Cerebral ischemia in newborns - symptoms, treatment methods, consequences. Development factors and stage of cerebral ischemia

Cerebral ischemia in the newborn - one of the most serious problems of child neurology, effective methods of pathology therapy have not yet been developed. The forecast of the course of the disease directly depends on the severity and timeliness of the started treatment.

The only reason for the development of cerebral ischemia is the violation of the blood supply of the child's brain during pregnancy and childbirth. Two forms of the disease are distinguished: partial (hypoxia) and complete (anoxia). Denote this problem in a newborn usually by the term "hypoxic-ischemic encephalopathy", it means damage to the tissues of the brain due to insufficient oxygen intake. The most common and dangerous types of encephalopathy include perivativericular ischemia, affecting the brain vessels and having severe consequences for the child, up to the development of cerebses and epilepsy.

The mechanism of development of cerebral ischemia in newborns is as follows. With sufficient blood supply to the organism, oxygen is distributed evenly between all organs and tissues. In the case of a short-term circulation of blood flow, oxygen comes first in vital organs - the heart and brain, and the remaining organism systems are experiencing its deficit. If it continues, the blood feeds oxygen primarily the heart, and the tissue of the brain gradually begins to die. The longer the state of oxygen starvation of the brain continues, the harder the consequences for the child.

The shortage of blood circulation in the newborn baby occurs in the following situations:

1. An unfavorable course of pregnancy
   - any acute and chronic mothers diseases, including hormonal disorders;
   - Preeclampsia, Eclampsia and Gestosis;
   - detachment and damage to the placenta, the pathology of the umbilical cord;
   - Major;
   - bad habits;
   - use of prohibited drugs;
   - age less than 18 and over 35 years old.
2. Complications in the process of delivery
   - childbirth for a period of up to 37 or after 42 weeks;
   - protracted / rapid childbirth;
   - long anhydrous period;
   - big blood loss;
   - campus umbilical;
   - artificial stimulation of generic activity.
3. Other factors
   - hereditary predisposition to neurological disorders;
   - Some pathology of the cardiovascular system in the fetus.

The risk of cerebral ischemia is increasing in the case of prolonged drug-proof treatment. According to statistics, almost two-thirds of infants, the first signs of brain pathology are noted even during the period of intrauterine development, and a minor of cases develops after delivery.

Varieties of pathology

Cerebral ischemia in newborns is distinguished by varying degrees of gravity:

1. The first (light) degree is characterized by a slight increase in muscle tone and amplification of tendon reflexes. During the first 3-7 days after birth, the child has increased drowsiness, lethargy or excessive excitement. In some cases, there is a slight chin tremor and limbs, a disorder of the gastrointestinal tract, abundant joining. Typically, symptoms take place independently and do not pose a threat to the health and development of the child.
2. The second (average) degree is accompanied by a reduced muscle tone and the extinction of some congenital reflexes. Causes arise and - sudden short-term breathing delays. With a timely initiated therapy, the forecast is generally favorable, up to full cure.
3. The third (severe) degree is expressed in the absence of the required reflexes, a decrease in tone, expressed body seizures and limbs, brain hydrocephalus, hearing and vision organs. In most cases, the child cannot breathe independently, does not respond to external stimuli.

Diagnosis of Ischemia

Usually cerebral brain ischemia in the newborn is diagnosed in the first hours after childbirth. The disease is confirmed during the test of congenital reflexes, and its difficult flow is usually determined by the naked eye. Low scores on the apgar scale are talking about serious disorders and severely after 5 minutes after the appearance of the light (from 0 to 3) and the visible symptoms of the brain disorders and the remaining internal organs.

In addition to external inspection, the following research methods are used to confirm the disease and establishing severity:

• common blood test with evaluation of coagulation and quantitative determination of electrolytes and dissolved gases (in hypoxia, a high carbon dioxide content in the child's body is noted);
• magnetic resonance imaging, allowing to estimate the degree of damage to the tissues of the brain and the CNS;
• Ultrasound head helping to eliminate the presence of edema and damage to the vessels;
• electroencephalography - reveals hidden cramps.

Effects

Speaking about the disease forecast, its severity should be taken into account, the timeliness and success of the appointed therapy. Cerebral ischemia 1 degree in a newborn, as a rule, ends safely. The following implications include the following:

• hyperactivity;
• increased excitability;
• irritability, plasticity;
• difficulties with falling asleep.

Cerebral ischemia of 2 degrees is characterized by more severe complications: headaches, sleep disorders, nervous disorders. Such kids are much more difficult to adapt to the environment, slower peers develop and have difficulty learning.

Cerebral ischemia is severe almost in half cases ends with a fatal outcome. Among the surviving kids are often complications: cerebral palsy, epilepsy, autism, mental retardation. Only 10% of children with a complicated form of the disease, even at a timely manifold medical care, do not have pronounced complications.

Experts noted if during one month the symptoms of the child does not fade or increases, the brain activity is not restored and the disease has an unfavorable forecast.

Treatment

The priority goal of therapy is the restoration of normal cerebral circulation and the prevention of the development of irreversible complications. Specific treatment does not exist, in each case an individual approach is applied depending on the peculiarities of the pathology and the presence of concomitant diseases.

With a light degree of dysfunction, standard treatment is to assign a common massage that stimulates normal blood flow. Ceraity of Ischemia 2 degrees in newborns, in addition to massage, usually requires the use of drug therapy that restores the normal work of vital organs. Therapy for severe illness includes the following:

• the appointment of drugs that prevent the development of convulsions and funds supporting the work of the child's heart;
• artificial ventilation of the lungs;
• hypothermia to preserve brain tissues;
• special massage and exercises for cerebral palsy.

Rehabilitation takes from 2-3 months to several years. The kids who have undergone the disease of medium and high gravity are registered with the neurologist. They show therapeutic physical education, physiotherapy, swimming in the pool. If necessary, children are appointed additional course therapy by nootrops, vascular preparations, herbs, homeopathic agents. and disorders of the musculoskeletal system are assigned to wearing special retention devices: corsets, Longets, orthopedic shoes. In some situations, it is necessary to conduct classes with speech therapists and defectologists.

Cerebral brain ischemia in newborns is preventable. In order to minimize the risk of serious pathology, a pregnant woman should fulfill the following recommendations:

• observe the appointment of the observer physician;
• prevent the exacerbation of chronic diseases;
• on time to pass tests and undergo research;
• do not neglect exercise, more walking;
• eat well and get enough sleep;
• lead a healthy lifestyle.

If it was not possible to avoid the problem, it is important to reconcile measures to eliminate it. Much more efficiently eliminate the disease itself at an early stage than to treat her consequences.

Ischemia in the newborn (cerebral ischemia) develops with insufficient provision of a cerebral of a baby saturated with oxygen blood. Nervous tissue is extremely sensitive to oxygen starvation, so blood supply disorder quickly leads to the development of metabolic disorders and damage to the brain.

In the first stages, perinatal hypoxia (oxygen starvation), contributes to the redistribution of blood flow between the organs to maintain sufficient cerebral blood supply.

However, a long deficiency of O2 in blood (hypoxemia) and a progressive hypercup (increasing the concentration of carbon dioxide in the blood), contribute to the violation of the autoregument of the vessels and the development of cerebral hypoperfusion (reducing blood flow in brain vessels).

Important. Hypoperfusion is the main cause of severe cerebral ischemia in newborns, accompanied by the development of hyrogen (hypoxic-ischemic encephalopathy).

Reference. Cerebral hypoperfusion is diagnosed with a decrease in the speed of cerebral blood flow below 10 ml per 100 g of tissue per minute. As a rule, such changes are specific for premature babies.

The reduction in the SMC leads to damage to the cells of the endothelium and the sharp narrowing of GM capillaries. As a result, the resistance of the vascular bed in the influx of blood increases, contributing to:

• violation of the autoregument of blood supply;
• significant exacerbation of ischemia in the newborn;
• development of hypoxic-ischemic encephalopathy (GE).

The term GE implies the presence of acute damage to GM, as a result of hypoxia (oxygen starvation) and ischemia (blood supply deficit). That is, the term brain ischemia in newborns is considered to be wider in its meaning, including in itself and the primary deficiency of O2 and a violation of brain perfusion.

The cerebral ischemia of the newborn also includes ischemia caused by congenital vices of a blue type of heart (, anomaly of Ebstine).

Reference. HE implies an ischemia version with already existing damage to the cells of the brain. Therefore, the term hypoxic-ischemic encephalopathy in clinical practice is applied more often.

The severity of damage to the structures of the GM is caused by the duration and degree of severity of hypoxia and ischemia, as well as the primary cause of oxygen starvation of tissues.

Brain ischemia in newborns. Causes of occurrence

In the overwhelming number of cases, ischemia in a newborn is perinatal, that is, it comes in the womb. Less often, it is a consequence of asphyxia in childbirth.

The brain ischemia is more characteristic of premature babies, as the vascular system has not yet fully formed. In the docking kids, this diagnosis is rare.

Brain ischemia in newborns can be associated with:

• maternal pathologies, leading to fetoplacental failure:
  • anemia,
  • diabetes,
  • coagulopathy, accompanied by a tendency to thrombosis,
  • thrust diseases (thyroid gland),
  • kidney pathology,
  • endometriosis,
  • miometry hypoplasia,
  • hypovolemia
  • hypoxemia
  • congenital heart disease,
  • low or high blood pressure,
  • late speakers, including preeclampsia and eclipism;
• intrauterine fetal infections;
• infection or enhancing infection in childbirth;
• the reliant of the umbilical cord (in childbirth or due to the true nodes of the umbilical bodies) and the fetal capture;
• shell attachment of umbilical cord;
• vessel thrombosis or large cord cysts;
• deposition of umbilical
• acute lack of placenta;
• detachment placenta;
• low preview of the placenta;
• bleeding in childbirth;
• asphyxia due to excessive bouts;
• injuries in childbirth, including because of a narrow pelvis;
• gap of the uterus.

The risk factors of the occurrence of ischemia in the newborn are divided into the antenatal and intranatal.

The antenatal factors include:

• mother's age older than 35 years old
• premature and protracted labor
• non-compliance with the mother of the principles of a healthy lifestyle (smoking, heating of alcoholic beverages or narcotic substances during pregnancy),
• refusal to observe the doctor, as well as the presence of it:
  • endocrine diseases (especially diabetes mellitus);
  • long-term toxicosis;
  • threats of pregnancy interrupt;
  • multiple pregnancy;
  • infectious inflammatory diseases (especially in the second and third trimester of pregnancy);
  • autoimmune pathologies.

The intranatal risk factors of cerebral ischemia in newborns include:

• acute maternal hypoxia in childbirth (development of shock, decompensation of chronic somatic pathologies, etc.);
• anomalous prevention of the fetus;
• the use of obstetric benefits (nippers, vacuum extractors);
• impairment of fetoplacentar blood circulation due to eclampsia, tight cord cord, short umbilical umbilical cords, true nodes of umbilical cords, biposts loss, etc.;
• rupture of the uterus;
• emergency cesarean section;
• discordinated generic activity;
• rapid, rapid or protracted labor.

Ischemia in a newborn. Pathogenesis of development

Compensatory vasopressor factors contribute to:

• an increase in the tone of peripheral vessels of the fetus,
• the emergence of tachycardia
• increasing the IOC (minute volume of blood),
• an increase in reflex motor activity.

Further progression of hypoxia contributes to:

• depletion of compensatory mechanisms
• changing heart rate (bradycardia development),
• oppression of motor activity,
• loss of ability to cerebral auto regulation,
• weighing brain hypoterfusion,
• as a result - ischemia of a newborn.

Attention! The loss of the ability to auto regulation in premature babies occurs much faster than the docking.

Violation of compensatory blood flow mechanisms leads to the fact that the brain becomes extremely vulnerable to blood pressure oscillations. This significantly increases the risk of severe intraventricular hemorrhages (GWK).

Intrauterine ischemia can lead to:

• delay of intrauterine development
• failure to pregnancy
• throw out.

It should also be noted that heavy ischemia in the newborn contributes to the violation of the rheological properties of the blood and an increase in its viscosity. Therefore, children with severe hypoxia and asphyxia in the first day there is a pronounced hypercoagulation.

Normally, all newborns have a moderate thrombogenic activity of the system, but on the third day it decreases. In premature babies with ischemia, hypercoagulation is more pronounced and saved longer.

Pronounced ischemia in a newborn, accompanied by severe hypercoagulation, can be complicated by disseminated intravascular blood coagulation.

Attention! Heavy hypoxia and ischemia contribute to the accelerated anaerobic glucose metabolism, leading to a sharp decrease in the synthesis of adenosine trifosphoric acid (ATP). This leads to the opening of sodium, calcium and potassium channels, the aspiration of water flows and electrolytes in the neurons of the GM, causing the early cytotoxic edema of the brain.

Pathogenesis scheme

The main symptoms of ischemia in the newborn

Reflexes are broken, muscular tone is reduced. There is a chin tremor and limbs, frequent shudding. A seizures may develop.

The appearance of glasses of ice symptoms (Nistagm, Exophthalm), the ripples of a large spring is possible.

Characterized periodic short-term respiratory stops (apnea).

Important. In severe cases, the oppression of consciousness is possible, right up to the development of the coma.

Severity of ischemia

Cerebral ischemia in newborn 1 degree (light) is characterized by reversible violations. She manifests:

• a slight increase in muscle tone,
• revival of tendon reflexes,
• weak, sluggish sucking,
• refusal to eat
• frequent jerking
• concern
• constant crying.

Sometimes lethargy and drowsiness can be observed (more characteristic of premature babies).

Cerebral ischemia in a newborn 1 Art. Not accompanied by deep neurological disorders and is characterized in that all the symptoms are normalized within 3-4 days after birth.

Cerebral ischemia in newborn 2 degrees (moderate) is accompanied by a sharp decrease in muscle tone, lethargy and drowsiness, up to the state of the lethargy. There is severe muscular hypotension and a pronounced reduction of tendon reflexes.

Grass, sucking, as well as the reflex moro can be completely absent or being extremely oppressed.

Reflex Moro is checked with a passive, sudden pulling of a baby's feet or unexpected shock by the pillow, on which the baby's head is located. At the same time, in the first phase of the reflex, the child spreads half-bent in the elbows and spreads his fingers. In the second phase of the reflex, the knob is returned to its original position.

Cerebral ischemia in newborn 2 tbsp. It is also accompanied by periods of short-term respiratory stops (apnea), cramps, trembling limbs and a pronounced chin tremor.

With a decrease in the severity of the Symptoms of Hie for two weeks and the onset of complete neurological recovery, the forecast is favorable.

Important. In favor of the unfavorable forecast, the re-deterioration, which developed against the background of the normalization of symptoms.

Cerebral ischemia in a newborn 3 degree is characterized by severe oppression of consciousness, the development of a stupor or coma. Perhaps the complete absence of a reaction to external stimuli (including physical). There are frequent apnea, irregular breathing, the baby needs hardware keeping breathing.

Temor reflexes are missing, muscular tone is reduced sharply. It is also characteristic of the absence of reflexes of a newborn (moro, sucking, grasing, swallowing).

Overweight dysfunctions are noted, due to the defeat of the CHMN (brain-brain nerves). Characterized by the presence of Nistagma, the squint, Exophthalma, there are no friendly movements of the eyeballs.

The pupils of the baby are absolutely not reacting to the light, or the reaction is weak.

Generalized seizures resistant to anticonvulsant therapy may be occurred.

Complications

• brain swelling
• heavy heart rhythm disorders
• sharp jumps hell
• hemorrhage in the brain,
• development of DVS syndrome and polyorgan deficiency.

With long-term intrauterine ischemia, a delay of intrauterine development is noted.

In the future, depending on the severity of the damage to the GM, it is possible:

• lag in development (physical and mental),
• immune disorders (frequent infections),
• endocrine pathologies (high risk of diabetes mellitus),
• epilepsy.

Diagnosis of cerebral ischemia in newborns

The diagnosis of HE is exhibited on the basis of a physical inspection, scores on the apgar scale, assessing neurological status, as well as functions of respiratory and cardiovascular systems.

Also carry out:

• angiography of vessels of the neck and brain;
• magnetic resonance tomography and angiography;
• duplex scanning of um vessels;
• electroencephalography (standard and amplitude-integrated);
• electrocardiography and echo kg;
• an exploring ultrasound study of GM (neurosonography);
• general and biochemical blood tests;
• blood pressure monitoring;
• blood gases;
• inspection of the neurologist, ophthalmologist, neurosurgeon and cardiologist.

Treatment

Toddler's therapy with hyire aimed at:

• ensuring optimal conditions for their further fitting;
• correction of violations of respiratory and cardiovascular systems; elimination of hemodynamic disorders;
• normalization of the gas composition of blood, elimination of electrolyte disorders;
• prehaling development and elimination of already arising cramps.

Further treatment is aimed at correcting the developing complications and consequences. Can be appointed:

• courses Flammable, massage,
• treatments normalizing cerebral circulation (piracetam),
• vitaminotherapy (group B),
• the use of leviculture (elkar).

Forecast and consequences of cerebral ischemia in the newborn

The forecast of the disease depends on the severity of the brain damage. With light ischemia, clinical symptoms subspect for three to four days, no significant complications are observed. There is a slight lag in the mass set and an increased nervous excitability.

With medium severity ischemia, further forecast depends on whether the symptoms disappeared within two weeks. In the case of symptoms regressing, further forecast is favorable. If the symptoms did not disappear or continued to grow, as well as with severe ischemia, the forecast is unfavorable.

In the future, it is possible to lag in the development, mental retardation, cerebral palsy, autism, epilepsy.

Reference. The prevention of the development of GE in the newborn is regular and thorough control over the state of the kid, compliance with the pregnant principles of a healthy lifestyle (a refusal of smoking, walking in the fresh air, full-fledged nutrition, etc.)

Cerebral ischemia is a disease characterized by insufficient intake in the oxygen brain together with blood due to blockage of one or more vessels. Because of this, the newborn brain cannot be formed normally. With untimely medical intervention in tissues, bleeding and develop pathological changes may occur. It is timeliness that plays an important role in the treatment of brain ischemia in newborns.

Signs and symptoms of brain ischemia in newborns

The disease manifests itself with obvious symptoms that pay attention.

• The child is easily excited, crying without reasons, sleeps badly, shudders, he has a tremor.
• Muscular tone is lowered, the kid moves little, with difficulty sucks and swallows.
• Spring is increased, intracranial pressure is increased due to the fact that liquid accumulates in the brain.
• Causes arise, twitching limbs and heads, as well as comatose states with loss of coordination of movements, consciousness.
• The skin of the newborn acquires a marble shade.
• The work of the gastrointestinal tract is violated - bloated, constipation, diarrhea.

How does cerebral ischemia arise?

In 70% of cases, ischemia occurs in the fetus in the womb and is associated with the formation of a thrombus in one of the vessels that feed the brain, or with the insufficient development of the vessel. Most often, the disease is diagnosed with premature children who have a vascular system not yet fully formed.

As a result, an insufficient amount of blood flows into the vital organ, and with it - oxygen. Delegation with medical care leads to the defeat of larger parts of the brain, hemorrhage to the brain and other difficult consequences.

The reasons

In the overwhelming majority of cases, the causes of cerebral ischemia in newborns are concluded in various disorders of the fetus in recent weeks, as well as in non-standard situations during childbirth.

• Disposal of the placenta or impaired blood flow in it.
• Putting the cord, fetal suffocation.
• Congenital heart defects.
• Problems of blood circulation.
• Intrauterine hypoxia.
• Entering infection during childbirth.
• Openness of arterial duct.
• Acute placental insufficiency.

Risk factors

Various vascular and neurological pathologies, arterial pressure problems (especially hereditary), the mother should alert the doctor who is pregnant. Also, the risk factors for the child of cerebral ischemia are:

• mother age more than 35 years;
• endocrine diseases;
• premature, protracted labor;
• multiple pregnancy;
• late toxicosis;
• non-compliance with the mother of a healthy lifestyle;
• the aggravation of chronic or acute diseases of the mother when entering the fetus.

Diagnostics

Basically, the disease is diagnosed during the first few hours.

The presence of pathology is evidenced by deviations check reflexes, general analysis of blood. Typically, the analysis shows an increased content in the body of carbon dioxide.

When discovering explicit symptoms of severe illness spend magnetic resonance tomography, as well as electroencephalographyrevealing hidden cramps and other deviations in the work of the brain.

Degree of ischemia

Cerebral Ischemia 1 degree

A light shape characterized by the presence of weakly pronounced signs in the first 3-5 days after birth. Basically, manifests in the form:

• nervous excitation or oppression;
• small muscular tone;
• strengthen tendon reflexes.

The child monitors the doctor, and the symptoms gradually pass without complications.

Cerebral ischemia 2 degrees

Dangerous form of the disease. For her, characteristic:

• pronounced apnea (stop breathing in a dream);
• reduction of grabbing, sucking reflexes;
• weak muscle tone;
• an increase in the shape of the head due to the accumulation of the liquid;
• coordination violation;
• loss of consciousness;
• changes in color skin.

Most often, Ischemia of the 2nd degree manifests itself in the first day of the life of a newborn, and symptoms can be observed within 2-4 weeks. At this time, the child carefully observe doctors, he passes the course of therapy. If necessary, conduct a surgical surgery to remove the thrombus.

Cerebral ischemia 3 degrees

The most severe form at which:

• the baby has no reflexes;
• the child falls into whom;
• violated heart rhythm;
• blood pressure increases sharply;
• there are problems with independent breathing;
• summary is observed.

An experienced doctor already in the first 5 minutes of the newborn life can determine the presence of signs and symptoms of cerebral ischemia 3 degrees. In this case, the child is sent to intensive care, if necessary, connect to the device of artificial ventilation of the lungs.

Treatment of cerebral ischemia in newborns

The purpose of treatment is to restore normal blood circulation in brain tissues, prevent pathological changes and eliminate the effects of ischemia. For the sickness of the 1st degree, treatment is usually consigned to the intended massage to improve blood circulation.

In case of diseases of the 2nd and 3rd degrees, drug therapy and surgical intervention are used to remove the thrombus in the vessel and restore the structure of the vascular bed. In difficult cases, the baby undergoes a recuperation course of intensive therapy.

Forecast and consequences of cerebral ischemia

Much more efficiently eliminate the ischemia after the birth of the baby, rather than treat her complications. Among the consequences of cerebral ischemia 2 degrees:

• sleep disorders;
• headaches;
• irritability;
• closed;
• hydodine.
• The disease of 3 degrees has the most difficult consequences:
• attention deficit syndrome;
• mental retardation;
• symptom of Gref and others.

If all actions to eliminate ischemia were carried out by doctors in a timely manner, the symptoms are held during the rehabilitation period, which is usually 6-12 months.

The birth of a child is one of the most joyful events in a person's life. But, unfortunately, sometimes joy is overshadowed by the fact that the crumb is included in the world with diseases acquired before birth. One of the possible pathologies is called cerebral ischemia. This is a sonorous and incomprehensible phrase in a literal translation means insufficient blood supply to the brain.

The consequences of cerebral ischemia for a child can be very heavy. However, to panic, if immediately after birth, the pediatrician put this diagnosis, the parents are not worth it. The disease can manifest itself in different ways. Often, this condition in the infants passes without treatment.

Cerebral ischemia is developing not only from the smallest, but the most adults. Based on the age gradation, the disease is divided into the following types:

• congenital - cities of newborns;
• acute;
• chronic.

Congenital cerebral ischemia

The brain ischemia in the newborn in most cases begins in the late months of pregnancy and directly in childbirth. Reduced supply of blood (ischemia) of the brain leads to insufficient oxygen flow (hypoxia) in tissue. Cerebral ischemia in the newborn is classified in 3 degrees, each of which has its own signs and consequences for the baby.

Cerebral ischemia 1 degree in newborn

The easiest form of pathologists. Clinical picture was smeared. Experienced pediatricians determine its complex of three signs.

1. The kid has changes in behavior. The child is worried, often crying, despite drowsiness and lethargy, sleeps badly.
2. There is some tension in the muscles.
3. Tender reflexes above the norm.

In premature children, the last two signs look in different: muscle tone and tendon reflexes, on the contrary, lowered.

It is not necessary to treat the infants, usually grabs a restorative massage. It is carried out in order to relax muscles, improve blood flow and supply of brain oxygen. In the room where the newborn is, there should be enough oxygen, so it is recommended more often to air.

The forecast is positive. The baby develops, no lagging behind his peers.

Cerebral ischemia 2 degrees in a newborn

The future of babies looks not so cloudless. Mental deviations are celebrated almost in half cases of the disease. 20% suffer from increased intracranial pressure. Cerebral ischemia 2 degrees in the newborn has the following symptoms:

• breathing disorders in a dream;
• muscle weakness;
• weakened grabbing and sucking reflex;
• skin pallor with a bluish shade or red-bluish pattern;
• possible increase in head (hydrocephalic syndrome).

Treatment of cerebral ischemia 2 degrees in newborns combined. Preparations for the extension of blood vessels are used, against seizures that reduce blood coagulation, outputing excess fluids during hydrocephalus, electrophoresis and massage. If necessary, surgical intervention is carried out

Cerebral ischemia 3 degrees in a newborn

A severe form of pathology, in which important brain functions are seriously damaged. In most cases, the following manifestations are recorded.

1. There is no reaction to external stimuli.
2. The child is not able to breathe independently, take food.
3. There are involuntary cramps.
4. Increased intracranial pressure.
5. There is a hydrocephalic syndrome.

The newborn has no chance of survival without emergency medical care. The kid is connected to an artificial respiratory unit. Surgical ways are removed by the thrombus. The shunt is made to remove the cerebrospinal fluid in the ventricles of the brain. Vasasculating and diuretic products are prescribed, anticoagulants.

However, immediate medical care is often unable to save the life of the newborn. For the third degree of the consequences of cerebral ischemia, the newborn is extremely severe. Each second child does not survive. About 80% of the survivors suffer from autism and children's cerebral paralysis, 10% have minor mental deviations. And only one of the ten subsequently develops normally.

The reasons

Blooding the blood supply and nutrition of its cells with oxygen occurs when there is one or more of the following factors:

• pathology of placental blood circulation;
• prematurity;
• congenital heart disease;
• too fast or long childbirth;
• damage to the umbilical bodies during childbirth;
• infections made;
• bleeding caused by various injuries.

Prevention

Since the treatment of cerebral ischemia in newborns does not provide positive results in all cases, the prevention of diseases in the future mother becomes important. A set of preventive measures is simple.

1. To lead a healthy lifestyle: do not smoke, do not drink alcohol, do not comply with a tough diet, but at the same time do not overeat, do regular exercise.
2. Attending female consultation, treat infectious and other diseases.

Chronic cerebral ischemia

Chronic brain ischemia develops in people of senior and old age. As with congenital brain ischemia, 3 degrees of illness are classified.

Symptoms

Brain ischemia Chronic manifests itself depending on the stage of development.

1. The first stage of the disease signals about itself by the fact that the patient begins to quickly tighten with mental tension, it has light problems with memory, hearing, vision. Sleep disorders are noted, headaches, general weakness. Mood changes quickly without significant causes. Most people consider these signs not to illness, but to age.
2. Chronic brain ischemia is characterized by increasing problems. In particular, there is a sharp decrease in memory and performance. Dizziness occurs even with the easiest moves. Does not let alone weakness, sometimes cramps. There are negative changes in the individual plan.
3. Chronic cerebral ischemia at the final stage leads to organic brain damage and serious violations of cerebral activity. The patient loses the ability not only to intelligent labor, but also to performing simple actions, for example, to care. Developing dementia. There are either small strokes or an extensive stroke. Because of the violation of the brain circulation, the lack of left ventricle of the heart can develop. And with acute left ventricular insufficiency, the development of cardiac asthma and edema of the lungs is very likely.

The reasons

Two reasons for chronic cerebral ischemia stand out:

• atherosclerotic lesions of the arteries that feed the brain;
• arterial hypertension.

Atherosclerosis of the coronary and cerebral arteries is caused by cholesterol sediments on the walls of the vessels. Cholesterol plaques violate normal blood flow in the body. Arterial hypertension is characterized by persistent increased arterial pressure. Both diseases are widespread, especially among older people. It leads to them and genetic predisposition, and an unhealthy lifestyle.

Both diseases extremely negatively affect the brain. For example, a cerebrovascular failure may develop, when focal damage to small vessels arise in the brain.

Treatment and prevention

Treatment of chronic ischemic brain disease combined. Mainly, drug treatment is practiced to expand the clearance of the arteries, improve the blood supply of the brain and slow down the development of the disease (pentoxifylin, nimodipine, piracetam, etc.). Prevention is aimed at this (refusal of bad habits, healthy nutrition, moderate physical activity). With progressive damage to the main arteries of the head, surgical intervention is used.

Causes and treatment of chronic coronary heart disease

Chronic brain ischemia arises due to the blockage of cerebral brain vessels or their long-term narrowing. The result becomes gradual damage to the brain tissues, which leads to microindarcts, and also the cause of the formation of essential territorial brain infarction.

• The reasons
• Symptoms
• Development Stages
• Diagnostics
• Features of treatment
• Forecasts

As statistical data show, the relevance of chronic cerebral ischemia takes place in 70 cases out of 100. With regard to the relevant preventive measures and proper treatment, they are directly dependent on the direct activities of patients. Thus, it is the disorders of the psyche and the central nervous system that have a direct impact on the ability to work.

The most common causes of the development of this disease are diabetes, myocardial disease, as well as atherosclerotic damage to the walls of the vessels. Among other things, one should not be ignored by such factors as problems with microcirculation, which, most often, appear as a result of an increase in blood viscosity. They also cause blockage of small arteries and the occurrence of thromboms.

The reasons

As modern medical practice shows, chronic brain ischemia can be due not only to major, but also secondary reasons. Consider them in more detail:

• With incorrect development of the arteries of the brain, as well as vessels involved in a large circulation circle. As a rule, such anomalies do not have pronounced symptoms and begin to actively progress at the time when any significant changes occur in the vascular system, and the corresponding treatment is not carried out;
• The presence of pathology in the venous system. These may be all sorts of thrombosis and thrombophlebitis;
• The diseases of the spine, which become the cause of the violation in the blood circulation of the arteries and their late treatment. These diseases include the hernia of intervertebral discs, osteochondrosis and others;
• Appearance in the circulatory system and internal organs of amyloid (insoluble protein);
• With any blood disease.

Symptoms

From how timely the chronic brain ischemia and appointed proper treatment, the consequences are directly dependent. It is for this reason that you should immediately pay attention to the appearance of the following symptoms:

• periodic or permanent headaches;
• feeling of gravity in the head area;
• periodic dizziness;
• decline in attention that may gradually progress;
• worsening memory with subsequent progression;
• the emergence of problems with sleep;
• the appearance of disorders in coordination of movements, especially when walking;
• the appearance of emotional instability and instability.

In fact, the weaker the blood supply to cerebral neurons becomes, the more brain ischemia progresses, leading to the development of heart attacks.

Development Stages

Depending on the symptoms and various clinical signs, 3 main stages of the disease can be distinguished:

1. The initial (1st) stage is accompanied by headaches, a deterioration in memory, periodic dizziness, partial sleep disorders, emotional instability, as well as a feeling of weakness throughout the body that does not have any neurological symptoms;
2. Subcompensation (2nd stage). Its main features is the progression of symptoms characteristic of the 1st stage, as well as a gradual change in personality. There is an apathetic attitude to most events, a depressive state is developing, the circle of interest is sharply reduced. Among other things, light insufficiency develops, oral automatic reflexes deteriorate and disorders coordination appear;
3. Decompensation (3rd stage). It is characterized by coarse disorders of the nervous system caused by multiple heart attacks, strong disorders of coordination of movements, psychoorganic and other syndromes, which were not characteristic of the 1st and 2nd stages. A vascular dementia (sharp decrease in the level of intelligence, a violation of social adaptation) begins to gradually formed in the patient.

Diagnostics

In most cases, diagnose chronic brain ischemia using the abstract of the disease itself and its careful analysis. Incidentally important is neurological and neuropsychological symptoms, as well as various cardiac studies (ECG, ECH kg and others).

MRI brain for 1, 3 and 28 days after a stroke

They will allow you to establish the true cause of the progression of the disease. Among other things, it is recommended to use laboratory diagnostic methods necessary to exclude or confirm somatic pathology.

For a full-fledged examination of the brain tissues, MRI or CT must be made, scanning with ultrasound use or conduct other specialized research.

Among other things, it follows with special attention to track the amount of sugar, cholesterol and other substances in the composition of blood. After all analyzes and research, appropriate treatment is prescribed.

Patients who have the 1st, or, in other cases, the initial stage of the disease, in most cases, suffer from periodic headaches, which over time may increase and occur more and more often. Among other things, noises and severity arise in the head.

There are problems with sleep, and memory worsens. The patient with the 1st stage suffers rapidly fatigue and increased weakness, becomes more irritable. From time to time there may be disorders in coordination of movements and an unstable emotional state. Another of the symptoms of the 1st stage is to reduce interest in knowledge, as well as poor memory for recent events.

Brain CT-Snapshot Series

For the 2nd stage of the disease, a significant strengthening and progression of symptoms, which from time to time appear at the 1st stage. The worsening of memory becomes more explicit and can progress every day. The patient is becoming increasingly harder and harder to concentrate its attention on a particular action, and also gradually loses the ability to plan and control its actions.

At the 2nd stage, a personality and emotional disorder occur more often, a depressive state develops and the ability to criticize is developing. As a rule, it is at the 2nd stage that adaptation is a violation of social and professional terms. But, along with the above disorders, the patient retains the ability to serve himself.

This stage combines the symptoms of the 1st and 2nd stages that begin to progress sharply. The patient is becoming increasingly harder and harder to control its movements and manage muscle reduction.

At this stage, frequent fainting and epileptic seizures are possible. Man begins to lose interest in everything that is happening, and also becomes more inhibited. In most cases, patients fully lose their self-service ability and become non-adaptable in social and consumer relations, which was not observed in the 1st and 2nd stages.

Features of treatment

The main task of treating chronic brain ischemia is to prevent the progression of various brain disorders, as well as the prevention of possible small strokes and exacerbations, or, speaking otherwise, crises. Treatment of the disease is simultaneously both therapeutic and primary prophylactic nature. It includes the following steps:

• A gradual increase in physical activity, a refusal of alcohol and tobacco, as well as a change in the diet, due to which the correction of arterial hypertension without the use of drugs becomes possible. In some cases, the reception of medicines is assigned. This stage is very important for the 1st and 2nd stage of the disease;
• Permanent control of blood sugar and cholesterol in the blood. If necessary, a special diet is appointed. If there is no effect, the correction is carried out by medication;
• Treatment of disorders and processes that are somatic nature and being associated;
• Purpose of drugs that have vasculating effects. The effect of such treatment directly depends on how much the brain is struck. Otherwise, sensitivity to drugs is reduced to a minimum or simply absent. In most cases, it is relevant for patients with the 1st and 2nd degree of the disease. Among other things, patients are appointed reception of drugs that impede the formation of thrombus;
• Appointment of drugs aimed at enriching the brain with oxygen and restoration of normal blood circulation, preventing convulsion, as well as improved properties and blood characteristics.

Forecasts

All changes must be adjusted accordingly. Special attention should be paid to accompanying ailments, which often flow in heavy forms.

If the 1st and 2nd stage of the disease chronic brain ischemia is already behind, and the disease is launched, or speaking otherwise, the patient appealed to help very lately, this suggests that multiple microinsults and injuries have already occurred in the brain. In such a situation, the forecast will be extremely unfavorable. As a rule, the patient becomes disabled or dying.

Thanks to the achievements of modern medicine, today, patients with chronic brain ischemia have the ability to identify the disease in a timely manner and to obtain appropriate treatment. Unfortunately, such people are forced throughout the specialists and from time to time to undergo a comprehensive examination and appropriate treatment. Ignoring all or even some recommendations may have fatal consequences and lead to a brain infarction.

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Causes and treatment of sinus bradyritium

A disease at which the frequency of heart abbreviations is reduced is called sinus bradyritium. Pathology may appear at any age. The violation of the heart rhythm begins with a sinus node. The main problem in the diagnosis of the disease is that, in general, the cardiovascular system seems healthy, and disturbances are quite difficult. Along with this, the body constantly suffers from hypoxia, which brdiarhythmia causes.

The extensive medical section "Cardiology" is engaged in the study of pathological processes in the work of the cardiovascular system in adults and children.

Causes and mechanism of development

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