What Are the Different Types of Spasms?

Cerebral vasospasm refers to the stimulation of the walls of arterial blood vessels supplying the brain for various reasons, causing vasospasm, reducing cerebral blood flow, and a transient ischemic attack.

Cerebral spasm

Cerebral spasm symptoms

Cerebral vasospasm is related to the location of the spasm, the length of the spasm, and the severity of the disease. Common cerebral vasospasm symptoms are:

Severe headache, dizziness, tinnitus, transient blindness, speech disorder, skewed mouth and eyes, numbness of one side of the limb, or movement disorder, etc .; those with short spasticity, mild symptoms, or no obvious symptoms.

Causes of Cerebral Spasm

1) Arteriosclerotic plaque in the internal carotid artery or vertebral-basal artery system, narrowing the blood vessel lumen and eddy blood flow, stimulating the vessel wall to cause vasospasm, and causing insufficient blood supply to the cerebral vertebral-basal artery;

2) Persistent hypertension can cause cerebral vasospasm or hypertensive encephalopathy;

3) Subarachnoid hemorrhage can cause extensive and localized cerebral vasospasm.

Those who are caused by subarachnoid hemorrhage or hypertensive encephalopathy should be hospitalized early;

Nimodipine can selectively dilate cerebral blood vessels and relieve cerebral vasospasm. Early application of nimodipine treatment can reduce related neurological deficits. In severe cases, 10 mg to 20 mg, static, 1 mg / hour for 14 consecutive days; or

Nimodipine 20 40mg, 3 times a day; Flunarizine (Cibilin) 5-10mg once a day before bedtime.

Cerebral angiospasm refers to atherosclerotic plaques in the internal carotid artery or vertebral-basal artery system that narrow the blood vessel lumen and vortex flow. When the eddy current is accelerated, the vascular wall is stimulated to cause vasospasm and a transient ischemic attack occurs. The symptoms disappear when the vortex is decelerated. However, some scholars believe that due to the specificity of the cerebrovascular structure, spasm is unlikely to occur. However, most scholars believe that vasospasm can undoubtedly occur in the internal carotid artery and the cerebral arterial ring. Aortic spasm can be seen in cerebral angiography; subarachnoid hemorrhage can cause extensive and focal cerebral vasospasm; When the aorta is operated, the diameter of the artery can be noticeably reduced. Therefore, it can also cause cerebral arterial spasm and cause transient ischemic attack under the stimulation of persistent hypertension, local injury or microparticles.

Pathological cause

Emotional fluctuations, anger and excitement, psychological disorders, and stress are the most common causes of cerebrovascular spasm. Most patients are students, especially high school and college entrance examination students. They have a stressful study life, lack of sleep time, and have no chance to relax at all. Cerebral vasospasm, insomnia can also cause cerebral vasospasm. In young women, the incidence of mental workers is relatively high.

Mechanical stimulation of blood vessel walls by blood;

Damage to the vessel wall structure caused by compression of blood clots and vascular nutrition disorders;

Oxygenated hemoglobin oxidizes to methemoglobin and releases damage caused by oxygen free radicals;

Vasoconstriction of various other vasoactive substances, such as 5-HT, catecholamines, hemoglobin and arachidonic acid metabolites;

Increased intracranial pressure, excessive dehydration treatment without timely replenishment of blood volume;

And vascular wall inflammation and immune responses. In addition, the sympathetic / parasympathetic balance, and the self-regulation mechanism of cerebral blood flow are also hot topics.

It may be due to hematoma or blood clot, mechanical tension and compression of the skull base artery, and the nerve medium released by the hypothalamus changes the sympathetic nerve tension, which causes cerebral vasospasm through nerve reflex. Increased vasoconstriction substances in body fluids, such as thromboxane A2, catecholamines, angiotensin and other 5? Serotonin are the main causes of delayed cerebral vasospasm. Cerebral vasospasm is the main cause of disability and death in subarachnoid hemorrhage. Therefore, rescue treatment should be actively carried out.

Cerebral spasm clinical manifestations

After the occurrence of cerebral vasospasm, clinically increased intracranial pressure (headache, vomiting, fundus edema appears or worsens), and the disturbance of consciousness worsens. The patient changed from sober to drowsiness or coma; or from coma (early cerebral vasospasm usually recovered within 2 days) awake coma (again cerebrovascular spasm). This dynamic change in consciousness is a prominent feature of cerebral vasospasm. At the same time, focal signs such as hemiplegia, paresthesia, aphasia, etc. often appear in different degrees. The patient continued to have fever, and the peripheral blood like white blood cells continued to increase. The aggravation of the above symptoms, it is difficult to explain the rebleeding (such as lumbar puncture failed to confirm rebleeding) and intracranial hematoma, and vascular spasm can be diagnosed as cerebral vasospasm by angiography.

Need to be distinguished from :

1. Focal epilepsy The performance of various types of focal seizures is similar to that of TIA, such as epileptic seizures or motor seizures are easily confused with TIA. Tension-free seizures are similar to sudden attacks. It is better to perform 24-hour EEG Holter monitoring. If there is a focal epilepsy discharge, it can be diagnosed as epilepsy. If there is no abnormality, consider the possibility of TIA. CT or MRI examination found focal non-infarct lesions in the brain, which can also be considered as epilepsy.

2. The duration of vertigo in Meniere's disease is long (up to 2-3 days), accompanied by tinnitus, hearing loss after multiple episodes, and no other signs of localization of the nervous system.

3. Most of the patients had black eyes, dizziness, and unstable standing before syncope, accompanied by pale complexion, cold sweats, pulse and blood pressure, and transient consciousness but recovered quickly after falling to the ground, and there was no nerve localization. Physical signs. Occurs more than upright.

Fourth, migraine mostly occurs in adolescence, often with a family history, and the onset is mainly autonomic symptoms such as migraine headache and vomiting, and there is less focal neurological loss and longer onset. Whatever the cause of TIA, it should be regarded as an important risk factor for complete stroke, especially the authors repeatedly and repeatedly in a short period of time. The disease can resolve on its own, and treatment focuses on preventing recurrence.

Cerebral spasm damage

Simple cerebral vasospasm refers to the abnormal contraction of the cerebral arteries over a period of time. It is a functional disease. Most of the patients are young people and have better self-regulation ability, so the prognosis is good. Most patients can completely recover after treatment and relaxation. The disease does not occur with hemiplegia and psychotic abnormalities.

However, if it is combined with intracranial aneurysms, or cerebral arteriosclerosis, hypertension and other diseases, it may easily lead to cerebral hemorrhage. If not treated in time, paralysis or other neurological symptoms may even be life threatening.

Cerebral spasm prevention

1. Reasonable diet. It is recommended to eat more fresh vegetables and fruits and less greasy foods. It is recommended to drink red wine (50-100mml) and green tea, and eat yellow food (such as carrots, sweet potatoes, corn, tomatoes, etc.) black fungus and oatmeal.

2, the right amount of exercise. The best exercise is walking, and it is safe to master the "three five seven" exercise. "Three" means walking 3 kilometers a day for more than 30 minutes; "Five" means exercising more than five times a week; "Seven" means heart rate plus age about 170 after exercise. This amount of exercise is of moderate intensity. In addition, you can jog, Yu Jia, Tai Chi, cycling, swimming, etc. according to your own situation. It has been reported that cerebral arteriosclerosis can be prevented in those who exercise equivalent to 3 kilometers of walking or jogging.

3. Quit smoking and limit alcohol. The dangers of smoking are unquestionable and should be resolved to quit. If you cannot quit smoking completely, it is recommended that you limit your daily smoking to 5 cigarettes. You can drink in moderation. It is recommended to drink a small amount of red wine. The beer should not exceed 300ml, and the white wine should not exceed 25ml. Never drink alcohol.

4. Psychological balance. A healthy lifestyle is important, and of all health care measures, psychological balance is the most important. Eliminate concerns about illness, establish a correct attitude towards illness, maintain a calm mind and a happy mood, and avoid emotional excitement.

Cerebral spasm treatment

First, the cause of treatment

Find out the cause and carry out active treatment, especially the prevention and treatment of atherosclerosis. ^[1]

Drug treatment

1. Early use of cerebral vasodilators and volume expanders can significantly reduce and terminate clinical episodes of TIA. Can choose to use 20mg betaine and 5% glucose 500ml, or low-molecular dextran or 500ml intravenous infusion. Wei Nao Lu Tong, Sibiling, etc. may also have a certain effect.

2. Antiplatelet aggregation agents reduce the occurrence of microemboli. If there is no ulcer or hemorrhagic disease, aspirin is usually used for treatment ranging from 50mg to 300mg per day. Most people think that a smaller dose is appropriate, and the dose can be reduced if taken for a long time. Persantin (25mg 3 times a day) in combination with aspirin can play a synergistic effect, and can reduce the dose of aspirin. If the patient should not take aspirin or take aspirin with unsatisfactory results, he can switch to Ticlopidine (200--250mg 1--2 times a day) or ticlid 250mg (1 time a day). Attention should be paid to strengthening the prevention and treatment of toxic and side effects such as bleeding.

3 Anticoagulation therapy is frequent for those with frequent attacks, serious illness and progressive aggravation, and there is no obvious contraindication to anticoagulation therapy. Early anticoagulation therapy has positive significance for reducing the incidence of attacks and preventing cerebral infarction. Commonly used 12500U heparin was added slowly in 5% glucose saline.

4 Calcium antagonists can selectively act on calcium channels of cerebral vascular smooth muscle, prevent calcium ions from flowing into cells from outside the cell, and have the effects of preventing cerebral arterial spasm, dilating blood vessels, increasing cerebral blood flow and maintaining red blood cell deformation. Generally, 5--10 mg sibilin is used once a day.

5. Other methods such as extracorporeal anti-bore, ultraviolet light quantum therapy, and blood dilution methods, as well as Chuanxiong and Tongjing Huoluo traditional Chinese medicine can also be used.

Third, surgical treatment

It is confirmed by angiography that there is obvious narrowing or occlusive disease of the aorta of the neck, and the curative effect of the drug is poor. Patients are generally allowed, and those with conditions can consider internal carotid endarterectomy, stent placement or intracranial extracranial anastomosis. It has certain effects on eliminating microembolism, improving cerebral blood flow and establishing collateral circulation. Because it is not a radical method, and the indications and effects of surgery have not yet been confirmed, it is still rarely used in China.

Cerebral spasm diet

Steamed Pig Brain with Qi Ju Turtle Fragrant

Ingredients: 150g of pig brain, 15g of red wolfberry, 9g of chrysanthemum, 12g of Ligustrum lucidum, 12g of mulberry parasite, 15g of golden dendrobium, 15g of raw turtle plate, 12g of echinacea, 30g of black beans, 12g of hemp tomorrow, 15g of raw oysters, Hangzhou white 12g, Chuanfu 4.5g, whole scorpion tail 4.5g, dried 2-3, real musk 0.6 1g, Sichuan safflower 9g, 5 onions, black hair fungus 30g, soy sauce, salt, monosodium glutamate, white sugar , Aged wine, sesame oil in small amounts.

Method: Put chrysanthemum, Ligustrum lucidum, Mulberry parasitica, Eclipta prostrata, Baiji, Chuanxiong, Scorpion, Pupae, Safflower into net gauze medicine bag, tie the bag tightly; put into ceramic pot, add Turtle plate, oyster, golden chrysanthemum, wolfberry, black beans, gastrodia, light onion, pig brain, black fungus, salt, soy sauce, monosodium glutamate, sugar, and water; put it in a drawer and steam over high heat for 2 hours. Remove the lid, pour 2 tbsp of old wine, sesame oil, add musk to mix evenly, and drink it slowly with the medicine soup. Patients taking this meal changed their consciousness to normal sobriety, and the headache was greatly reduced, that is, the original prescription was subtracted from musk, and it should not be used for a long time to avoid the disadvantages of qi injury and loss of yin and jin. clothes.

Indications: Loss of liver, hyperactivity of liver and yang, water does not nourish wood, liver and kidney deficiency, chronic illness entering the network, internal movement of virtual wind, committing the brain and blood stasis of the brain. For a long time, the brain is occluded, and the headache caused by the pain is long, the pain is fixed, the pain is like a thorn, or the headache is light and heavy, and when the work is worsened, dizziness, tinnitus, dizziness, upset, irritability, Chest tightness, bitter mouth, dry throat, slow response, and astringent speech. Or strong tongue and tongue, crooked mouth and eyes, paraplegia, convulsions, disturbance of consciousness, hemiplegia, aphasia, numbness of hands and feet, dull complexion, tarnished lips, salivation of mouth corners, purple tongue, little moss and lack of veins, anger of sublingual veins Zhang Qing purple or petechiae, the pulse string is fine. More common chronic cerebral arteriosclerosis, cerebral thrombosis, cerebral infarction, cerebral embolism, sequelae of cerebral concussion, cerebral vasospasm, cerebral atrophy, vascular neuropathic headache, brain tumor or bleeding headache dizziness after surgery.

Function: Pinggan Qianyang, nourishing the kidney and nourishing the liver, clearing the brain and resuscitating, relieving wind and stopping spasm, promoting blood circulation and removing blood stasis.

Drinking cold drinks in summer can cause cerebral vasospasm and cause headaches

On hot summer days, some people will experience headache and dizziness. In severe cases, it will affect daily life and work. According to statistics, the number of headache patients who develop onset in July and August is 18% higher than the annual average.

The main reason why people are prone to headache and dizziness in the summer is mainly due to the following reasons: First, in summer, the human body emits a large amount of sweat in order to cool and cool down. Insufficient blood supply to the brain and headache and dizziness symptoms; Second, people often suffer from malnutrition and low blood sugar in the summer due to poor sleep, weak spleen and stomach, and poor appetite; third, In summer, people are used to drinking cold drinks. Cold drinks can cause spasms of hot oral and gastric submucosa blood vessels, and cause cerebral vasospasm. Although this spasm is not long, it makes the brain hard to endure such sudden blood flow. Fourth, in the summer, some people wash their heads with cold water after sweating, and the blood vessels dilate under high temperature. At this time, rinsing with cold water may cause abnormal intracranial blood vessel function. Dizziness, dark eyes, and vomiting may cause severe intracranial hemorrhage.

The following measures can be taken during midsummer to prevent headaches:

1. Pay attention to avoiding summer heat and cooling, and do not work in high temperature environment for a long time.

2. Achieve a scientific diet, add water in time, and eat more vegetables and fruits.

3. Pay attention to rest, maintain enough sleep, eliminate fatigue, and make people energetic.

4. People who are prone to headaches when drinking cold drinks should avoid cold drinks, let alone cold drinks.

5. For people with dehydration headaches, in addition to replenishing water in a timely manner, a low pillow or pillowless lying position should be adopted to make blood flow to the brain as much as possible.

6. After sweating, do not rush to wash your face with cold water. You can use a dry towel or use a wet towel to wipe the sweat.

The outcome and prognosis of cerebral vasospasm

This disease is a functional disease that can be completely recovered after treatment and relaxation. Most of the patients are young people and have better self-regulation ability, so the prognosis is good and most patients can be cured. The disease does not occur with hemiplegia or psychotic abnormalities.