O que é encefalopatia hipertensiva e sintomas da doença?

1 Causes of hypertensive encephalopathy

Encephalopathy of the hypertensive type is a brain disease in which inflammatory processes do not develop, but its functioning is disrupted, the level of damage varies. The main factor is hypertension in neglected form. But the reasons are as follows:

• rapid increase of the blood pressure record;
• hypertensive crisis;
• eclampsia;
• exacerbation of jade.

The acute stage of the development of hypertensive encephalopathy is especially dangerous. It develops due to a hypertensive crisis. In this case, a high risk of damage to the brain tissue and disruption of the functioning of various organs. With timely medical care, the processes will be reversible.

The main reason for the development of such a disease is an increase in blood pressure to critical levels. There are many different factors that can cause a sharp or gradual increase in blood pressure. Conditionally they are divided into 2 categories: acquired and congenital. Congenital include various defects and anatomical features of blood vessels, for example, a weak tone of the walls of blood vessels or aneurysms.

Regarding the acquired causes, these are conditions that affect a person and lead to spasmodic blood vessels in the brain and ischemic disease. The acquired factors include:

• stroke;
• nephritis in acute form;
• formation of blood clots;
• elevated platelet count;
• high cholesterol;
• hypertensive crisis;
• poisoning with drugs or other chemicals;
• alcohol abuse;
• overdose with various medications;
• some pathologies of the brain.

Because of congenital or acquired causes, the patient's blood pressure fluctuates: it rises sharply, then decreases. Both cases are extremely dangerous for human health.

The risk group includes people with such pathologies:

• a tendency to high blood pressure;
• hypertension and its chronic form;
• disease, accompanied by a sharp increase in blood pressure;
• permanent mental, psychological and nerve load.

2 Main features of

Acute hypertensive encephalopathy appears against the background of a hypertonic crisis, while blood pressure may vary in patients. For example, in hypertensive patients who suffer from a chronic disease, 180 mm Hg is considered critical. Art. In people who have a tendency to hypotension, a breakdown can occur and at a rate of 150 mm Hg. Art.

The main symptoms of the acute form of the disease:

1. Headaches, their severity gradually progresses. Usually the pain has a bursting or pressing character. First appears in the back of the head, but then spreads to the rest of the head.
2. Nausea, vomiting attacks that do not bring relief.
3. The ability to see sharply deteriorates as the part of the optic nerve swells. Because of this, there are pinpoint bleedings in the retina.
4. Dizziness, pronounced, but intermittent. It does not have a system character.
5. Patient's state of health worsens when sneezing, coughing or straining.
6. Convulsions.
7. Deafness and stuffiness of the ears.
8. Disturbance of susceptibility, paresis of peripheral type.
9. Meningism( the manifestation of meningeal symptoms, but there are no inflammatory processes in the membranes of the brain).

Usually, all these signs are present in the standard hypertensive crisis, but they also indicate that the brain tissue is involved in pathological processes, the swelling in the nervous tissue is unevenly distributed. If there is no treatment, then there are ischemic foci, where the activity of neurons decreases, and then they die. This may be preceded by a stroke.

Symptoms of chronic form of hypertensive encephalopathy appear gradually. At the first stage, there is absent-mindedness, trouble with attention. A person quickly becomes tired, short-term memory worsens, headaches appear. In 2 stages neurological syndromes appear. The patient's condition worsens, there are problems with cognitive functions. Sometimes there are also behavioral disorders. Stage 3 can develop a lacunar infarction. Epileptiform seizures repeat. Older people develop Parkinsonian syndrome.

3 Diagnosis and treatment

Treatment is performed only after diagnosis. It involves several steps:

1. Verify hypertensive disease or symptomatic hypertension as a possible cause of brain damage. Clarify the course of the disease and the factors that provoked it.
2. Consultation with a neurologist to identify all symptoms when examined. Cognitive disorders are also considered.
3. If necessary, consult a psychiatrist to exclude diseases that have similar symptoms.
4. General clinical examination. General and biochemical blood tests are performed to exclude possible factors that provoked cerebral symptoms: diabetes mellitus, anemia, toxic brain tissue damage in hepatic or renal failure.
5. Exclusion of syphilitic lesions of the central nervous system.
6. Exclusion of severe generalized form of atherosclerosis( UZDG and blood test performed).
7. Computer and magnetic resonance imaging is performed to visualize the state of the brain. By the way, usually at the first stage of the development of hypertensive encephalopathy there are no changes, however, starting from phase 2, they will already be noticeable.
8. If there are indications, an EEG is performed to evaluate the bioelectrical activity of the brain.
9. Spinal puncture. It is carried out in some cases to determine the pressure of the liquor and to analyze the composition of the liquid.

If the patient is diagnosed as hypertensive encephalopathy, then first of all, appropriate antihypertensive therapy should be selected. At the same time, medicines are selected that will monitor the blood pressure level, and gradually reduce its indices to the required rate.

Many people believe that in the elderly, the pressure is 150 to 90 mm Hg. Art.is normal. Of course, for a patient such indicators are considered normal and habitual, so that he does not experience discomfort. However, such pressure can cause changes in the brain, which will later become irreversible.

If the patient has hypertensive encephalopathy, then therapy is administered individually for the patient. Usually, drugs with a long-lasting effect are used to help make the normal pressure level stable throughout the day. Quite often, if the symptoms of the disease interfere, funds with combined properties are prescribed: diuretics, ACE inhibitors, calcium antagonists, beta-adrenoblockers. They are used in different combinations.

If the patient has acute hypertensive encephalopathy, then funds with diuretic and decongestant properties are prescribed. Also it is necessary to control the content of electrolytes in the blood. Gradually, it is required to lower the blood pressure level to prevent complete brain ischemia.

If the patient has a chronic form of the disease, then funds are allocated that can improve blood circulation.

For example, these are disaggregants and thrombolytics( the latter are prescribed if necessary).Still need vitamin-mineral complexes and drugs to improve metabolic processes. If cognitive impairment progresses, nootropic medications are used. Additionally, drugs that have a neuroprotective effect and improve the condition of the walls of blood vessels are used.

4 Conclusion

Hypertensive encephalopathy is considered one of the most serious side-effects of hypertension. For treatment, hypotensive therapy is prescribed. The selected drugs will help maintain a normal level of blood pressure. In addition, other medications and procedures are prescribed.