Circulatory disorder in the brain
introduction
A circulatory problem in the brain can lead to a variety of symptoms. Depending on the extent of the disorder, the symptoms can range from mild visual disturbances to dizziness to a stroke. Since circulatory disorders can potentially herald a stroke, certain symptoms should definitely be clarified. Risk factors for circulatory disorders are generally smoking, overweight, lack of exercise, an unbalanced diet and various diseases such as diabetes (diabetes mellitus).
For information on the typical signs of a stroke, read our page Signs of stroke.
Circulatory disorders in the brain are often caused by diseases of the cardiovascular system such as atrial fibrillation or Vascular calcification (Atherosclerosis) in the area of the brain or neck vessels.
A adequate blood supply is particularly important for the sensitive brain. Although the brain makes up only two percent of the total body mass, it consumes a quarter of the total oxygen and sugar intake of humans.
If the brain is no longer adequately supplied with oxygen due to a circulatory disorder, kick Sensory and cognitive disorders on.
If a chronic process takes place and the circulatory disturbance increases over the years, the cerebral efficiency can be impaired, it comes to one vascular dementia.
An acute circulatory disorder in the brain, on the other hand, leads to attacks of sensory and perceptual disorders that last a few minutes to a few hours and as transitory ischemic attacks (TIA) are designated. These attacks are often harbingers of one Stroke (Stroke), which is also caused by an acute circulatory disorder in the brain.
Symptoms
The structure and function of the brain is very complex. For this reason, a wide variety of symptoms and complaints are possible with circulatory disorders in the brain. Certain symptoms often give an indication of the affected vessel or brain area.
For example, if there is a circulatory disorder in one half of the cerebrum, the symptoms appear in the opposite half of the body.
Sensory disturbances and paralysis can occur, which can be felt on the fingers, face or legs. It can also lead to impaired consciousness or perception. Visual disturbances or loss of vision as well as dizziness, unsteadiness when walking, speech disorders, nausea and vomiting are also possible symptoms of circulatory disorders in the brain.
Chronic circulatory disorders, on the other hand, tend to impair memory function and reduce brain performance.
You can also find detailed information on this under: What are the symptoms of circulatory disorders in the brain?
First signs of a circulatory disorder
Signs of impaired blood flow to the brain may, among other things, appear suddenly dizziness, Speech disorders, Disorders of coordination ("normal" walking or targeted movement of the arms or hands is no longer possible), Sensory disturbances, Visual disturbances and Paralysis be.
Paralysis can manifest itself in the fact that the legs suddenly give way, the arm can no longer be lifted or paralyzes in the area of the facial muscles and the face looks asymmetrical and changed.
Overall, however, it must be said that the symptoms of a circulatory disorder in the brain can be very different.
Sensory disturbances in a circulatory disorder
A feeling disorder means a decreased perception of, for example, touch stimuli and is also called a sensitivity disorder or Hypesthesia designated.
There are, however, numerous other forms of feeling perception, such as temperature perception, pain perception and vibration perception.
Such a sensory disturbance can occur if the blood supply to the brain is reduced, especially if there is a circulatory disturbance in one of the two internal carotid arteries (inner carotid artery) or one of the smaller vessels that branch out from it.
Please also read our article on this Clogged carotid artery (carotid stenosis)
However, a sensory disorder can also have its cause further peripherally (i.e. not directly in the brain), for example through damage to the spinal cord or the peripheral nerves.
The next article may also be of interest to you: Stroke in the spinal cord
Dizziness if you have a poor circulation
dizzinesscaused by a circulatory disorder in the brain is called central dizziness because the brain is considered to be one of the centers of the body.
In contrast, there is also peripheral vertigo, e.g. such that by Disturbances in the area of the inner ear is triggered.
Circulatory disorders of the brain can occur in a wide variety of places and thus trigger a wide variety of symptoms.
A central dizziness is often caused by a circulatory disorder in one of the two Vertebral arteries (Spinal arteries), which the Brain stem supply, triggered.
These run in the area of the spine towards the brain and unite there to form Basilar artery. Usually one of the two is in the area of a circulatory disorder Vertebral arteries Dizziness is not the only symptom, it can also lead to impaired vision, speech, coordination and sensitivity.
Paralysis in a circulatory disorder
A complete paralysis one or more body parts is also called Plegia (ancient Greek: blow, paralysis).
Often there is also paralysis that is called incomplete are designated. Here, for example, those affected can still move their arm minimally. However, it can also happen that movement is no longer possible, but one can still see movement of the muscle groups, i.e. muscle contractions.
There are two types of paralysis.
In the flaccid paralysis movement is no longer possible and, for example, the arm hangs limply.
In the spastic paralysis, in which movement is also no longer possible, however, there is an increase in muscle tone, i.e. muscle activity. The arm or leg appear stiff and can only be moved with force by other people (e.g. the doctor treating you).
The type of paralysis that occurs depends on the location of the trauma.
A circulatory disorder of the brain that leads to paralysis usually leads to one spasticity.
Visual disturbances with a circulatory disorder
Visual disturbances are a typical neurological symptom that can occur after a circulatory disorder in the brain.
Different types of circulatory disorders lead to different symptoms.
For example, an arterial occlusion of the retina is characterized by sudden, unilateral blindness without pain, while so-called giant cell arteritis is noticeable with strong throbbing headache on both sides in the temple area.
However, certain diseases and habits such as high blood pressure, smoking, vascular calcification (arteriosclerosis), diabetes (diabetes mellitus) or lipid metabolism disorders can also affect the retinal artery.
If there is a circulatory disorder, parts of the cerebral cortex of the back of the head, also known as the “visual cortex”, can be affected. Short visual losses, black flickering, visual field losses, double images and numerous other visual disturbances can set in.
In many cases the restrictions subside after a short time. One speaks of a so-called "Amaurosis fugax". It describes a short and sudden loss of vision, which seldom leads to protracted consequences, but is an important warning signal for neurological disorders.
Migraines with a circulatory disorder
There are various theories about the causes of migraines, as it has not yet been clarified how migraines develop. There are several reasons for a circulatory disorder in the brain as a possible explanation for the migraines. For example, the headache of a migraine is throbbing and increases with each pulse, which suggests a problem with the blood vessels. In addition, the brain itself is not sensitive to pain, whereas the blood vessels in the brain have pain-sensitive nerve fibers. Other circulatory disorders, such as a stroke or inflammation of the blood vessels, also lead to headaches that are similar to migraines.
The assumption that a migraine attack is caused by circulatory disorders in the brain is mainly supported by the effectiveness of certain drugs.
The so-called Triptans are drugs that affect the blood flow in cerebral vessels and are used successfully against migraine attacks.
Read more on this topic at: migraine
Speech disorders in a circulatory disorder
Speech disorders are a symptom that is under a Stroke, usually caused by a circulatory disorder in the brain, occurs relatively frequently.
One can often observe that the speech disorders slowly regress after therapeutic treatment; this is also not infrequently the case with paralysis or partial paralysis in the context of a stroke.
A language disorder as a result of insufficient blood supply to the brain occurs when the area of the brain is affected in which (to put it simply) language is understood or planned. These areas are called Broca area and as Wernicke area designated.
The Type of speech disorder can ultimately indicate which of the two areas is affected.
However, this is of little importance in everyday clinical practice in the acute phase of circulatory disorders in the brain, since the main goal here is to restore blood flow as quickly as possible, regardless of the affected area.
The disorders of language caused by a circulatory disorder of the brain can be very different.
It can be, among other things slurred speech, Word finding disorders, Repeating syllables, Forming non-existent words (Neologisms) and complete loss of speech to lead.
Forgetfulness with a circulatory disorder
Circulatory disorders in the brain can cause acute as well as chronic damage to the cerebral cortex, which is significantly involved in learning processes, memories and memory skills. Forgetfulness is a typically insidious symptom that can indicate a progressive circulatory disorder in the brain. It often only progresses slowly and is therefore difficult to distinguish from general forgetfulness or the forgetfulness of old age.
In particular, advancing degeneration of the blood vessels in old age, which leads to deterioration of the blood flow in the brain, can trigger a form of dementia ("vascular dementia") that is initially difficult to distinguish from old-age forgetfulness. However, this form of forgetfulness can be treated and stop.
The main risk factors for this type of dementia are high blood pressure, smoking, diabetes mellitus and various heart diseases.
Basically, the risk of developing vascular dementia increases with age.
Depression can be a typical but unspecific symptom of a chronically progressive deterioration in blood flow to the brain. The slow damage to areas of the cerebral cortex can lead to the clinical picture of vascular dementia. Typical are unspecific symptoms such as tiredness, forgetfulness, poor concentration, a depressed mood and lack of drive.
Here one can already speak of a slight depressive mood. However, it should not be confused with age-related depression, as both diseases can occur in similar patient groups.
causes
Circulatory disorders are caused by narrowing or clogging of the blood vessels. This can have a variety of causes.
The most common cause of circulatory disorders in the brain is calcification of the arteries (arteriosclerosis). Certain substances are deposited in the arterial wall.
These deposits or so-called Plaques grow stronger over time and narrow the diameter of the blood vessels.
A vascular occlusion (embolism) arises when a blood clot, a piece of tissue or an air bubble (air embolism) clogs the blood vessel.
In the area of the brain, vascular occlusion is also called a stroke.
Rarely does it occur due to vascular inflammation (Vasculitis) in the brain to circulatory disorders.
For example, various diseases or certain medications or drugs can lead to inflammation of the blood vessels.
Chronic occlusive processes lead to what is known as vascular dementia in the brain.
A bulging of a blood vessel (brain aneurysm) in the brain can also lead to circulatory disorders. Such an aneurysm in the brain is at risk of rupturing, which can lead to severe bleeding into the cranial cavity and dangerously increased pressure on the brain.
Congenital or acquired malformations of the blood vessels can also cause circulatory disorders in the brain.
stroke
A stroke means a functional impairment of the brain due to an insufficient supply of the nerve cells with oxygen and other substrates.
This could be due to a cerebral hemorrhage or acute occlusion of a venous or arterial blood vessel, for example.
A common cause of such a blood clot is an abnormal heart rhythm called atrial fibrillation. Here the heart beats uncoordinated (arrhythmic), which in the course of the formation of a blood clot (thrombus) in the area of the heart.
This can then be flushed out into the bloodstream by the pumping action of the heart and from there it can get into the vessels supplying the brain and block one of them. This brings the blood supply to a standstill in the section of the brain supplied by this vessel, resulting in a lack of oxygen. One speaks of one Ischemia. Therefore, this type of stroke is also called an ischemic stroke.
Less commonly, bleeding in the brain is responsible for a stroke, this type of stroke is known as hemorrhagic.
Possible symptoms of a stroke can include speech disorders, visual disorders, numbness, confusion, headaches, coordination disorders, sensory disorders, motor disorders, such as paralysis and dizziness.
The symptoms vary depending on where in the brain the stroke occurs. A stroke in the cerebellum, for example, shows quite different symptoms.
Read about this also:
- Blood clots in the head
- Cerebellar infarction
- Causes of a stroke
TIA
TIA is an abbreviation of medical terminology and describes the "transitory ischemic attack". It is a temporary attack-like circulatory disorder that presents itself with the same symptoms of a real stroke. However, unlike a stroke, these symptoms are completely resolved within 24 hours.
In the acute stage, there is no clinical distinction between TIA and stroke, but the symptoms often disappear very quickly (after one to two hours).
TIAs are not infrequently the harbingers of a “real” stroke and are therefore taken very seriously. After a TIA, the patient is usually given acetylsalicylic acid for life Platelet aggregation inhibition receive.
Read more on the topic: Transient ischemic attack
Can a circulatory disorder in the brain be caused by problems in the cervical spine?
A symptomatic circulatory disorder caused by Problems in the cervical spine caused is rare.
Nonetheless, are Discomfort in the cervical spinewhich lead to symptoms like Tension, Sensory disturbances, Tingling sensations, a headache and similar complaints very often. However, this is most likely caused by impairment of the nerves Bad posture or degenerative changes in the spine responsible.
diagnosis
The diagnosis of circulatory disorders in the brain usually results from the typical picture of the symptoms. In the case of newly occurring neurological deficits such as visual and speech disorders, a stroke be suspected, with severe attack-like headache a Migraine attack be the cause.
Evidence of the diagnosis can often be provided by an imaging test such as computed tomography of the head (cCT) or Magnetic resonance imaging of the head (MRI of the head) are provided. It can be used to measure and analyze the blood flow to the brain and any circulatory disorders.
In addition, there is a suspicion of a circulatory disorder in the brain as well Ultrasound examination, Examinations of the heart for possible underlying diseases and examining the blood for clotting disorders.
MRI for circulatory disorders in the brain
MRI, short for magnetic resonance tomography, is a detailed and radiation-free diagnostic method that can provide precise diagnoses, particularly in the case of structural damage in the brain and after circulatory disorders
On the one hand, other diseases such as a brain tumor can be ruled out, and on the other hand, if a stroke is suspected, a circulatory disorder can be detected and localized even at the smallest extent. The MRI examination is also important for monitoring the progress.
Circulatory disorders of the brain often arise from the cervical or cerebral vessels, which are particularly good with special methods of the so-called MR angiography can be diagnosed.
Read more about this under MRI of the brain
Diagnosing a stroke
The symptoms of a stroke depend on which one localization the undersupply of the nerve cells takes place.
In the acute phase, the diagnosis is imaging of the head, usually in the sense of a Computed Tomography, made. A Bleeding can be seen here immediately, Ischemia (undersupply of a brain area due to a blood clot in a cerebral artery) often only shows up after several hours.
therapy
The treatment of circulatory disorders in the brain is done depending on the cause. It will be between one acute treatment in the acute stage of a circulatory problem (e.g. stroke), a preventive and one Rehabilitation treatment distinguished.
In the case of an acute circulatory disorder in the brain, the cause of the symptoms must be eliminated as quickly as possible, which in the case of a stroke is usually done with the help of drug treatment.
As a preventive measure against circulatory disorders in the brain or for rehabilitation after a stroke, other measures are usually in the foreground. In this case it should Risk factors are reducedby regularly Sports is driven, the blood sugar is well adjusted with the Quit smoking will and Obesity decreased becomes.
Medicines to thin the blood and physiotherapy measures are also often used.
Diseases of the cardiovascular system must be treated as a possible cause of the circulatory disorders in the brain, and narrowed neck vessels may need surgery.
Which doctor treats this?
The circulatory disorder in the brain can have numerous causes and be associated with many secondary diseases, which is why the treatment should be carried out by doctors from many specialist disciplines. For diseases of the nerve cells in the brain, the neurologist is primarily the first point of contact. Treatment is also directed by a neurologist for strokes, TIAs or vascular dementia. However, other specialist disciplines are also assigned important tasks in the treatment of neurological diseases.
For many neurological diseases, the first treatment by a family doctor or emergency doctor is decisive for the prognosis. Emergency medical treatment is often crucial, especially when it comes to recognizing a stroke. The radiologist fulfills an important function in the diagnostic recognition of the clinical picture. Radiologists can also carry out important acute treatments themselves with the help of so-called "interventions". In the long-term treatment and follow-up care of neurological diseases, treatments by the family doctor and an internist are important, which minimize risk factors, influence the patient's lifestyle and medically treat underlying diseases.
Therapy for a stroke
If a circulatory disorder in the brain is a stroke caused by a blood clot, various therapy options can be used
Depending on what type of stroke it is and how much time has passed since the symptoms began, a so-called Thrombolysis as a therapeutic option. The goal here is to dissolve the blood clot that has blocked the blood vessel or at least prevent it from growing further.
The drug, which is supposed to help dissolve, is injected through a venous access.
A newer method is the so-called Neurothrombectomy which attempts to remove the clot from the vessel with a catheter. This procedure is mainly used in patients who have a large blood vessel closed is.
Medication
Various medications are given to people who have previously suffered from impaired blood flow to the brain to make it less likely to recur.
For example, a circulatory disorder can manifest as stroke express with disorders of language, motor skills, sensory or optics, but also as Transient ischemic attack (TIA). A TIA is, so to speak, one Harbingers of a stroke and symptoms similar to those of a stroke occur, but they are completely reversible relatively quickly.
If there is a circulatory disorder in the brain, the affected patients usually receive once a day Acetylsalicylic acid (please refer: aspirin) if there are no contraindications or the patient is taking medication that prohibits them. Acetylsalicylic acid is a drug belonging to the group of Platelet aggregation inhibitors counts, in the vernacular one speaks of a "blood thinner".
In addition, usually a Statin prescribed. This is a drug that the Cholesterol levels should lower in the blood. Typical representatives are e.g. Simvastatin, Pravastatin or Atorvastatin.
Is with the affected patient high blood pressure before, this is how it is treated.
Often one is not discovered before Atrial fibrillation of the patient is responsible for the circulatory disorder. With atrial fibrillation, the heart beats irregularly and the risk of blood clots is increased. These can then be flushed out of the heart by the pumping action of the heart into the bloodstream and transported to the brain, where they clog a blood vessel.
This leads to an acute stroke.
If there are no contraindications, patients with atrial fibrillation are given a blood thinner how Phenprocoumon (Marcumar® or Falithrom®) or one of the newer blood thinning drugs such as Apixaban or Rivaroxaban.
In the acute case of a circulatory disorder of the brain, depending on the length of time between the onset of the symptoms and the presentation in a hospital, a drug is used to prevent the blood clot from enlarging further. This is known as "Lysis Therapy". Here comes among other things rtPA (Tissue plasminogen activator) is used, which is administered via a venous access.
Tebonin
Tebonin® is a purely herbal medicinal product that contains ginkgo extract as a potential active ingredient.
This ginko extract is said to help with dizziness, tinnitus as well as concentration disorders and forgetfulness.
Studies that examine whether ginko actually has positive effects on cognitive abilities vary, but there is no reliable evidence of its effectiveness so far.
The preparation can be purchased without a prescription in the pharmacy, it is offered in different strengths. Tebonin konzent® 240 mg costs just under 76 euros for 60 tablets. Tebonin intens® for ringing in the ears costs just under 40 euros with a pack size of 60 pieces.
Read more on the subject under: Tebonin®
prophylaxis
Circulatory disorders can be prevented by general measures. It has been scientifically proven that certain illnesses and lifestyle increases the risk of circulatory disorders.
An important and avoidable risk factor is smokingwhich is generally not recommended. Diseases such as high blood pressure and diabetes (diabetes mellitus) are also associated with an increased risk of circulatory disorders, which is why the consistent treatment of the diseases important is.
In addition, obesity, a lack of exercise and an unhealthy diet lead to an increased risk of a number of diseases and circulatory disorders are also more common.
A healthy lifestyle is essentialto prevent diseases such as circulatory disorders.
