Wednesday , August 4 2021

[Malalties del cor, ictus]Difficulty swallowing, personality change or brain disease of small blood vessels involving multiple organs, clinical manifestations vary widely (modern Chinese medicine) -Ming Pao Health Net

[Notícies de Ming Pao]Heart disease and stroke are the third and fourth leading causes of death in Hong Kong. The main causes of these two serious diseases are pathological changes in the coronary arteries and cerebral blood vessels, such as atherosclerosis and vascular infarction. Small cerebral vessel disease (CSVD) is the most common among cerebrovascular diseases. In recent years, the medical field has paid more and more attention to small vessel brain diseases and, with in-depth research, its damage has deepened. As its name suggests, cerebrovascular disease is a pathological change in small arteries, capillaries, and venules in the brain that causes damage to normal brain function. Magnetic resonance imaging (MRI) shows several images of white matter hyperintensities, subcortical infarcts, enlargement of perivascular spaces, intracranial hemorrhage, and cerebral atrophy.

[Malaltia cardíaca, ictus]Difficulty swallowing, personality changes, or brain disease of small blood vessels involving multiple organs.  The clinical manifestations are varied (modern Chinese medicine)
Small Cerebral Vessel Disease- Small cerebral vascular disease causes a wide range of diseases, involving multiple organ systems, and the clinical manifestations are varied. (Lixuyao @ iStockphoto)

Variety of clinical manifestations involving multiple organs

Small cerebral vessel disease causes a wide range of diseases, involving multiple organ systems, and the clinical manifestations are varied. It is summarized as follows:

. Stroke: Small vessel brain disease can cause lacunar stroke, intracranial hemorrhagic stroke and increase the risk of stroke in patients. Studies have shown that approximately two and a half ischemic strokes and almost all hemorrhagic strokes are caused by small glasses

.Cognitive Dysfunction: Cerebral vascular disease can cause mild cognitive impairment, affecting concentration, judgment, and execution, and even confusion; it can cause vascular dementia and aggravate the symptoms of brain degeneration.

. Symptoms of the nervous system: including dysphagia, dysarthria and extrapyramidal syndrome (manifested mainly as muscle stiffness, tremor, slow expression and inability to sit still, etc.)

.Annormal thinking and emotions: such as an indifferent expression, depression in old age, frequent fatigue and even personality changes, etc.

.Instability of gait and balance: manifests itself mainly as unstable balance, frequent falls, walking breaks and motor retardation, etc.

.Active vesicle and urinary incontinence: may also be related to diseases of small blood vessels in the brain

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What causes small vessel brain disease? According to the results of epidemiological studies, the high risk factors for cardiovascular disease are closely related to the onset of small vessel brain diseases:

.Advanced age: The study noted that the comparison of white matter leukoplakia rates (the most important imaging feature of small cerebral vessel disease) among people under 55 and 64 years of age was 11 % and 21% respectively; between 82- in the elderly, the rate increased to 94%, indicating that small vessel brain disease is proportional to age

. Hypertension (greater than 140/90 mmHg): Especially if blood pressure does not drop at night, or even increases, it is more likely to cause white matter leukoplakia. Other studies have shown that hypertension is related to bleeding. microvascular disease (one of the biomarkers of small vessel brain disease)

.Diabetes: lacunar infarction and microhemorrhage in type 2 diabetic patients, 2.8 times the normal rate

. Metabolic syndrome: It is known that metabolic syndrome is related to occult cerebral infarction and lacunar infarction. A 2019 study on risk factors for small vessel brain disease in Asians showed that high levels of triglycerides in the blood increase the chances of lacunar stroke and high-density lipoproteins may reduce the risk of lacunar stroke. cerebral infarction.

In summary, the onset and development of small cerebral vessel disease are related to some basic diseases that affect vascular function. Prevention and early treatment of the above diseases can help prevent the onset and deterioration of small cerebral vessel disease.

Related article:[CanIpreventstroke?】Threemaxims:highbloodpressurehighbloodcholesterolhighbloodpressurecaneasilyleadtoattentiontothesymptomsofasmallstrokeOtherthingstoreducethepossibilityofastroke[Espotprevenirl’ictus?】Tresmàxims:lapressióarterialaltaelcolesterolelevatelsucreenlasangil’altestrèspodeninduirfàcilmentl’atencióalssímptomesd’ictuspetitsFeutrescosesperreduirlapossibilitatd’ictus

Go to bed early to quit smoking and go on a low fat and low alcohol diet

The spectrum of diseases caused by cerebrovascular diseases is very wide, among them stroke and cognitive dysfunction cause a great burden for patients, families, medical systems and society as a whole. Active prevention and treatment are very important. How to effectively prevent small cerebral vessel disease in life? Summarizing the results of some epidemiological studies, the following healthy lifestyles help prevent and prevent the onset and deterioration of small vessel brain disease:

1. Eat a healthy diet, eat more fish, fruits and vegetables, and consume less animal fat; reduce your sodium intake (the main source is salt). Excess sodium (> 5 mg / day) will increase the risk of stroke and increase the white matter leukoplakia, increase the burden of small blood vessel diseases in the brain

2. Insist on exercise and develop a good regular exercise habit

3. Get rid of bad habits, including smoking and drinking excessively. Studies have shown that in patients with small stroke, drinking alcohol can increase white matter leukoplakia.

4. Develop good sleep habits and improve sleep quality. Long-term sleep disorders, such as obstructive sleep apnea, are related to the formation of white matter leukoplakia and hidden lacunar infarction.

Text: Lin Zhixiu (Associate Dean, Registered Chinese Medical Doctor, School of Traditional Chinese Medicine, Chinese University of Hong Kong)

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