brain-derived syncope
Introduction
Introduction to brain-derived syncope Brain-derived syncope refers to syncope that occurs when blood vessels in the brain (including the carotid system, vertebral-basal system, aortic arch and its branches such as the subclavian artery, innominate artery, etc.) develop transient ischemia. It is distinguished from epileptic seizures (small episodes), vertigo attacks, and seizures. basic knowledge The proportion of the disease: the incidence rate of the elderly over 50 years old is about 0.5% -1% Susceptible people: more common in the elderly Mode of infection: non-infectious Complications: nausea and vomiting, urinary incontinence
Cause
Brain-borne syncope
1. Cerebrovascular disease syncope
More common in the elderly, often accompanied by other brain stem symptoms, such as dizziness, unilateral limb and facial numbness, visual field changes, ataxia, etc., often recurrent, is a precursor to cerebrovascular accidents.
2. Medullary syncope
Because the lesion involves the medullary cardiovascular center leading to dysregulation. Common in medullary poliomyelitis, rabies.
3. Tube disease: cerebral arterial diffuse sclerosis, transient ischemic attack, cerebral vasospasm, arteritis, subclavian artery stealing blood, medullary cardiovascular central disease, migraine.
Prevention
Brain-borne syncope prevention
The main purpose of treatment for patients with syncope should include prevention of syncope recurrence and related injuries, reduce the mortality of syncope, and improve the quality of life of patients.
Most syncopes are self-limiting and are benign processes. However, when dealing with a fainting patient, the physician should first think of emergency rescue situations such as cerebral hemorrhage, massive internal bleeding, myocardial infarction, and arrhythmia. Elderly patients with unexplained syncope should be suspected of complete heart block and tachycardia even if no abnormalities are found in the examination. After finding a patient with syncope, the head should be placed at a low position (the head is drooped when lying down, and the head is placed between the legs when sitting) to ensure blood supply to the brain, loosen the buckle, and turn the head to the side to prevent the tongue from blocking the airway. Spraying a small amount of cold water on your face and a cool towel on your forehead can help you wake up. Keep warm and don't feed food.
Do not stand up immediately after waking up. After standing up and unable to improve, gradually stand up and walk. The risk of syncope in the elderly is sometimes not due to the primary disease, but to head trauma and limb fracture after fainting. Therefore, it is recommended to cover the toilet and bathroom floor with blankets, carpets in the bedroom, and outdoor activities on grass or land to avoid standing too long.
Complication
Brain-derived syncope complications Complications, nausea and vomiting, urinary incontinence
A small number of responders can cause unnecessary damage after fainting falls. For the elderly, it may induce aggravation of chronic diseases, and complications are life-threatening.
Symptom
Symptoms of brain-derived syncope Common symptoms Stun syncy, dizziness, syncope, erectile dysfunction, swollen, swollen, moderate coma, dizziness, dizziness, short-term interruption, fainting during urination
Symptoms of autonomic nerves were obvious, and suddenly pale, cold sweat, nausea, upper abdominal discomfort, enlarged pupils, fatigue, dizziness, loss of consciousness, and loss of body muscle tone. The patient's pulse is subtle, the blood pressure is often lowered, the breathing becomes shallow, the pupil dilated and the light reflex disappears, the tendon reflex disappears, the extremity is cold, and there may be urinary incontinence. In this period, after a few seconds to a few minutes, the consciousness gradually recovers and enters the next step. Period. Patients with brain-derived syncope have many signs of nervous system damage such as aphasia and hemiplegia.
Examine
Examination of brain-derived syncope
Patients with syncope should immediately measure pulse, heart rate, and blood pressure, and pay attention to whether they have pale complexion, difficulty breathing, and peripheral varicose veins. In particular, attention should be paid to orthostatic hypotension, examination of blood pressure in the upper limbs and physical and mental signs of the heart and brain. The standing blood pressure should be measured after the patient stood up for 5 minutes after lying 5 minutes.
Some special medical history, symptoms or signs often suggest the possibility of some type of syncope.
In addition, it can be used for head CT, cerebral angiography, carotid artery and vertebral artery B-ultrasound.
Diagnosis
Diagnosis and diagnosis of brain-derived syncope
According to the history and performance, it is not difficult. It is easier to discharge the dead bone through the sinus and the sinus. X-ray films confirmed the presence or absence of dead bones, understanding the shape, number, size and location. And the surrounding shell grows. Cases do not require CT. CT can be used because it is difficult to show dead bone due to thick bone.
Brain-derived syncope refers to syncope that occurs when blood vessels in the brain (including the carotid system, vertebral-basal system, aortic arch and its branches such as the subclavian artery, innominate artery, etc.) develop transient ischemia. It is distinguished from epileptic seizures (small episodes), vertigo attacks, and seizures.
The most common cause of brain-derived syncope is stenosis or occlusion caused by atherosclerosis, followed by cervical vertebrae (including cervical vertebrae and its joint hyperplasia, cervical muscle disease, soft tissue lesions of the neck, skull base deformity) Arterial compression, such as the arterial itself, trauma, tumor, deformity, or the involvement of the sympathetic plexus around the vertebral artery causes reflex vertebral artery spasm.
