Circulatory failure CEREBRAL
Disease information
Circulatory failure CEREBRAL
Cerebral
circulatory
insufficiency.
Definition.
It is defined as
cerebral
circulatory
insufficiency to the set of hemodinámicas disturbances of the
arterial
system
, pronouncing
itself
like an insufficiency of the
circulatory
flow in the
arterial
system
of the brain. The upheavals of the perfusión of the
cerebral
weave cause
a
set of clinically different symptoms, according to the zone and the size of the affected
cerebral
trunks.
Etiologías.
Generally, the appearance of
a
cerebral
circulatory
insufficiency is consequence of several phenomena. It is the conjunction of factors that diminish the caliber of the
arterial
network and of that they increase viscosity sanguineous. The etiologías are numerous.
The estenosante reach is in first term. These estenosis, to the margin of some malformations vasculares and
cervical
traumatismos, are originated generally by lipídicos upheavals: hiperlipidemia, hipercolesterolemia and hipertrigliceridemia.
In the long term,
a
too rich nourishing
cholesterol
and saturated fat contribution can cause ateromas. Nevertheless, it is not necessary to underestimate the presence of other factors of risk like:
•
Diabetes
.
•
arterial
Hypertension
.
• Upheavals of the coagulation.
• estrogénicas Deficiencies.
• sedentary Life.
• Tabaquismo.
• and some hereditary and ethnic factors.
Clinical signs.
Clinically, the
cerebral
circulatory
insufficiency is translated in located painful signs in an encephalic
arterial
zone. Often, the clinical expression is moderated by the presence of an auxiliary
circulatory
network, specially, the polygon of Willis that communicates the vertebrales arteries right and left. In order to illustrate the
cerebral
circulatory
insufficiency, one resorts generally to the description of
a
characteristic and individual forms
clinic
: the insufficiency to vértebro - basilar.
The symptoms are transitory, being mainly the following ones:
• Vertigos and upheavals of the balance favored by rotation of the head.
• optical Upheavals that can go from the simple blurred vision to the transitory bilateral o'culo - motor paralysis.
• recidivantes Migraines.
• Síncopes, lipotimias.
• Upheavals of the watch.
Nevertheless, during most of the time, the manifestations of the
cerebral
circulatory
insufficiency are more discreet, being translated in
a
reduction of the perfusión at more
peripheral
arterial
level.
The clinical signs settle progressively and insidiosamente. It is catalogued to them like psico - comportamentales upheavals of the
cerebral
senescencia.
• upheavals of the behavior and humor.
• upheavals of the dream.
• upheavals of the memory and the conception of ideas.
• upheavals of the concentration,
attention
and the watch.
These upheavals are the consequence of an alteration of the
cerebral
cells.
Mechanisms of the alteration.
The investigators show
a
great interest in the molecular modifications, because these would explain the appearance of the observed cellular alterations during isquemia
cerebral
. The reduced oxygen contribution causes numerous biochemical phenomena that cause
a
disfunción of the cellular metabolism.
Therefore, in case of hypoxia, the cells present / display upheavals of the permeability due to the opening of different ionic channels from membrane level. This causes
a
intracytoplasmic
calcium
invasion in the cell. The massive calcic ion presence activates fosfolipasas that takes to
a
lisis of the phospholipids with severe disturbance of the membrane
functions
, specially, of necessary protéicas enzymes for the maintenance of the ionic levels.
The lisis of the phospholipids provides free fatty acids of between which some of them will be metabolizarán in mediators.
These mediators, prostaglandins, leucotrienos and tromboxanos are the people in
charge
of the observed injuries (edemas, microcirculatory upheavals) that produce free radicals. Of simultaneous form, the power
deficiency
of the hipóxica cell causes an alteration of the oxidorreductor potential of mitocondrias, also favoring the production of free radicals and
a
reduction of the protective antirust agents (enzymes: catalasa, glutatión peroxidasa, superoxide dismutasa and vitamins)
The conjunction of these phenomena is translated in
attacks
of the free radicals on the membrane fatty acid chains that have double connections. The attacked fatty acids form lipoperóxidos toxic in the cell, whose presence in the
cerebral
weave is well - known for
a
long time.
It is identified to them in pigment form like the lipofucsina. At level of the
cerebral
cells, the lipídicas
anomalies
are responsible for serious disturbances in the permeability of membranes, particularly, in the
system
of pumping of sodio / potasio and in the ionic force of the cytoplasm.
This is translated in deficiencies of the sináptica neurotransmisión. It it is come off, the implication of the free radicals in the isquémicos processes of involución and
cerebral
aging.
Deformabilidad of
red
globules.
It remembers that the size of
a
red
globule
is of 7 µ and that the diameter of
a
small 3 capillary is of µ.
In order to arrive at the most distant level, the eritrocito must undergo
a
deformation necessarily.
For it
, the
red
globule
adopts
a
biconcave form that can be observed the microscope very easily. In case of diminution of the power of
globular
deformabilidad, the
cerebral
cells experience
a
hypoxia with the consequences that we finished seeing. Therefore, to conserve
a
correct physiological neuronal operation, it is important to maintain the flexibility of the eritrocitaria membrane.
This deformabilidad of the
red
globule
is determined by numerous factors, specially, by the particular constitution of its membrane phospholipids.
These phospholipids lock up an important poliinsaturados fatty acid content of 20 and 22 carbons. These fatty acids can come directly from foods,
but
generally, are synthesized from nutritional fatty acids of 18 carbons (the calls
essential
fatty acids) thanks to
specific
enzymes able to extend to the chain
charge
of coal from 18 to 20 or 22 (elongasas)
Nevertheless, the western feeding is poor in fatty acids of 20 and 22 carbons, that are those that improves the flexibility of membranes. This originates
a
weakening of the sintetizador power of enzymes, situation that is worsened with the age.
In the upheavals of the deformabilidad, it is then, of great interest the suplementación of the diet with
essential
, present fatty acids in
vegetal
oils.
In case of oxidation of membrane lipids, also they can appear alterations of the deformabilidad.
A
red
globule
with oxidized lipids (lipoperóxido) presents / displays membrane
anomalies
: extreme rigidity and forms cellular abnormal.
The oxidating phenomena must to the presence of toxic substances in the blood (
alcohol
, some medicines) and of free radicals. The variation of the index of rigidity of
red
globules can be measured perfectly before the presence of these oxidating agents.
Therefore, it is of great interest to find molecules antirust that they protect the membrane of the eritrocito of the
attacks
of the free radicals.
For it
, it is advised to eliminate the toxic factors before.
Carried out recent studies with
olive
tree leaf have shown the unsuspected one to be able antirust of this plant on
red
globules.
Also, analyses of variation of the
globular
deformabilidad have been made in two lots of
red
globules exposed an oxidating agent: the
T
. B.
U
. being stated that:
The first lot, not protected by the
olive
tree, underwent
a
peroxidation. The index of rigidity of these
red
globules
was
multiplied by four.
Nevertheless, the
red
glógulos of the second lot, protected by the
olive
tree, conserved intact their deformabilidad with respect to the control (measured carried out by means of hemoreómetro)
Therefore, the
olive
tree exerts
a
protective action the membrane of
red
globules before the injurious peroxidations.
This antirust and protective power of the free radicals must to the oleuropeósido presence of in the leaf of the
olive
tree, concretely, of the fraction hidroxitirosol of this molecule.
Treatment.
1. Hygienic -
dietetic
rules.
Factors of risk.
The risk factors must be fought with
specific
measures.
These factors are the following ones:
Obesity
,
hypertension
,
diabetes
.
Nourishing regime.
In order to avoid or to stabilize the aterosclerosis phenomena, it is fundamental to control the lipídico contribution.
1) Reducir the fat contribution to 20 or 30 % of the caloric total.
To reduce injurious fats (saturated or modified fatty acids) mantequilla, milky products, margarina, greasy meat (lamb, pig, charcutería) frituras, pastry shop.
To choose
vegetal
oils in
liquid
form (fatty acids insaturados) and fished (fatty acids of long chain of 20 and 22 carbons)
2) Limitar the nourishing
cholesterol
300 mg / día (the equivalent one to an egg yolk)
To reduce the egg consumption, mantequilla, greasy cheeses, hunts, vísceras and crustaceans.
3)
cerebral
Gymnastics.
It is necessary to insist on the necessity to carry out
a
daily
cerebral
gymnastics. To practice intellectual activities: reading, party games.
2.
Fitoterapia
.
The
fitoterapia
, associated to hygienic -
dietetic
rules, allows to treat the
cerebral
circulatory
insufficiency without toxicity nor indirect effect.
We would propose, first of all, regulating plants of the sanguineous flow of the brain, like
ginkgo
and vinca
pervinca
. Also we will return to speak of the
olive
tree by its antirust and protective properties from the membrane of the
red
globule
.
Plants adapted for this
disease
.
Ginkgo
.
Vinca
Pervinca
.
Olive
tree.
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