Cerebrovascular sclerosis
Introduction
Introduction to Cerebrovascular Cerebral Atherosclerosis refers to a series of pathological changes caused by diffuse atherosclerosis, stenosis of the lumen and small vessel occlusion resulting in a decrease in blood supply to the brain. The disease is a common disease of the central nervous system, and its clinical features are progressive hypofunction, complicated with cerebral infarction, cerebral hemorrhage and diffuse brain damage. The earliest change was the strip of lipids in the lining of the intima, and the microphages that phagocytose lipids under the microscope were clustered under the inner membrane. This change was reversible at an early stage. Spontaneous cerebral hemorrhage accounts for 10-20% of all strokes, and mortality and disability rates are high. basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: dementia
Cause
Cerebral arteriosclerosis
High blood pressure (30%):
Hypertension is the most important and independent risk factor for cerebrovascular disease. Studies have shown that systolic blood pressure greater than 160mmHg and/or diastolic blood pressure greater than 95mmHg, the relative risk of stroke is about four times that of normal blood pressure.
Diabetes (20%):
Diabetes is an independent risk factor for ischemic stroke, but not a risk factor for hemorrhagic stroke. Diabetes increases the risk of ischemic stroke by a factor of 3-4.
Other heart disease (20%):
For example, myocardial infarction, cardiac catheterization and endovascular treatment, cardiac pacemakers, and radiofrequency ablation all increase the incidence of embolic stroke.
Diet (10%):
Diet and nutrition increase the daily intake of vegetables and fruits, and the relative risk of stroke is reduced. Low sodium and high potassium intake may reduce the risk of stroke and may be related to lowering blood pressure.
Prevention
Cerebrovascular sclerosis prevention
Cerebral vascular sclerosis is a common disease of the central nervous system, which is easy to cause the occurrence of stroke. The symptoms of early and late patients are different and the symptoms are more. In terms of prevention, there are many vegetables and fruits that can play a good role. effect.
First: control blood pressure. Most patients with cerebrovascular disease have a history of hypertension. Hypertension is a lifelong disease. It is necessary to take medicine for life, not to fish for three days, and to dry the net for two days. Standardized antihypertensive treatment must be performed and reviewed regularly. If you do not insist on taking the medicine, it will cause high and low blood pressure fluctuations, which will easily lead to rupture of blood vessels and cerebral hemorrhage.
Second: pay attention to blood sugar and blood lipid changes. Diabetes can cause macrovascular and microvascular diseases, and elevated blood lipids can cause arteriosclerosis. Therefore, in addition to the treatment and monitoring of related diseases, people with diabetes, hyperlipidemia and heart disease should also be listed as the focus of prevention and treatment. Intervention target.
Third: the law of life. Develop the habit of going to bed early and getting up early, especially in the elderly, the body's adjustment function is reduced, and you can't stay up late. It is necessary to rest on time and ensure sleep, especially at noon. It is best to have a lunch break of more than half an hour.
Fourth: a reasonable diet. Do not smoke, drink less alcohol, avoid obesity, advocate low-salt and low-fat diet, diet should be light and diverse. All kinds of grains should be eaten. It is advisable to eat more foods rich in vitamins and minerals such as fish, beans, egg white, milk and lean meat, as well as fresh vegetables and fruits.
Fifth: a healthy mindset. A healthy mindset is an effective means of preventing arteriosclerosis and hypertensive cerebral hemorrhage. Middle-aged and elderly people with cardiovascular and cerebrovascular diseases should be good at regulating and controlling emotions. It is not appropriate to stock stocks and play mahjong to prevent cerebrovascular accidents from being caused by violent fluctuations in mood.
Sixth: physical exercise. Encourage the right amount of labor, such as simple housework, not to be too tired. Develop the habit of physical exercise, mobilize the positive factors of the human body, and keep the body in a healthy state.
Seventh: timely rescue. Once the patient is ill, immediately call the emergency number to the hospital for rescue. Do not arbitrarily use the hemostatic agent or other drugs to the patient to avoid delaying the optimal treatment time.
Complication
Cerebral vascular sclerosis Complications dementia
1. After cerebral arteriosclerosis reaches the late stage, life cannot take care of itself, self-knowledge is incomplete, or even complete dementia.
2, on the basis of cerebral arteriosclerosis is prone to ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease, cerebral arteriosclerosis is an important risk factor for cerebrovascular disease.
3, microthrombus formation, microthrombus, that is, the atherosclerotic plate of the arterial detachment, the formation of microemboli in the blood flow, with blood flow to the small artery and block the blood vessels, there will be insufficient blood supply to the brain.
Symptom
Symptoms of cerebral arteriosclerosis Common symptoms Brainwave changes Brain cerebral ischemia Pillow pain Dizziness Thinking Discontinuous Nausea Intermittent dizziness Dizziness Memory disorder Facial muscle weakness
Cerebral vascular sclerosis is a kind of arteriosclerosis, which is very dangerous because it is easy to cause stroke. In the early and late stages of the disease, the symptoms of cerebral arteriosclerosis are different.
Initial symptoms
The main symptoms of cerebral arteriosclerosis are: dizziness, headache, dizziness, headache, and more in the forehead and occipital (ie, the back of the head). The nature is mostly dull and painful. It is most likely to occur when the body position changes or the original symptoms are aggravated. Some patients feel asymmetrical walking. If the arteries at the base are hardened, there may be dizziness, nystagmus, nausea, facial muscle paralysis, and some may have difficulty swallowing. Memory loss, inattention, mental work ability, and work and study are struggling. Memory loss is also manifested in the recent forgetting of the past, remembering the past, but the memory defect is not obvious. This is often the earliest manifestation of intracranial arteriosclerosis, suggesting that the brain is not adequately supplied with blood and affects normal mental work.
Late symptoms
Symptoms of cerebral arteriosclerosis mainly manifest as brain parenchymal symptoms and dementia syndrome, namely cerebral arteriosclerotic psychosis. Outstanding performance is memory loss, in addition to significant memory barriers, long-term memory is also affected. Patients can't describe their experiences or even know their family. Computation, judgment, and comprehension are progressively declining, and consciousness barriers are impossible to complete daily work. Slow thinking activities, difficult associations, even inconsistent thinking, repeated or confusing speeches, sometimes delusions, and more pervasive delusions, relationship delusions, and sinful thoughts. Sometimes there are hallucinations or olfactory hallucinations, and the content is more related to fantasy. Personality and emotional change often become indifferent, lonely, lazy, embarrassing, childish, untidy, and even casual. Behavior disorder, doing nothing, sometimes impulsive, aggressive behavior, self-control disorder. The condition is getting worse and worse, the time is fluctuating, the symptoms are relieved and the aggravation occurs alternately. In severe cases, the consciousness is cloudy or paralyzed, and soon it is suddenly awake. Often misdiagnosed as "neurasthenia", "neurofunction", "menopausal syndrome".
It can be seen that there are many symptoms of cerebral arteriosclerosis, both early and late. When some symptoms appear, the patient should go to the hospital for a diagnosis and treatment under the guidance of a doctor.
Examine
Cerebrovascular sclerosis examination
1, blood lipid determination, cholesterol > 200 ~ 250mg%, triglyceride > 130mg%, beta lipoprotein > 450 ~ 600mg%.
2, cerebral blood flow map, including drug trials. The cerebral blood flow map has a prolonged rise time, the severe beat wave weakens or disappears, the main peak angle becomes dull, and the amplitude decreases.
3, EEG, including the neck induction test.
4. Perform cerebral angiography if necessary.
5, brain CT often have varying degrees of brain atrophy and infarct size and size.
Diagnosis
Diagnosis and diagnosis of cerebral vascular
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1, neurasthenia
Early symptoms are similar, but the age of onset of neurasthenia is 40 years old. Symptoms often worsen after the brain, relieve after rest, memory loss is obvious, no neurological signs and laboratory evidence does not support the diagnosis of cerebral arteriosclerosis.
2, mental disorders associated with essential hypertension
The key lies in the differential diagnosis of primary disease, namely the differential diagnosis of cerebral arteriosclerosis and essential hypertension. Clinically difficult to identify. Because often two primary diseases exist simultaneously. Generally speaking, patients with mental disorders associated with essential hypertension have an earlier onset age. There are many years of hypertension before the onset of mental symptoms. Mental factors are often the predisposing factors, and mental symptoms occur more rapidly. Most of the affective disorders are fear and anxiety. The disturbance of consciousness is more common. The mental disorders associated with cerebral arteriosclerosis are more autonomic nervous system symptoms.
3, intracranial tumor
Some mental disorders associated with cerebral arteriosclerosis with prominent focal symptoms and progressive development should be differentiated from intracranial tumors. The latter often presents headaches and is obvious in the morning, exacerbated by coughing and exertion, accompanied by vomiting, optic disc edema, short course of disease, and rapid progress. CT or magnetic resonance imaging can help identify intracranial space-occupying lesions.
4, other
When accompanied by obvious depression or anxiety, attention should be paid to the identification of depression and anxiety; with seizures, it should be differentiated from primary epilepsy or other symptomatic epilepsy. Clear physical signs and laboratory tests can distinguish functional psychosis.
