Polymorphism of clinical manifestations of CIM. Pathogenetic therapy
Bogolepova Anna Nikolaevna - MD, Professor of the Department of Neurology, Neurosurgery and Medical Genetics of the Federal State Autonomous Educational Institution of Higher Education Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation, Head of the Department of Cognitive Impairments of the Federal State Budgetary Institution Federal Center for Medical Sciences of the Federal Medical and Biological Agency of Russia
Announcement:
In the lecture “Polymorphism of clinical manifestations of chronic cerebral ischemia (CCI)”, Professor Anna Nikolaevna Bogolepova examines in detail the key aspects of diagnosis and treatment of this common condition.
What is HIM?
Chronic cerebral ischemia is a progressive disorder of the brain due to a long-term lack of blood supply. It is not an independent disease, but occurs as a complication of hypertension, atherosclerosis, diabetes and other cardiovascular pathologies. With age, its frequency increases sharply: after 80 years, leukoaraiosis (damage to the white matter) occurs in 95% of people.
Main symptoms
- Cognitive impairment (75% of cases): slow thinking, memory problems, decreased concentration.
- Asthenia is fatigue that does not go away after rest, often the first sign of chronic cerebral palsy.
- Movement disorders: unsteadiness of gait, parkinsonism, pseudobulbar syndrome (dysphagia, forced laughter/crying).
- Emotional disorders: depression (60% of patients), apathy, anxiety.
Diagnostics and differentiation
- Vascular dementia is diagnosed when daily activities are impaired due to cognitive deficits.
- It is important to distinguish vascular parkinsonism from Parkinson's disease: symmetry of symptoms, low effectiveness of levodopa.
Modern approaches to treatment
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- Correction of risk factors: control of blood pressure, sugar levels, quitting smoking.
- Non-drug methods:
- Cognitive training (crosswords, language learning).
- Physical activity (dancing, walking) improves blood supply to the brain.
- Drug therapy:
- Mexidol (ethylmethylhydroxypyridine succinate) has been proven to improve cognitive functions, reduce asthenia and anxiety.
- Optimal regimen: 2 weeks of injections + transition to Mexidol Forte tablets 250 mg 3 times a day.
Clinical recommendations
The Clinical Guidelines “Cognitive Disorders in the Elderly and Older Adults” emphasize the importance of pathogenetic therapy and an individual approach, especially in elderly patients.
Conclusion: CIM is a multifactorial disease that requires complex treatment. Early diagnosis and proper therapy can significantly improve the quality of life of patients.
Who is this video for?
Neurologists, therapists, geriatricians and anyone who works with patients with vascular cognitive impairment.