Overview
Hypertensive Encephapathy, HE is an acute brain function disorder caused by chronic, highly uncontrolled hypertension. Hypertensive cerebropathy is mainly manifested in the symptoms of the nervous system such as headaches, nausea, vomiting, cognitive impairment, visual impairment, which can even lead to coma or death. It is one of the serious complications caused by hypertension, usually when blood pressure suddenly rises to a certain level, especially among patients with untimely controlled hypertension.
II. Causes and mechanisms of hypertension
The occurrence of hypertension is closely related to the increase in blood pressure leading to changes in brain blood flow mechanics. Under normal circumstances, the cerebral vessels maintain a stable supply of blood by self-regulating mechanisms (e.g., automatic brain blood flow) and can maintain normal brain tissue injection even in cases of blood pressure fluctuations. However, when blood pressure rises to a certain degree, this mechanism of regulation may fail, resulting in an inability of the cerebral vessels to respond effectively to changes in blood flow.
Mechanisms for the occurrence of hypertension include the following:
1. Blood-brain barrier damage: Long-term hypertension or acute hypertension risk can cause damage to the inside-vascular cell, damage the integrity of the blood-brain barrier and cause plasma to penetrate the brain tissue, causing brain edema.
2. Brain vascular fractures: hypertension increases the tension of the cerebral vascular, leads to cerebral vascular fractures, small haemorrhages, and leads to local brain dysentery and hypoxia.
3. Brain edema: Increased vascular permeability due to high blood pressure can lead to ecstasy between brain cells, especially in the cerebral cortex and brain stem areas. Oedema increases internal pressure and causes headaches, vomiting and other symptoms.
4. Changes in brain blood flow: As blood pressure rises, the ability of brain vessels to regulate themselves is gradually lost, which may lead to rapid or slow circulation of local brain blood, which in turn causes brain dysfunction.
III. Clinical manifestations of hypertension
Clinical manifestations of hypertension are usually associated with a sharp increase in blood pressure, and symptoms can range from mild discomfort to severe neurological disorders. Typical clinical performances include:
1. Headaches: One of the most common symptoms, usually persistent, severe headaches, especially on the top and back of the head. The degree of headache may increase as blood pressure rises.
Disgusting and vomiting: Patients are often associated with nausea and vomiting as a result of increased internal pressure and the effects of brain oedema. These symptoms are often sudden and difficult to mitigate.
3. Visual impairment: Hypertensive cerebropathy can lead to retina vascular changes that affect vision. Patients may suffer from blurred vision and loss of vision.
4. Consciousness disorders: As the condition increases, the patient may suffer from different levels of cognitive disorders, ranging from sleep addiction to coma, and may even cause epilepsy in serious cases.
5. Neural signs: Hypertensive cerebropathy may be associated with various neurotic symptoms, such as paraplegia, speech disorders, pacing disorders, etc., reflecting damage to the cerebral cortex and brain stem.
6. Earnings, dizziness: due to insufficient brain blood or oedema, the patient may feel an ear ringing or dizziness, especially when the body changes.
7. Vomiting: Continued vomiting is a common manifestation of hypertension, usually due to increased internal pressure caused by brain oedema.
IV. Diagnosis of hypertension
The diagnosis of hypertension of the brain is usually based on clinical symptoms, signs, blood pressure measurements and image tests. The following are common diagnostic steps:
1. Blood pressure monitoring: The most important characteristic of hypertension brain disease is the sharp increase in blood pressure. It is clinically possible to confirm whether blood pressure continues to be above normal levels by means of repeated measurements of blood pressure.
Neurological imaging: Head C.T. or MRI tests can show brain oedema, brain haemorrhage or brain infarction. Brain edema is usually shown in the decrease in brain white density, and signs of increased intracircle pressure can be observed when severe.
3. Eye-to-eye examination: People with high blood pressure can detect retina vascular lesions, such as retina haemorrhage, seepage, emema, etc., from the background. These changes may be indirect evidence of hypertension.
Laboratory examinations: Blood tests can help to remove neurotic symptoms from other causes, such as metabolic disorders, infections, etc. Serum electrolyte, liver and kidney function, blood sugar etc. are often subject to examination.
5. Neural system examination: Detailed neurosystem examination, including state of consciousness, language, motor function, reflection, etc., can help to assess the extent of brain impairment.
V. Treatment of hypertension
Treatment for hypertension includes, inter alia, emergency relief, control of brain oedema and improvement of brain function. Treatment should take place as soon as possible with the aim of avoiding further damage to the neurological function and restoring the normal physiological function of the patient.
1. Emergency pressure relief: The primary objective of treatment is to reduce blood pressure rapidly, but the speed and extent of pressure relief requires caution. Excessive or over-pressure can lead to under-injection of brain blood, which in turn exacerbates brain damage. Commonly used decompressive drugs include sodium nitrate, labelol and nitrobenzene. These drugs should be used under hospital supervision, with strict blood pressure monitoring.
2. Treatment of cerebral oedema: Dehydration drugs such as glyphine, fur sermi, etc. can be used to reduce brain oedema, reduce the internal pressure of the skull and mitigate symptoms in cases where there is already an apparent brain oedema.
3. Correcting electrolyte disorders: Hypertensive cerebropathy may be associated with electrolytic disorders, such as low sodium haematosis. Maintain normal functioning of the body by supplementing electrolyte and regulating the balance of liquids.
4. Maintenance of organ function: Patients may suffer from system functional impairments such as respiratory, cycling, and therefore require comprehensive treatment, including maintenance of open respiratory tracts, oxygen recharge and correction of metabolic acid poisoning.
5. Prevention of complications, such as epilepsy, infection, haemorrhage, etc., which may aggravate the patient ‘ s condition and require appropriate treatment.
6. Long-term management: When a patient recovers, he/she shall be subjected to rigorous management of hypertension in order to avoid further sharp fluctuations in blood pressure. Lifestyle adjustments, such as salt reduction, adequate exercise, weight retention, smoking and alcohol cessation, and the use of depressive drugs, as prescribed by the doctor, are essential for long-term control of blood pressure.
VI. Prevention and planning
Hypertensive cerebropathy is one of the more serious complications for high blood pressure patients, but many can fully recover if identified and treated in a timely manner. The most important measure to prevent the occurrence of hypertension is effective control of blood pressure. High blood pressure patients should regularly monitor blood pressure and use drugs rationally to avoid a sudden increase in blood pressure. Maintaining a healthy lifestyle, reducing intake of high-salt and fat food, weight control, appropriate physical exercise and abdication of alcohol are important measures to reduce the risk of hypertension.
In general, hypertension is a serious acute nervous system complication, and timely diagnosis and treatment is essential. Symptoms can be effectively mitigated and mortality and disability rates reduced by means of blood pressure control, treatment of cerebral oedema and depressure treatment. The long-term management of patients after treatment is equally important, and reasonable control of blood pressure is key to preventing relapse.
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