Cerebrovascular thrombosis
The formation of a blood clot in the arterial or venous system of the brain, in the sinuses of its hard shell is diagnosed as vascular thrombosis. This condition poses a great danger not only to health, but also to the patient's life itself, provoking a stroke. Thrombosis occurs more frequently in old age, although cases of the disease occur in every age population.
Content:
- Classification of pathology
- Causes of cerebral thrombosis
- Symptoms and manifestations of cerebral thrombosis
- Diagnostics
- Treatment of cerebral thrombosis
- Prevention measures
Classification of pathology
Depending on the location of the pathological process, the types of thrombosis are distinguished:
- Extracranial (extracranial);
- Itcranial (intracranial).
Extracranial thrombosis is not as dangerous as the intracranial form of pathology. It can be asymptomatic or manifest with minimal neurological signs of circulatory disorders. Compensation of the functions of vessels temporarily dropped out of the circulation occurs due to collateral blood flow. In this scenario of extracranial thrombosis, ischemia of cerebral structures will be minimal.
The most common place of localization of thrombosis is the venous sinuses, which are reservoirs for the movement of blood into the jugular veins. Venous sinus thrombosis is manifested by significant complications.
Classification of cerebral sinuses prone to thrombosis:
- The lower is stony;
- The upper is stony;
- Sagittal;
- Occipital;
- Straight;
- Transverse;
- Wedge-parietal.
With the development of thrombosis in the intracranial arteries, the clinical picture of the disease is similar to the clinical picture of stroke.
Before a stroke, precursors appear, indicating an incipient cerebral circulation disorder:
- Drowsiness,
- Dizziness,
- Headache,
- Visual impairment
- Violation of sensitivity and motor functions.
Causes of cerebral thrombosis
At risk are the elderly, patients with hypertension and diabetes mellitus. Improper nutrition, alcohol abuse, smoking, frequent psycho-emotional overload are factors that provoke thrombosis.
The reasons for the formation of a predisposition to blood clots:
- Physical inactivity
- Increased platelet count;
- Heart disease, anemia, history of meningitis;
- Decreased immunity;
- Excess weight;
- Postoperative complications;
- Childbirth, pregnancy complications;
- Head trauma, mechanical damage to blood vessels;
- Sinusitis, otitis media.
Thrombosis of the arteries of the brain occurs due to clogging of the arteries with cholesterol plaques, due to thromboembolism of the heart vessels, complications of inflammatory processes.
Venous sinus thrombosis occurs due to thrombophlebitis (inflammation of the venous walls). Diseases that increase the likelihood of developing venous sinus thrombosis:
- Purulent wounds of the skull, soft tissues of the head;
- Stomatitis;
- Tuberculosis;
- Viral and fungal infections;
- Complications after craniotomy, after anesthesia, surgery;
- Head trauma;
- Brain neoplasms of any etiology;
- Late toxicosis of pregnancy;
- Hypertension of pregnant women;
- Caesarean section, postpartum complications;
- Pathology of blood and hematopoietic organs;
- Side effects of hormonal therapy, taking oral contraceptives;
- Dehydration of the body.
Symptoms and manifestations of cerebral thrombosis
General cerebral group of symptoms:
- High intensity headache;
- Nausea and vomiting;
- Impaired sensitivity of the limbs, facial skin;
- Facial muscle asymmetry;
- Decrease in hell;
- Weak filling of the pulse;
- Seizures;
- Increased intracranial pressure;
- Paralysis and paresis;
- Photophobia.
Focal symptoms that manifest themselves in different ways in certain areas:
- Double vision;
- Narrowing of the visual field, decreasing its acuity;
- Cyanosis of the skin;
- Difficult movements of the eyeballs, their protrusion.
Symptoms caused by intoxication of the body:
- Hyperthermia;
- Chills, aching joints;
- Weakness, lethargy;
- Drowsiness.
With venous sinus thrombosis caused by an infected blood clot, the patient is diagnosed with confusion, fever, excessive sweating, and sallow skin.
Diagnostics
Blockage of blood vessels in the brain with a thrombus is an urgent condition that requires urgent diagnosis. There is an express test that allows to suggest the presence of pathology before instrumental examination.
What is suggested to be done to the patient:
- Show language. Due to impaired blood circulation in the brain, the patient's tongue will bend, will sink in one direction.
- Smile. Symmetrical smile during ischemia will not be possible, it will turn out to be one-sided.
- Raise your hands up. A patient with thrombosis cannot do this.
- Say a short sentence of several words like "we go to the store for bread." Disruption of the blood supply to the brain will make speech slow and slurred.
Diagnostic methods:
- Doppler ultrasound;
- Angiography;
- Rheoencephalography;
- MRI.
Treatment of cerebral thrombosis
After the diagnosis is made, it is necessary to urgently begin a course of therapy for the pathological process.
Treatment methods:
- The use of drugs to dissolve a blood clot and restore blood circulation. In most cases, the tissue activator Plasminogen is injected intravenously. This drug may have severe bleeding side effects.
- Intra-arterial thrombolysis is the introduction of a catheter into a large vessel to deliver a drug that dissolves a blood clot to a thrombus.
- Surgery to remove a blood clot.
When choosing treatment methods, the doctor takes into account the localization of the pathology, the patient's age, medical history and other factors. To restore the range of motion, a therapeutic massage is performed, and physical education is practiced.
In the treatment of venous sinus thrombosis, antibiotic treatment is required to eliminate the focus of infection.
Untimely started treatment can cause severe complications and even death.
Serious complications result from oxygen starvation of the brain:
- Paralysis;
- Heart attack, stroke;
- Disorder of speech and cognitive functions (memory, ability to read and write);
- Visual impairment.
Severe forms of cerebral thrombosis end in the death of the patient. It occurs as a result of embolism, when a blood clot detached from the vessel wall moves through the circulatory system until it blocks the blood supply to a vital organ.
Prevention measures
To prevent the development of the disease, it is necessary to analyze the causes that cause it.
Preventive measures to reduce the likelihood of thrombosis:
- A varied menu that excludes fatty foods, smoked meats, extractives;
- Quitting smoking and alcohol;
- Weight control;
- Timely treatment of inflammatory diseases, infections;
- Monitoring blood sugar levels in diabetic patients;
- Physical activity for at least 30 minutes a day.
The earlier the diagnosis of thrombosis is carried out, the higher the likelihood of a favorable outcome of the disease.
The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist
Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.
