What are the symptoms of cerebral vascular stenosis?

The brain is the most complex part of the human body. If the cerebral blood vessels are narrowed, it will pose a serious threat to the health of the brain. The occurrence of cerebral vascular stenosis causes more obvious symptoms to patients, such as ischemia in the blood supply area, ischemia in related areas, brain hypoxia, etc. Cerebral vascular stenosis poses a threat to the overall health of the brain, and if not treated in time, it may threaten the patient's life. Everyone must pay attention to cerebrovascular health issues, especially middle-aged and elderly people. They should adjust their lifestyle and diet to better prevent diseases such as cerebral vascular stenosis. They can also do more brain exercises.

Clinical classification (Tiantan classification)

Asymptomatic stenosis

Symptomatic stenosis (ICA, CA stenosis >70%, MCA, BA stenosis >50%)

Type I stenosis: The blood supply area of ​​the stenotic blood vessel is ischemic, and clinical manifestations of ischemia in the related area appear.

Type II stenosis: Stenosis causes ischemia (blood steal) in the collateral vessel supply area, and the blood supply area of ​​the stenotic vessel is compensated, resulting in steal syndrome.

Type III stenosis: mixed type

Each type is further divided into three subtypes: A, B, and C.

Type A: There is no infarction in the corresponding area, or there is lacunar infarction but no neurological sequelae, and the acetazolamide (Diamox) provocation test is abnormal. It is expected that the patient will benefit from vascular reconstruction surgery.

Type B: There is a small area of ​​infarction in the corresponding region or combined with tandem stenosis of distal vessels or occlusion of the distal main trunk, but the branch artery still participates in the collateral blood supply of other stenotic vessels. It is expected that the patient can partially benefit from vascular reconstruction surgery.

Type C: There is a large area of ​​infarction in the corresponding area, sequelae of major stroke, or chronic occlusion of the distal main trunk, and the branch artery does not participate in the collateral blood supply of other stenotic blood vessels. It is expected that the patient will not benefit from vascular reconstruction.

Treatment

There are three treatments for cerebral artery stenosis: drug therapy, surgical treatment and vascular stent therapy. If the stenosis of the lumen is less than 50%, we can take medication, mainly aspirin (A), probucol (P) and statins (S). This therapy is referred to as PAS therapy. If the blood vessel stenosis exceeds 50% of the diameter, a carotid endarterectomy surgery or placement of a vascular stent in the narrowed blood vessel is required to expand the lumen to achieve the treatment goal. Among them, intravascular stent therapy is currently the most widely used. Its main advantage is that it causes little trauma to patients and can treat multiple stenotic lesions at the same time. Therefore, it is particularly suitable for patients who cannot tolerate or refuse surgery, patients whose vascular stenosis recurs after surgery, patients with multiple blood vessel stenosis, and patients whose stenosis sites cannot be reached by surgery. These three treatment methods have their own indications, advantages and disadvantages and can complement each other.