Chronic cerebral ischemia, a developing and progressive cerebrovascular disease caused by chronic circulatory failure in the brain, is one of the leading neurological diseases in the elderly. The factors that lead to this disease are:
vascular diseases;
chronic hypoxia;
metabolic disorders;
somatic diseases;
various intoxications.
Arterial hypertension and atherosclerosis play an important role in the etiological factors leading to microcirculatory disorders in the brain. These pathologies are more common in adults.
MENTAL DISORDERS
Amyloid angiopathies are the leading cause of cerebral circulatory disorders in the elderly. The clinical manifestations of this disease include neurological, neuropsychological, and psychoemotional disorders, the manifestations of which depend on the severity of the disease and the area in which the ischemic lesions are located.
Depending on the level of the disease clinic, there are three stages (I-mild, II-moderate, III-severe).
Nausea, dizziness, sleep disturbances, rapid fatigue, and general weakness are characteristic of the mild (first) stage of the disease. Mental and emotional stress exacerbate these symptoms.
Cognitive impairments often precede neurological symptoms. This is especially true of attention and memory impairments. When a person is mentally active, he gets tired quickly.
The patient's memory also begins to deteriorate due to attention deficit. The ability to remember recent things decreases, but the events of childhood are remembered. Symptoms of psychoemotional disturbances include fatigue, irritability, and crying. The patient becomes very sensitive, and there are also autonomic disorders.
Sometimes mild symptoms are ignored and stage I is undetectable. If left untreated, the disease progresses to stage II.
In the second to moderate stage, the subjective symptoms worsen and new ones are added. The patient has trouble sleeping, sleeps during the day, cannot sleep at night or wakes up quickly and has many dreams. The headache is constant and simple analgesics do not help. Dizziness intensifies and backwardness begins to be felt. Attention and memory impairments increase. Along with mental fatigue, there is also physical fatigue.
IT IS DIFFICULT TO CONCENTRATE
The neurological and neuropsychological symptoms worsen as the blood flow to the brain becomes chronic. In the second stage, the number of visits to the doctor increases. Thinking disorders are more common in patients.
Cognitive impairments, such as inability to concentrate, memory loss, and impaired thinking, negatively affect a patient's professionalism. It can even lead to depression.
In the third-severe stage, the main complaints of the patient are diffuse headache, memory loss, insomnia, tinnitus, dizziness, and dizziness while walking.
Those who engage in mental labor are not able to perform their duties to the required level. Most patients are also unable to cope with daily family chores. Physical and mental fatigue increases.
The patient's range of thinking narrows, he becomes dull, capricious, small. Symptoms of amiostatic syndrome also appear in his movements.
EXTRAORDINARY SYNDROME
In chronic cerebral ischemia, several different syndromes are observed in the elderly.
Forehead syndrome is characterized by dementia and severe mental disorders. There is ataxia of the forehead, the patient is swaying, and there are cases of falling while walking.
Sometimes forehead syndrome is manifested by strong psychomotor movements, which make it difficult to control the patient. Sometimes, on the contrary, the patient's will fails. As the disease progresses, control over pelvic function also weakens.
In vascular dementia, cognitive disorders (disorders of perception, cognition, thought) predominate over neurological disorders, and the patient develops dementia. Gradually, the patient becomes indistinguishable from left and right, upper and lower. Due to visual agnosia and amnestic aphasia, he does not recognize his relatives and forgets their names. These disorders are also known as subcortical atherosclerotic encephalopathy, also known as Binswanger's disease.
Parkinsonism and pseudobulbar syndromes are unique. In Parkinson's syndrome, the patient develops urinary incontinence. Pseudobulbar syndrome is characterized by spontaneous crying and laughing, dysarthria, dysphagia, and dysphonia. These disorders are often accompanied by amyostatic syndrome and subcortical dementia.
Vertebrobasilar syndrome is associated with damage to the spinal arteries and basilar arteries and is characterized by symptoms of the spinal cord and brain. Symptoms such as constant dizziness, hearing loss, nystagmus ataxia, and intension tremor are observed.
Bulbar paralysis occurs if ischemia is observed in the lower part of the cerebellum.
When cases of chronic cerebral ischemia are observed, the patient should consult a neurologist and receive serious treatment. Multi-stage treatments and the care of loved ones alleviate the patient's condition.
Elbek MIRJOʼRAEV,
neurologist, doctor of medical sciences, professor.
