Cerebrovascular diseases

Description:

Cerebrovascular diseases are characterized by acute disorders of cerebral circulation which background for development are atherosclerosis and a hypertension. On the being - it is cerebral displays of atherosclerosis and idiopathic hypertensia, is more rare - symptomatic hypertensia.
As independent group of diseases cerebrovascular diseases are allocated, as well as coronary heart disease, in connection with their social importance. These diseases in economically developed countries on incidence and a lethality "caught up" with coronary heart disease.

Symptoms of Cerebrovascular diseases:

Distinguish tranzitorny ischemia of a brain and a stroke from the acute disorders of cerebral circulation which are the cornerstone of cerebrovascular diseases. A stroke (Latin of in-sultare - to jump) call sharply (suddenly) developing local frustration of cerebral circulation which is followed by damage of substance of a brain and disturbances of its function. Distinguish:
- the hemorrhagic stroke presented by a hematoma or hemorrhagic treatment of substance of a brain; rank as it also subarachnoidal hemorrhage;
- an ischemic stroke which morphological expression is the heart attack (ischemic, hemorrhagic, mixed).

The ischemic heart attack of a brain which is formed at fibrinferment atherosclerotic of the changed pretserebralny or cerebral arteries has various localization. It is the most frequent (75% of cases) display of an ischemic stroke. The ischemic heart attack as the center of a gray encephalomalacia looks. At microscopic examination of the environment of necrotic masses it is possible to find the died neurons.

The hemorrhagic heart attack of a brain resembles the center of hemorrhagic treatment superficially, but the mechanism of its development another: initially ischemia of brain fabric, for the second time - hemorrhages develops in ischemic fabric. The hemorrhagic heart attack meets in a cerebral cortex more often, is more rare - in subcrustal nodes.

At the mixed heart attack which always arises in gray matter of a brain it is possible to find sites of both an ischemic, and hemorrhagic heart attack. On site brain heart attacks, as well as a hematoma, cysts are formed, and the cyst wall on site of a hemorrhagic heart attack contains hemosiderin accumulation ("a rusty cyst").

Reasons of Cerebrovascular diseases:

Everything that was told about an etiology and a pathogeny of coronary heart disease, is applicable to cerebrovascular diseases. Among proximate causes of acute disorders of cerebral circulation the main place is taken by a spasm, thrombosis and a thrombembolia cerebral and pretserebralny (sleepy and vertebral) arteries. Huge value has the psychoemotional overstrain leading to angioneurotic disturbances.

Treatment of Cerebrovascular diseases:

Drug treatment. Now the main directions of medicamentous therapy continue to remain the general actions and use of antitrombotichesky means (antiagregant and anticoagulants).
Clinical trials did not provide convincing data on expediency of use of Sulfinpyrazonum, suloktidil or Dipiridamolum though recently messages that appointment or aspirin in low doses, or Dipiridamolum in high doses is more effective than placebo and that action amplifies at their combination appeared. The research CAPK1E was conducted for assessment of comparative efficiency of use of a klopidogrel (75 mg/days), a modern antiagregant, and aspirin (325 mg/days) in decrease in incidence of not fatal stroke, not fatal myocardial infarction (MI) and cardiovascular mortality among 20 000 patients who recently had an ischemic stroke or to THEM, and also having clinically expressed peripheral atherosclerosis. Results of this research showed that клопидогрель more than aspirin, reduces the combined risk of an ischemic stroke, myocardial infarction and cardiovascular mortality at patients with atherosclerotic defeat of vessels.