MRI in discirculatory encephalopathy: signs


Discirculatory encephalopathy (DEP) – the disease is chronic and progresses over time. It consists in focal or widespread lesions of the cerebral vessels. Leading change in discirculatory encephalopathy: intellectual, emotional, motor disorders, personality disorders. Patient with this pathology in the brain accompany migraines, fatigue, memory impairment. The term «encephalopathy» was introduced into medicine by G. A. Maksudov and V. M. Kogan, in 1958 the ICD to date, discirculatory encephalopathy (DEP) is not included, but similar among disease clinic presented cerebral atherosclerosis progressive vascular leukoencephalopathy, hypertensive encephalopathy, unspecified other diseases of vessels of the brain, including cerebral ischemia (chronic) and unspecified cerebrovascular disease (TSVB).

In the DEP identified three phases, which are characterized by the following features:

The signs on MRI images indicating cerebral ischemia

Analysis of changes in discirculatory encephalopathy (DEP) as follows.

For hypertensive dyscirculatory encephalopathy characterized by such signs:

  • multiple small lacunar infarcts located in the white matter, subcortical nuclei, thalamus, varoliev the bridge, the cerebellum;
  • the formation of small lacunar infarcts, which accompany hypertensive crises; they often are formed with the absence of symptoms and can be detected only when CT or (more often) by MRI;
  • changes in the volume and mass of the brain (largely the reduction of the white matter);
  • a slight extension of the brain furrows (especially in the frontal lobe and of Sylvian fissure);
  • significantly dilated ventricles;
  • periventricular lachares.

For MRI picture of dyscirculatory encephalopathy (DEP) occurred on the background of carotid atherosclerosis, characterized by:

  • a lot of small deep infarcts (more than 30% of cases, clinically asymptomatic);
  • single or multiple small infarcts in the cerebral cortex;
  • the extension of the cortical furrows, indicating atrophic process (granular atrophy of the cortex).
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MRI-angiography with DEP – a standard with which to compare the results of other studies. Angiography lies in the fact that through the contrasting image of the vascular pattern of the brain. Angiography shows in what sequence and over what period of time are filled with blood vessels in the brain. On angiography it is also possible to see which workarounds the blood supply has formed after the onset of the disease.

Indications for MRI and MRI angiography: DEP, TSVB, other vascular brain disease both acute and chronic.

Briefly about in which cases the research is not carried out

Direct contraindications to MRI are:

  1. Established the patient has a pacemaker (MRI electromagnetic field can disrupt his work).
  2. Surgical staples and other items made of paramagnetic materials within the body of the patient, are not subject to removal.
  3. Middle ear implants of ferromagnetic materials.
  4. Renal pathology, which complicates the withdrawal of contrast from the body.
  5. Excessively overweight.
  6. Hemostatic clips to blood vessels of the brain.

Relative contraindications when the final decision on the study made by a doctor, is an insulin pump; paramagnetic middle ear implants; prosthetic heart valves; braces; a prosthetic inner ear containing metal parts. Before angiography, the patient receives an Allergy test and if positive, cancel the study.

Possibilities of therapy of vascular diseases

The most important thing in the treatment of DEP is an early start. Therapy:

  1. Etiopathogenetic treatment (aimed at the cause or process of disease development).
  2. Symptomatic treatment.
  3. Surgical treatment.

Plays a significant role to prevent the development of DEP in the presence of risk factors: healthy lifestyle, physical therapy and psychotherapeutic treatment.

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A few words about the importance of early diagnosis

When are harmless for most people, the symptoms, such as headache, impaired attention and memory, sharp groundless changes of mood, start to be continuous, it may be signs of developing dyscirculatory encephalopathy (DEP). Take care of your health and consult a doctor, because early treatment stops the disease.