease. In this case, the doctor will check reflex reactions, and will also check for mental disorders in the patient. It is also very important to collect information about well-being from the patient himself. It is after receiving such information that the specialist will be able to determine what kind of examination the injured person should undergo in this case.

First of all, you will be asked to take a blood test to check your sugar and cholesterol levels, and also determine the state of fat metabolism in your body. Next, the vascular system of the head and neck is examined. It is also very important to examine the cervical spine in order to understand the condition of the artery supplying blood to the brain.

The patient will also have to undergo a magnetic resonance examination and electrocardiography.

If the disease has affected other organs or organ systems, then you will have to contact other specialists, such as a cardiologist, otolaryngologist, and others.

Features of treatment

In fact, it is possible to eliminate such a pathology as focal changes in the brain substance of a dyscirculatory nature if we approach the problem in a comprehensive manner. First of all, you need to do everything to establish blood supply to the brain. In any case, treatment will be selected individually. After all, each patient had his own special reasons for the development of this disease. The doctor also takes into account the patient’s gender and age, his general condition and drug tolerance. It is very important to treat not the pathology itself, but also the ailments that accompany it. Only in this case can we hope for a positive result.

Basic treatment methods

First of all, it is very important to establish blood supply to the brain, as well as provide support to healthy nerve cells so that the disease does not continue to progress. If necessary, the patient can take sedatives and other medications. This must be done to support normal life activities. Very often, oxygen starvation leads to complications, so it is important to eliminate this phenomenon in a timely manner. You also need to strengthen. For this, experts recommend taking safe and effective herbal preparations. It is also necessary to ensure that the brain cells receive a sufficient amount of microelements and vitamins. It is very important to tone the blood vessels and expand them so that oxygen starvation does not occur.

If the patency of the arteries deteriorates significantly, then the doctor may decide to perform surgical intervention. However, this is done only as a last resort.

Dieting is the basis of good health

Defeats individual areas brain is not uncommon. As mentioned above, in order to eliminate such a pathology, it is very important to take comprehensive measures. You will also need to adjust your diet, because what we eat directly determines how we feel.

It is very important to include foods rich in vitamins B, C and PP in your diet. It is also beneficial to eat foods rich in magnesium and potassium. If the patient has a disordered fat metabolism, then experts recommend eating foods that can break down fats. First of all, garlic and onions should be included here. Try to eat cereals daily, as they strengthen the walls of blood vessels very well. Also, eat seafood at least twice a week.

A few words about the consequences

The disease described in this article is very dangerous, so at the first signs it is very important to contact a neurologist. Your doctor will tell you where to get an MRI of the brain. This procedure is usually carried out in the hospital itself or at a testing center. In any case, do not ignore it, as it will help establish an accurate diagnosis.

Focal changes in the brain substance of a dyscirculatory nature can lead to very serious consequences. The presence of this disease can affect the entire body as a whole: blood pressure will increase, and the risk of such a dangerous condition as a stroke will also increase. The patient may completely lose vision and hearing, and also have problems with coordination. An unidentified disease in time can lead to fatal outcome, so don’t ignore your poor health.

Preventive measures

Any disease is easier to prevent than to treat, and focal changes in the brain substance of a dyscirculatory nature are no exception. Every person in this world should try to lead an active lifestyle. Exercising significantly improves metabolism and cerebral circulation. So start exercising today.

Pay attention to what you eat and adjust your diet. Of course, it is very difficult to switch to healthy eating right away, especially if you are a big eater. harmful products. So do it gradually, it will put much less stress on your body.

Learn not only to work, but also to relax. Constant stressful situations are fraught with consequences for your well-being and lead to the development of many dangerous diseases.

Also take care of your sleep. The optimal sleep time for an adult is seven to eight hours a day. Both lack of sleep and excess of it will negatively affect your health.

conclusions

Your health is in your hands, so now think about where to get an MRI of the brain. If during this procedure it has been determined that you have a predisposition to developing focal diseases brain, change your lifestyle urgently. Do not forget that it is much easier to prevent any disease than to try to get rid of it later. Focal changes in the brain substance of a dyscirculatory nature lead to extremely disastrous consequences, so think about yourself right now. Be healthy and take care of yourself!

In particular, this concerns circulatory disorders in the vascular system of the brain and spinal cord.

The cerebral circulation regulation system is physiological mechanism, which is aimed at maintaining a constant level of blood circulation during various changes in systemic blood flow and which compensates for changes in the chemistry of the environment or blood surrounding the vessels.

Disruption of the blood supply to any area of the brain usually leads to brain damage, and its severity is determined by the level of decrease in cerebral blood flow. The area of the brain in which the blood flow level becomes less than 10 ml/100 g per minute is irreversibly damaged, and destructive changes in brain tissue develop instantly - within 5-10 minutes.

There are many various reasons leading to impaired cerebral circulation. The severity and localization of changes in brain tissue, the area of blood supply to the damaged vessel, the mechanisms that give rise to circulatory disorders, individual characteristics patient - all these changes in brain tissue are called morphological signs of the disease. They are determined using MRI. Carefully examining these morphological signs, among them we can distinguish cerebral circulatory disorders of a diffuse and focal nature.

Focal changes in the brain substance are diseases that reveal lesions not of the entire brain, but only of a part or individual parts. Such diseases include cerebral infarction, hemorrhagic stroke, intrathecal hemorrhage. The very nature of the disease may be different types: post-ischemic, dystrophic and discirculatory are distinguished. It is the latter that will be discussed.

– this is the name for diseases closely associated with chronic and slowly progressive disorders of cerebral and spinal circulation. Such diseases are quite difficult. They are usually accompanied by dizziness, headaches, noise in the head and ears, sleep disturbances, and decreased performance.

Focal changes of a discirculatory nature in the initial stages are quite difficult to detect. This is due to the fact that the condition does not have pronounced symptoms: as a rule, there are only scattered microsymptoms. Such focal changes in the brain substance are usually accompanied by the following diseases: atherosclerosis, arterial hypertension, neurosis, and vasomotor dystonia.

In other words, to put it more in simple language, then focal lesions of the brain substance of a dyscirculatory nature are lesions of individual parts of the brain due to impaired blood supply and impaired blood circulation.

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Carrying out MRI for focal brain lesions

focal lesions Focal brain lesions can be caused by trauma, infectious disease, vascular atrophy and many other factors. Often, degenerative changes are accompanied by problems associated with disruption of normal vital functions and coordination of human movement.

MRI for focal brain lesions helps to identify the problem in the early stages and coordinate drug therapy. If necessary, based on the results of the examination, minimally invasive surgery may be prescribed.

Signs of focal lesions

All disorders of brain activity are reflected in the natural daily functions of human life. The location of the lesion affects performance internal organs and muscular system.

Change vascular origin can lead to mental disorders, cause an increase blood pressure, stroke and other unpleasant consequences. On the other hand, subcortical lesions may not have clinical manifestations and be asymptomatic.

One of the obvious signs of the presence of a focal lesion is:

Hypertension - a lack of oxygen supply to the brain caused by vascular dystrophy leads to the fact that the brain accelerates and increases blood circulation.

Signs of single focal changes in the brain substance of a dyscirculatory nature on magnetic resonance imaging mean that the patient has certain deviations in the functioning of the vascular system. Most often this is associated with hypertension. The diagnosis and explanation of the study results will be provided by the attending physician.

The picture of focal changes in the substance of the brain of a dystrophic nature is observed, according to various sources, from 50 to 80% of all people as they age. Ischemia, as a result of which normal blood supply is stopped, causes provoking changes in the soft tissues. Resonance tomography helps to identify the causes of violations and carry out differential analysis diseases.

Small focal changes that do not cause concern at first can eventually cause a stroke. In addition, foci of increased echogenicity of vascular origin may indicate oncological cause violations.

Timely identification of the problem helps prescribe the most effective therapy. A focus of dyscirculatory origin, clearly visible on MRI, may indicate the following pathologies:

In the cerebral hemispheres - indicates the following possible causes: blocking the blood flow of the right vertebral artery through a congenital anomaly or atherosclerotic plaque. The condition may be accompanied by a herniated cervical spine.

If the MRI report indicates the diagnosis: “signs of multifocal brain damage of a vascular nature,” this is a reason for certain concerns. The attending physician will be required to establish the cause of the changes and determine methods of conservative and restorative therapy.

On the other hand, microfocal changes occur in almost every patient after 50 years. The lesions are visible in angiography mode, if the cause of occurrence is disturbances in genesis.

If a dystrophic focus is detected, the therapist will definitely prescribe a general medical history of the patient. With absence additional reasons for concern, it will be recommended to regularly monitor trends in the development of pathology. Substances may be prescribed to stimulate circulation.

Changes in the brain substance of a discirculatory-dystrophic nature indicate more serious problems. Pressure and lack of circulation can be caused by injury or other causes.

Signs of small-focal brain damage with a vascular etiology of moderate expansion can cause the diagnosis of encephalopathy, congenital and acquired. Some medications can only make the problem worse. Therefore, the therapist will check the relationship between medication and ischemia.

Any pathological and degenerative changes should be well studied and tested. The cause of the focal lesion was determined and, based on the MRI results, prevention or treatment of the detected disease was prescribed.

Question-Answer: Vascular genesis

The MRI concluded #8212; MR picture of single focal changes in the brain substance, probably of a dystrophic nature. Hello! Mom had an MRI and the report says. many focal lesions white matter brain most likely of vascular origin.

Focal brain lesions can be caused by trauma, infectious disease, vascular atrophy and many other factors. MRI for focal brain lesions helps to identify the problem in the early stages and coordinate drug therapy. All disorders of brain activity are reflected in the natural daily functions of human life.

Changes in vascular genesis can lead to mental disorders, cause increased blood pressure, stroke and other unpleasant consequences. Hypertension #8212; The lack of oxygen supply to the brain caused by vascular dystrophy leads to the brain accelerating and increasing blood circulation. Pain syndrome#8212; chronic headaches, migraines may indicate the need for general examination patient.

Signs of focal lesions

Small focal changes that do not cause concern at first can eventually cause a stroke. In addition, foci of increased echogenicity of vascular origin may indicate an oncological cause of the disorders. Multiple focal changes in the brain substance indicate the presence of serious deviations in genesis.

If the MRI report indicates the diagnosis: “signs of multifocal brain damage of a vascular nature” #8212; this is a cause for some concern. Changes in the brain substance of a dyscirculatory-dystrophic nature indicate more serious problems. Signs of small-focal brain damage with a vascular etiology of moderate expansion can cause the diagnosis of encephalopathy, congenital and acquired.

The cause of the focal lesion was determined and, based on the MRI results, prevention or treatment of the detected disease was prescribed. Conclusion: MRI picture of a single lesion in the left frontal lobe, external hydrocephalus. But what about the headache that doesn’t go away for so long, and the MRI report about hydrocephalus? If the age is old, then these may be age-related changes of vascular origin, if young, it may be a sign of a demyelinating disease.

Diagnosing changes

And it’s already written there: there are small focal changes of less than 3x in the right frontal lobe. Most likely of vascular origin. Hello Irina! Hydrocephalus occurs when a cyst blocks the ducts of the brain, leading to poor circulation. cerebrospinal fluid. Hello, please help me decipher the MRI of the brain. 24 years old, terrible headaches have been going on for 2 weeks without stopping for 3 years now.

2nd doctor. MRI picture of an arachnoid cyst of the pole of the left temporal lobe. Focal changes in the brain substance of a dystrophic (vascular?) nature

Hello! A 23-year-old guy had a concussion as a result of an injury. Conclusion: MRI picture of a single lesion in the white matter of the frontal lobe on the left, most likely of post-hypoxic origin.

Often, degenerative changes are accompanied by problems associated with disruption of normal vital functions and coordination of human movement. The location of the lesion affects the functioning of internal organs and the muscular system. On the other hand, subcortical lesions may not have clinical manifestations and be asymptomatic. Ischemia, as a result of which normal blood supply is stopped, causes provoking changes in the soft tissues.

In the cerebral hemispheres #8212; indicates the following possible causes: blocking the blood flow of the right vertebral artery due to a congenital anomaly or atherosclerotic plaque. Concerns arise about the tendency to increase the area of damage, as well as the accompanying changes in motor function disorders. May be caused by either a pre-stroke condition or senile dementia, epilepsy and many other diseases, the development of which is accompanied by vascular atrophy.

The attending physician will be required to establish the cause of the changes and determine methods of conservative and restorative therapy. Substances may be prescribed to stimulate circulation.

Pressure and lack of circulation can be caused by injury or other causes. Any pathological and degenerative changes should be well studied and tested. It is beneficial for them to have many patients, otherwise what are doctors for? Perhaps this attitude depends on their salary and healthcare system.

Is it dangerous? and what are the consequences please tell me

These are the doctors! I can indicate the names of the doctors and the place of their appointment! Good day! Here I am writing, and I myself have terrible headaches that have not stopped for a whole month, day after day. Constantly dizzy. There has never been hypertension (working pressure/). strokes, chronic diseases no, the work is mental and nervous...

I am 66 years old. Hypertension for 20 years already. About 5-6 years ago I once felt a severe headache. I didn’t attach much importance to it, because I chalked it all up to weather dependence. Of course, the headache appeared more and more often, but less intense. I admit, I am a very emotional, quick-tempered person, and in my past life there were a lot of stressful situations.

With great difficulty I asked for a referral for an MRI, waited a month for this examination and this was the result. As I understand it, this is all due to pain in the spine. A doctor can clarify the cause of headaches, decide on treatment tactics and predict the course of the disease only after a full face-to-face consultation.

Strokes #8212; clearly defined focal changes in the brain vascular nature MRI allows us to establish pre-stroke status and prescribe appropriate therapy. Hello, I had an MRI. Diagnosis: MRI picture of changes in signals from the brain substance. It is necessary to differentiate changes of a vascular nature and a demyelinating nature.

Focal changes in the white matter of the brain

The human body is not eternal and with age various pathological processes develop in it. The most dangerous among them are focal changes in the brain substance of a discirculatory nature. They arise due to disruption of cerebral blood flow. This pathological process manifests itself in a number of ways neurological symptoms and it is characterized by a progressive course. It is no longer possible to bring lost nerve cells back to life, but you can slow down the course of the disease or completely prevent its development.

Causes and signs of pathology

The doctor should tell you what to do if there is a focal change in the substance of the brain, but the patient himself can suspect the presence of pathology. The disease often has a post-ischemic origin. It is characterized by a violation of blood flow in one of the areas of the hemisphere (hemisphere). It is difficult for some people to understand what this is, so for convenience, the development of changes in brain matter has been divided into 3 stages:

First stage. At this stage, signs of focal lesions in the brain matter do not appear. The patient may only feel slight weakness, dizziness and apathy. Occasionally, sleep is disturbed and headaches occur. Foci of vascular origin are just emerging and there are minor disruptions in blood flow;
Second phase. As the pathology develops, the course of the disease worsens. This manifests itself in the form of migraines, decreased mental abilities, ringing in the ears, outbursts of emotions and loss of coordination of movements;
Third stage. If the disease has reached this stage, then focal changes in the white matter of the brain have irreversible consequences. Most neurons die and the patient’s tone rapidly decreases muscle tissue. Over time, symptoms of dementia (dementia) appear, the senses cease to perform their functions and the person completely loses control over his movements.

Subcortical lesions in the white matter, localized under the cerebral cortex, may not appear at all for a long time. Such failures are diagnosed mainly by chance.

Changes in white matter frontal lobes manifest themselves noticeably more actively and mainly in the form of a decrease in mental abilities.

At-risk groups

If there are no signs of the disease, it is advisable to find out what risk groups are for this disease. According to statistics, focal lesions more often occur in the presence of such pathologies:

Atherosclerosis;
High pressure;
VSD ( vegetative-vascular dystonia);
Diabetes;
Pathologies of the heart muscle;
Constant stress;
Sedentary work;
Abuse of bad habits;
Overweight.

Damage to the white matter of the brain of vascular origin may occur due to age-related changes. Small single lesions are usually observed in people over 60 years of age.

Dystrophic nature of the damage

In addition to damage caused by vascular origin, there are other types of disease, for example, single focal changes in the brain substance of a dystrophic nature. This type of pathology occurs due to lack of nutrition. The reasons for this phenomenon are as follows:

Weakened blood supply;
Osteochondrosis of the cervical spine in the acute stage;
Oncological diseases;
Head injuries.

Damage to the brain substance of a dystrophic nature usually manifests itself due to a lack of nutrition of brain tissue. The patient experiences symptoms:

Decreased brain activity;
Dementia;
Headache;
Weakening of muscle tissue (paresis);
Paralysis of certain muscle groups;
Dizziness.

Diagnostics

Most people with age develop focal changes in the substance that arise due to tissue degeneration or as a result of disruptions in blood flow. You can see them using magnetic resonance imaging (MRI):

Changes in the cerebral cortex. Such a lesion occurs mainly due to blockage or compression of the vertebral artery. This is usually due to congenital anomalies or the development of atherosclerosis. In rare cases, along with the appearance of a lesion in the cerebral cortex, a vertebral hernia occurs;
Multiple focal changes. Their presence usually indicates a pre-stroke condition. In some cases, they can prevent dementia, epilepsy and other pathological processes associated with vascular atrophy. If such changes are detected, a course of therapy should be started immediately to prevent irreversible consequences;
Microfocal changes. Such damage is found in virtually every person after life. They can be seen with the use of a contrast agent only if they are of a pathological nature. Fine-focal changes are not particularly noticeable, but as they develop they can cause a stroke;
Changes in the white matter of the frontal and parietal lobes subcortically and periventricularly. This type of damage occurs due to constant high blood pressure, especially if the person had hypertensive crisis. Sometimes small single lesions are congenital. The danger arises from the proliferation of lesions in the white matter of the frontal and parietal lobes subcortically. In such a situation, symptoms gradually progress.

If a person is at risk, then an MRI of the brain (brain) should be performed once a year. Otherwise, it is advisable to do such an examination once every 2-3 years for prevention. If an MRI shows a high echogenicity of a lesion of disculatory origin, this may indicate the presence of an oncological disease in the brain.

Methods of combating pathology

Gradually affecting the human brain tissue, the disease can cause irreversible consequences. To prevent vascular changes in the white matter of the brain, it will be necessary to stop the symptoms that arise and improve blood flow with the help of medications and physical therapy. Treatment must be comprehensive, which means you will have to change your lifestyle. To do this you will have to follow these rules:

Active lifestyle. The patient should move more and play sports. After eating, it is advisable to go for a walk, and it doesn’t hurt to do the same before bed. Water procedures, skiing and running have a good effect. Treatment with an active lifestyle improves general condition and also strengthens the cardiovascular system;
Properly formulated diet. For successful treatment You will have to give up alcoholic beverages and reduce your consumption of sweets, canned food, as well as smoked and fried foods. You can replace them with boiled or steamed food. Instead of store-bought sweets, you can make homemade pie or eat fruit;
Avoiding stress. Constant mental stress is one of the causes of many diseases, so it is advisable to relax more and not overwork;
Healthy sleep. A person should sleep at least 6-8 hours a day. In the presence of pathology, it is advisable to increase sleep time by 1-2 hours;
Annual examination. If a change in the white matter of the brain is diagnosed, the patient should undergo an MRI twice a year. It is imperative to follow all the doctor’s recommendations and take the necessary tests on time.

Treatment of focal changes usually involves changing lifestyle and eliminating the cause of their development. It is advisable to detect the problem immediately in order to be able to slow down its progress. To do this, you should undergo a full examination annually.

Focal changes in the brain substance of a discirculatory nature

Without exaggeration, the brain can be called a control system for the entire human body, because different lobes of the brain are responsible for breathing, the functioning of internal organs and sensory organs, speech, memory, thinking, and perception. The human brain is capable of storing and processing a huge amount of information; At the same time, hundreds of thousands of processes take place in it to ensure the vital functions of the body. However, the functioning of the brain is inextricably linked with its blood supply, because even a slight decrease in the blood supply to a certain portion of the brain matter can lead to irreversible consequences - massive death of neurons and, as a result, severe diseases of the nervous system and dementia.

Causes and symptoms of focal changes of a discirculatory nature

The most common manifestations of impaired blood supply to the brain are focal changes in the brain substance of a discirculatory nature, which are characterized by impaired blood circulation in certain areas of the brain substance, and not in the entire organ. Typically, these changes are chronic process, developing over quite a long time, and in the first stages of this disease, most people cannot distinguish it from other diseases of the nervous system. Doctors distinguish three stages in the development of focal changes of a discirculatory nature:

At the first stage, in certain areas of the brain, due to vascular diseases, minor violation blood circulation, as a result of which a person feels tired, lethargic, apathetic; The patient experiences sleep disturbances, periodic dizziness and headaches.
The second stage is characterized by deepening of vascular damage in the area of the brain, which is the focus of the disease. Symptoms such as memory loss and intellectual abilities, violation emotional sphere, severe headaches, tinnitus, coordination disorders.
The third stage of focal changes in the brain substance of a discirculatory nature, when a significant part of the cells in the focus of the disease due to circulatory disorders has died, is characterized by irreversible changes in the functioning of the brain. As a rule, in patients at this stage of the disease, muscle tone is significantly reduced, there is practically no coordination of movement, signs of dementia (dementia) appear, and sensory organs may also fail.

Categories of people susceptible to the appearance of focal changes in the brain substance

To avoid the development of this disease, you need to carefully monitor your well-being, and when the first symptoms appear, indicating the possibility of a focal dyscirculatory change occurring in the brain, immediately contact a neurologist or neuropathologist. Since this disease is quite difficult to diagnose (a doctor can make an accurate diagnosis only after an MRI), doctors recommend that people predisposed to this disease undergo preventive examination see a neurologist at least once a year. The following categories of people are at risk:

suffering from hypertension, vegetative-vascular dystonia and other diseases of the cardiovascular system;
patients with diabetes mellitus;
suffering from atherosclerosis;
having bad habits and being overweight;
leading a sedentary lifestyle;
those in a state of chronic stress;
elderly people over 50 years of age.

Focal changes of a dystrophic nature

In addition to changes of a discirculatory nature, a disease that has similar symptoms, are single focal changes in the brain substance of a dystrophic nature due to a lack of nutrients. This disease affects people who have suffered head trauma, ischemia, cervical osteochondrosis in the acute stage and patients diagnosed with benign or malignant tumor brain. Due to the fact that the vessels supplying a certain area of the brain cannot fully perform their functions, the tissues in this area do not receive all the necessary nutrients. The result of such “starvation” of nervous tissue is headaches, dizziness, decreased intellectual abilities and performance, and in the final stages dementia, paresis, and paralysis are possible.

Despite the seriousness of these diseases and the difficulty in diagnosing them, every person can significantly reduce the risk of developing focal changes in the brain substance. To do this, it is enough to give up bad habits, lead a healthy and active lifestyle, avoid overwork and stress, consume healthy and healthy food and undergo a preventive medical examination 1-2 times a year.

Dyscirculatory changes in the brain

Currently, neurological diseases associated with impaired blood supply to the central nervous system are becoming increasingly common. Circulatory failure leads to serious consequences and affects normal life.

The trend towards an increase in the number of neurologist patients who are diagnosed with dyscirculatory changes in the brain tends to increase and rejuvenate the incidence.

What it is

Dyscirculatory changes in the brain, what is it - this is a multi-focal disease of the central nervous system, affecting the medulla, characterized by chronic course with slow development and subsequent severe course diseases.

The blood circulation of the tissue areas of the brain is disrupted in the form of small foci; according to the level of such changes, three stages of discirculatory changes are distinguished:

The first stage is the process of tissue changes associated with a minor pathology of the vascular system of the brain, which appears as a result of diseases of the circulatory system. Symptoms are mild, diagnosing dyscirculatory anomalies is unlikely;
The second stage is the process of death of nerve cells and tissues of the affected area of the brain, associated with a significant deterioration in the blood supply to the head. The symptomatic picture is vivid, the patient’s condition worsens significantly;
The third stage is the last stage, in which most of the cells in the affected area of the brain have died, and pathological changes begin in the functioning of the brain with disruption of many vital functions. Symptoms are severe: from total loss coordination of movements until a significant decrease in mental activity.

Reasons for appearance

Dyscirculatory changes in the brain are primarily associated with impaired blood circulation in cerebral vessels. Therefore, the causes of the appearance of focal lesions of the brain matter include:

Impaired blood flow functions due to osteochondrosis or injury to the cervical spine;
Hypertonic disease;
Diabetes;
Vegetative-vascular dystonia;
Hormonal imbalance;
Encephalopathy;
Atherosclerotic changes in the circulatory system;
Cardiovascular diseases;
Unhealthy lifestyle: smoking, drinking alcohol, lack of exercise;
Excess weight;
Oncological diseases;
Inflammatory, infectious diseases of the brain;
Hereditary diseases of the circulatory system;
Depressive states;
Trauma to the skull and brain of varying degrees;
Age category of persons over fifty years.

Signs of discirculatory anomalies

The symptomatic picture of this neurological disease appears already at the first stage. It is hardly noticeable, since small disturbances occur in Everyday life, which often boil down to:

Fatigue;
Lack of sleep;
Lethargy;
Rare headaches accompanied by dizziness;
Experiences and stress.

At the second stage of the disease, the following symptoms can be distinguished:

Minor psychosomatic disorders;
Feeling of noise, whistling, congestion in the ears;
Temporary loss of hearing and vision;
Decreased intellectual activity;
Cognitive impairment;
High blood pressure;
Strokes varying degrees severity and etiology;
Cerebral vascular dystrophy;
Epileptic seizures;
Ischemic tissue damage;
Head pain becomes chronic;
Contraction of muscle tissue occurs involuntarily, there is a violation of coordination of movements, rigidity of muscle fibers;
Other signs of pathology of the vascular system in the brain: a feeling of a veil before the eyes, instability in space, staggering, swaying to one or both sides of the body, dizziness when moving the body or lifting its body to a horizontal position.

Diagnostics

Pathology of brain tissue is poorly diagnosed in the early stages, since patients rarely come to see a doctor with their complaints.

If symptoms are obvious, the patient is referred by the therapist to a consultation with a neurologist.

The neurologist conducts a medical history, an external examination for the presence of neuropsychological abnormalities, and a check reflex function. Based on complaints and examination, the doctor decides how the examination will be carried out:

Biochemical blood test, coagulogram, sugar, cholesterol;
Analysis of the state of fat metabolism;
Blood pressure measurement and daily monitoring;
Doppler check of the vascular system of the head and cervical region;
Magnetic resonance imaging;
Electrocardiography;
If necessary, consultation with doctors: cardiologist, nephrologist, ophthalmologist.

Treatment

Based on the tests and diagnostics performed, the neurologist prescribes treatment. An individual therapy package is developed based on the patient’s general condition, allergies, and tolerance to drugs or other medications.

The main emphasis in therapy is on treating the concomitant disease that caused the onset of pathological changes brain

Restoring and improving the activity of the cerebral circulatory system;
Supports the functioning of healthy nerve cells;
Providing brain tissue with sufficient oxygen and nutrients;
Recovery normal level hemodynamics: antagonists, calcium blockers, phosphodiesterase inhibitors;
Suspension of cognitive pathological processes;
Improving the functions of the vestibular apparatus;
If there is a clear violation of the patency of the arteries due to atherosclerotic processes, ischemia or stroke, a decision is made on surgical intervention;
Sedative sedative effect;
Vasodilation;
Improvement of vascular tone;
Strengthening the nervous system containing phytoextracts;
Enriching the brain with essential minerals and vitamins.

Diet

Fresh vegetables and fruits, rich in vitamins: C, group B, PP, as well as minerals: magnesium, potassium;
Onions, garlic to break down excess fats;
Cereals to strengthen arteries;
If there are no allergies, a Mediterranean diet is possible.

Prevention

Preventive measures must be applied completely healthy people and when the first signs of discirculatory anomalies appear:

Maintaining a daily routine;
Adequate physical exercise;
Complete rest;
Healthy lifestyle;
Gymnastics, sports;
Proper, balanced nutrition;
Professional examination by a neurologist once a year.

Focal changes in the brain substance of a discirculatory nature

Some of the most important topics in medicine are those directly related to brain diseases. In particular, one of the serious issues is the disruption of blood circulation in the vascular system of the spinal cord and brain. There are many various reasons which lead to circulatory problems.

The location and severity of various changes in brain tissue in patients with diseases associated with cerebrovascular accidents, which can be determined by its underlying disease, the area of blood supply to the damaged vessel, various mechanisms, giving rise to circulatory disorders, as well as the individual characteristics of the patient - such as the history of previous diseases, age, build, etc. These changes are called morphological signs of the disease and are determined using MRI. Looking carefully at the morphological signs, we can distinguish among them cerebral circulatory disorders of focal and diffuse nature.

Focal changes in the brain substance are diseases that reveal lesions not of the entire brain, but only of its individual parts, or parts. These include diseases such as hemorrhagic stroke, cerebral infarction, intrathecal hemorrhage. The nature of the disease may be various types, here we distinguish dystrophic, post-ischemic, and also discirculatory. This is exactly what I wanted to focus on.

Focal changes in the brain substance of a discirculatory nature are diseases that are closely associated with chronically slowly progressing disorders of the spinal and cerebral circulation. These are quite severe diseases that are accompanied by headaches, dizziness, noise in the ears and head, decreased performance and sleep disturbances. In the initial stages, it is quite difficult to detect due to the fact that patients do not have pronounced symptoms - usually they are scattered microsymptoms. Focal changes in the brain substance of a dyscirculatory nature usually accompany diseases such as atherosclerosis, arterial hypertension, vasomotor dystonia, and nervousness.

In simple terms, this is damage to certain areas of the brain due to the fact that blood supply and blood circulation are disrupted.

Causes of focal changes in the brain substance of a discirculatory nature

Regulation of blood supply in the human head is a special physiological mechanism. The functions of this mechanism are aimed at supporting and normalizing blood circulation in the brain in situations where systemic blood flow changes for any reason. This compensates for disruptions in the chemical composition of the environment that surrounds the vessels, as well as the blood. If the blood supply is disrupted in some part of the brain, focal changes in the brain substance of a discirculatory nature may occur. During this time, loss of brain tissue function may occur, and the severity of the damage is determined by how much blood flow has decreased.

There can be many reasons that can lead to disruptions in the cerebral blood flow system. General picture of the localization of structural changes inside the brain tissue, their severity; mechanisms of damage that give rise to the development of disorders; the area of blood flow to the damaged vessel, the individual characteristics of the body - all such deviations in the brain structures relate to morphological characteristics this diagnosis. These signs of damage can be determined on MRI. This will help highlight places of disruptions in blood circulation, both local and widespread.

Local, or focal, changes in the white matter of the brain are diseases that are dysfunctions not of the whole brain, but only of a certain small part or several parts. An infarction in the brain will be such a lesion. In addition, stroke, for example, hemorrhagic type, as well as hemorrhage under the membrane. The nature and course of the disease may also differ:

Dystrophic type of disease;
Dyscirculatory type of diagnosis;
Postischemic type of condition.

Single focal changes in the brain substance of a discirculatory nature are diagnoses that are quite closely associated with chronic lesions of the cerebral and spinal blood flow. Such disorders develop and progress slowly, but very severely.

Focal changes in the brain are very difficult to identify in their primary stages of development. Such conditions do not have a good and clear expression of symptoms. All symptoms manifest themselves in the form of microsymptoms of a diffuse nature. These types of single focal changes in the brain substance of a dyscirculatory nature most often appear together with concomitant diseases, for example, neuroses, atherosclerosis, vegetative-vascular dystonia, as well as arterial hypertension.

In general, if we give a simple definition, then such lesions in the white matter in some areas and in certain places of the human brain appear due to vascular genesis, disturbances in the blood supply and blood circulation through the vessels of the brain.

Signs and symptoms of focal lesions in the brain

Any type or type of brain damage, as well as functional disorders of its structure and activity or the functioning of body systems closely related to it, are sure to affect a person’s daily activities, behavior, and functions. Also, the very location of the lesion can very noticeably affect the functioning of the body’s organ systems, as well as the proper functioning of the musculoskeletal and muscular systems.

In addition to pathologies that were caused by vascular origin, other types of diagnoses may occur, including single focal changes in the brain substance of a dystrophic nature. This type of pathology can most often occur due to insufficient supply nutrients and oxygen of brain tissue.

The reasons for this phenomenon:

Oncological type tissue damage;
Insufficient blood supply to a certain area of tissue;
Injury to the head and brain tissue;
Acute stage of cervical osteochondrosis.

When, due to vascular origin, a person experiences small focal changes in the brain, the following symptoms are usually observed:

Significant decrease in brain activity;
Pain in the head;
Dementia;
Frequent dizziness;
Paresis of muscle tissue, weakening;
Local, partial paralysis of some muscle groups.

In addition, changes in the blood circulation around the brain substance of a dystrophic nature can lead to a disorder of the human psyche. Due to vascular dystrophy, blood pressure may increase, a stroke may occur, as well as hyperintense brain phenomena. But it may also happen that subcortical lesions may not manifest symptoms.

The main signs of the presence of focal disorders

One of the main symptoms is hypertension. After all, if blood circulation in the brain is impaired, then it will suffer from a lack of oxygen, and this, in turn, will immediately lead to an acceleration of signals about the supply of blood to the brain, thereby increasing blood pressure. In addition, epileptic seizures may be observed in a sick person. Varied mental disorders are also the main sign of focal brain damage. Indeed, with pathological phenomena in the subarachnoid spaces, hemorrhages often occur. This can also lead to formations in the fundus, darkening and other symptoms that appear in the fundus. Here, dark spots form very quickly, blood vessels around the eye burst and the retina can rupture. Using these signs, you can determine exactly where multiple foci are located.

A possible stroke or micro-stroke is also the main sign. Focal changes in the brain are usually clearly visible on MRI, which makes it possible to determine the pre-stroke condition. This will allow the doctor to immediately prescribe the necessary treatment. The most obvious signs of damage can be considered single and multiple, small and large involuntary muscle contractions.

And, of course, pain is no exception. Migraines, frequent and severe headaches clearly indicate disorders of a multifocal nature.

Treatment

Individual changes in the white matter, which are clearly visible on MRI, may mean that the patient has abnormalities in the blood circulation of the brain of vascular origin. Based on these data, the doctor will prescribe an examination that will more clearly show the causes of this situation and allow you to prescribe the correct treatment.

To select treatment for focal changes in the brain substance of a dyscirculatory nature, the doctor first prescribes therapy for the disease that led to this situation. Drugs are prescribed that improve blood circulation between brain structures, oxygen exchange, reduce blood viscosity, have a sedative and analgesic effect, as well as complexes of vitamins and essential elements.

In addition, to restore the functions of the white matter of the brain, if possible, the patient is prescribed a strict diet, bed rest and rest. This will help avoid further changes in the brain substance. The patient's regimen should be normalized, it is important to exclude any physical activity, and also completely review his diet. You should unquestioningly obey the doctor’s orders.

Prevention

Prevention of multiple focal changes in the brain substance includes:

Maintaining an active lifestyle. After all, movement stimulates improved blood circulation throughout human body and in the brain, in particular, and thereby reduces the risk of lesions in the brain.
Proper and rational nutrition.
Avoiding stress and other nervous situations. After all, constant nervous tension may be the cause of more than one disease. There is no need to overwork often, you should rest and relax more.
Healthy and sound sleep is always the key to health. You need to spend at least 7-8 hours sleeping per day. If you experience insomnia or any other sleep pathologies, then your sleep time should be increased to 10 hours a day.
It is necessary to conduct an examination in the hospital every year to identify hidden pathologies and diseases. If symptoms are detected that may indicate changes in the brain matter, then an MRI is required 2 times a year, as well as all necessary tests.

Everyone knows that it is always easier to prevent a problem in advance than to look for a right and proper solution later. The same goes for health. It is easier to carry out the necessary prevention than to treat the disease later.

Focal changes in the brain substance of a discirculatory nature

Against the background of circulatory failure, focal changes in the brain substance of a discirculatory nature develop. The brain is supplied with blood from 4 vascular systems - two carotid and two vertebrobasilar. Normally, these pools are connected to each other in the cranial cavity, forming anastomoses. These compounds enable the human body to compensate for shortcomings in blood flow and oxygen starvation for a long time. Areas experiencing a blood deficiency receive blood from other pools through overflow. If these anastomotic vessels are not developed, then they speak of an open circle of Willis. With this structure of blood vessels, circulatory failure leads to the appearance of focal changes in the brain and clinical symptoms.

Clinical picture

The most common diagnosis in older people, made only on the basis of complaints, is discirculatory encephalopathy. However, it must be remembered that this is a chronic, steadily progressing circulatory disorder that develops as a result of suffering in the capillaries of the brain, which is associated with the development large quantity micro-strokes. Focal brain damage can be diagnosed only if certain criteria are met:

there are signs of brain damage, which can be confirmed objectively;
constantly steadily progressing clinical symptoms;
the presence of a direct relationship between the clinical and instrumental picture when conducting additional examination methods;
the presence of cerebrovascular disease in the patient, which is a risk factor for the development of focal brain damage;
the absence of other diseases with which the origin of the clinical picture could be associated.

Focal changes in the brain substance of a dyscirculatory nature are manifested by disturbances in memory, attention, movement, and emotional-volitional sphere.

The main influence on the functional state and social adaptation of the patient is exerted by cognitive disorders. When there is a focal lesion of the brain substance in the region of the frontal and temporal lobes of the dominant hemisphere, there is a decrease in attentional memory, a slowdown in thought processes, and a violation of planning and consistent execution of daily routine work. Cognitive impairments are explained by brain dystrophy of vascular origin. With the development of neurodegenerative focal changes in the brain, a person ceases to recognize familiar objects, speech suffers, and emotional and personal disturbances develop. Appears first asthenic syndrome And depressive states who respond poorly to antidepressant treatment.

Progressive dystrophic, degenerative disorders lead to the appearance of egocentrism, there is no control over emotions, and an inadequate reaction to the situation develops.

Movement disorders are manifested by staggering when walking, coordination disorders, central paresis varying degrees of severity, trembling of the head, hands, emotional dullness and facial expressions. Steadily progressing focal brain lesions lead to the final stage of the disease, when the patient is unable to eat due to constant choking. Violent emotions appear, for example, laughter or crying inappropriately, the voice becomes nasal.

Predisposing factors

Diseases leading to small-focal changes in the brain matter include arterial hypertension, stenotic and occlusive vascular lesions, lipid and carbohydrate metabolism disorders.

The main mechanism for the development of discirculatory encephalopathy is manifested by the formation of foci of ischemia and infarction. This is a state when dystrophic changes begin to develop against the background oxygen starvation, reduced blood flow, slow metabolism. Areas of demyelination, edema, glial degeneration, and expansion of the perivascular spaces appear in the brain. The above factors are the main ones. They explain the existing lesions and the genesis of the brain.

Additional examination methods

The main method for diagnosing this pathology is MRI of the brain, which detects hyperintense foci, small infarctions, post-ischemic degeneration, and dilation of the ventricular system. The number of heart attacks can be from single to multiple cases, the diameter is up to 2.5 cm. Fine-focal changes indicate that this is such a serious lesion that can lead to disability of the patient. This is where blood circulation suffers.

Ultrasound Dopplerography and duplex scanning are used, which can show disturbances in blood flow in the form of its asymmetry, stenosis, occlusion great vessels, increased venous blood flow, atherosclerotic plaques.

Computed tomography will allow you to see only traces of previous heart attacks in the form of lacunae filled with cerebrospinal fluid, i.e. cysts. Thinning is also determined - atrophy of the cerebral cortex, enlargement of the ventricles, communicating hydrocephalus.

Modern approaches to therapy

Treatment should be aimed at the underlying disease that led to brain disorders. In addition, it is necessary to use means to prevent the progression of the disease.

Mandatory appointment vascular agents, such as pentoxifylline, vinpocetine, cinnarizine, dihydroergocryptine. They have a positive effect on cerebral circulation, normalize microcirculation, increase the plasticity of red blood cells, reduce blood viscosity and restore its fluidity. These drugs relieve vascular spasm and restore tissue resistance to hypoxia.

Cytoflavin, Actovegin, thioctic acid, piracetam, and ginkgo biloba are used as antioxidant, nootropic, and antihypoxic treatments.

Treatment with vestibulotropic drugs reduces dizziness, eliminates unsteadiness when walking, and improves the quality of life of patients. Treatment with betahistine, vertigogel, dimenhydrinate, meclozine, and diazepam is justified.

With high blood pressure, regular monitoring of blood pressure and heart rate numbers is necessary and their normalization according to indications. Aspirin, dipyridamole, clopidogrel, warfarin, and dabigatran are used to thin the blood. Statins are used to treat high blood cholesterol levels.

Currently Special attention is given to calcium channel blockers, which, along with the function of normalizing blood pressure, have a neuroprotective effect. Cerebrolysin, Cerebrolysate, gliatilin, Mexidol restore cognitive functions well.

Neurotransmitters, for example, citicoline, have a nootropic and psychostimulating effect, normalize memory, attention, improve well-being, and restore the patient’s ability to self-care. The mechanism of action is based on the fact that the drug reduces cerebral edema, stabilizes cell membranes,

L-lysine escinate has anti-inflammatory, anti-edematous, and neuroprotective properties. Stimulates the secretion of glucocorticoids, restores vascular permeability, tones the veins and normalizes venous outflow.

Selective therapy for cognitive disorders

To restore memory, attention, and performance, donepezil is used - a drug that normalizes the exchange of neurotransmitters, restores the speed and quality of transmission of nerve impulses as intended. Restores daily activity of patients, corrects apathy, thoughtless obsessive actions, eliminates hallucinations.

Galantamine normalizes neuromuscular transmission, stimulates the production digestive enzymes, secretion of sweat glands, reduces intraocular pressure. The drug is used for dementia, dyscirculatory encephalopathy, and glaucoma.

Rivastigmine effective remedy. But its acceptance is limited by the availability peptic ulcer stomach, duodenum, conduction disturbances, arrhythmia, bronchial asthma, urinary tract obstruction, epilepsy.

For severe psycho-emotional disorders, antidepressants are used. Selective serotonin reuptake inhibitors have proven themselves to be effective in this pathology. These drugs include venlafaxine, milnacipran, duloxetine, sertraline. Drugs in this group are sold in pharmacies only by prescription. These medications are prescribed by the attending physician, taking into account the severity of intellectual-mnestic disorders, depression, and delusional ideas.

Prevention

Prevention of dyscirculatory encephalopathy is, first of all, treatment of the causes that lead to arterial hypertension, stress, diabetes, obesity. In addition to maintaining a healthy lifestyle, normalizing sleep, resting work schedule, it is necessary to avoid manual therapy on the cervical spine. Failure to tilt the head and neck correctly can lead to irreversible disruption of blood flow in the vertebrobasilar system and cause disabling or fatal complications.

If there are signs of increased fatigue, decreased memory, or poor performance, you should consult a doctor and perform examinations that will rule out disruption of blood flow through the vessels supplying the brain. Identifying cardiac, pulmonary, and endocrine pathologies and starting treatment in a timely manner is the path to success in the fight against dyscirculatory encephalopathy.