Oxygen starvation of the brain: symptoms and treatment

It is very difficult to predict the occurrence of hypoxia. The disease can develop not only at a very old age, but also during the process of intrauterine maturation of the fetus. The composition of the blood changes greatly during illness, which is why it stops flowing to the brain tissue. A person with pathology needs qualified medical assistance, otherwise he may fall into a coma and sometimes even die. Therefore, it is important to consult a doctor at the first suspicion of hypoxia. In everyday life, an oxygen concentrator can be used to prevent and treat pathological conditions.

General symptoms

The disease can be identified by signs such as:

• severe pain in the head;
• problems with memory and attention;
• the occurrence of ringing and buzzing in the ears;
• loss of concentration;
• fast fatiguability;
• nausea in the morning.

The longer a person is sick, the more manifestations of the disease appear at each stage:

• Excessive excitability. During diagnosis, a specialist may see that the structure of the brain tissue is slightly changed. This leads to the fact that the patient, who is in a state of euphoria, cannot control his behavior.
• Changes in appearance. A person has very pale skin, on which red spots or swelling appear that look blue. The human brain at this stage is busy restoring blood circulation. This leads to the patient's body becoming covered in cold sweat and perspiration appearing on the forehead.
• Disruption of the nervous system. The central nervous system of a sick person begins to slow down, as brain tissue is severely damaged. As a result, the person feels nauseous and constantly vomits. He also begins to feel dizzy, his vision becomes dark, and his visual function is impaired. In the future, the patient may lose consciousness.
• Damage to the central nervous system (perinatal). Edema develops in the brain tissue. As a result, the person loses all reflexes.

Forecast

The prognosis is determined by the dynamics/character and degree of changes/disturbances in the body’s vital functions, which depends on the type of hypoxia, its severity, rate of development, and state of the body. Thus, in severe fulminant form, hypoxia quickly leads to loss of consciousness, severe disruption of body functions and death of the patient (in case of acute arterial massive blood loss, ventricular fibrillation , cyanide , etc.). Chronic moderate hypoxia (constant/intermittent) is accompanied in most cases by the body's adaptation to hypoxia.

Hypoxic type

It can develop if there has been insufficient oxygen supply for a very long period of time. Most often, the disease manifests itself in people who regularly visit mountain slopes and peaks, fly by plane, and also stay in closed rooms for a long time, where there is practically no access to fresh air (for example, submarines, bunkers, etc.). The hemoglobin level decreases significantly. Often the patient has problems with water-salt balance, as well as the tone of blood vessels. Hyperventilation of the lungs also occurs due to increased excitability of the respiratory centers.

Characteristic signs of the hypoxic form of the disease are:

• constant desire to sleep;
• paresis;
• slower reactions;
• short-term memory impairment;
• decreased performance;
• accelerated movements and speech;
• rapid breathing;
• constant shortness of breath (both during exercise and in a relaxed state).

If treatment is not started in time, then in the final stages attacks of involuntary urination appear. A person often loses consciousness and eventually falls into a coma.

Classification

The classification of types of hypoxia is based on several criteria - the causes of development, the speed of their development, the severity of disorders in the body, duration.

Due to development they distinguish:

• exogenous types of hypoxia (normal/hypobaric);
• endogenous types of hypoxia (respiratory, circulatory, hemic, tissue, overload type of hypoxia, substrate type of hypoxia, mixed hypoxia).

According to the severity of disorders of the body's vital functions, they are distinguished:

• mild degree;
• moderate (average) degree;
• severe;
• critical (lethal).

Based on the speed of occurrence/duration of the hypoxic state, the following are distinguished:

• Lightning—occurs within seconds after exposure to the causative factor.
• Acute - develops within a few minutes after exposure to the causative factor (acute respiratory failure, acute blood loss).
• Subacute - develops over several hours within the first day (in case of poisoning with benzene, nitrates, nitrogen oxides).
• Chronic - development period from several days to several years (with respiratory/heart failure, chronic anemia).

Comatose type

About 50-60 seconds after oxygen stops flowing to the tissues, a coma occurs. The disease develops gradually, in several stages, and is accompanied by certain symptoms:

• The functioning of the cerebral cortex deteriorates. The patient is unable to navigate the surrounding space, does not feel time, practically does not react to various stimuli, and is unable to control the functioning of his bladder and intestines. Heart rate increases greatly. In this case, there is no need for artificial ventilation of the lungs, since the person’s breathing continues.
• After this, the performance of the anterior parts of the brain begins to decline. A person experiences convulsions, blood pressure decreases or increases strongly and quickly, speech is absent, and the reaction of the pupils to stimuli is practically absent.
• A sluggish coma may develop due to damage to another part of the brain - the bulb (medulla oblongata). This leads to the fact that the reaction to pathogens disappears completely, the respiratory system functions poorly, muscle tone and blood pressure decrease. The patient also experiences seizures.
• During the terminal coma stage, the brain stops functioning. The patient's blood pressure and temperature drop sharply, reflexes disappear completely, and atony occurs. At this time, it is vital to use a device for artificial ventilation.

Just five minutes after the patient goes into a coma, the person’s brain can die. At the fourth stage there is a high risk of death (90%).

List of sources

• Hypoxia. Adaptation, pathogenesis, clinic / Responsible. ed. Yu.L. Shevchenko. - St. Petersburg: Elbi-SPb LLC, 2000. -384 p.
• Kislitsyn A.N. The influence of hypoxia on the human body during high mountain ascents // General. resuscitation. - 2006. - T.II, No. 1. — P. 39-41.
• Lukyanova L.D., Kirova Yu.I., Sukoyan G.V. New information about signaling mechanisms of adaptation to hypoxia and their role in systemic regulation // Pathogenesis. - 2011. - T.9, No. 3. — P. 4-14.
• Chesnokova N.P., Brill G.E., Polutova N.V., Bizenkova M.N. LECTURE 10 HYPOXIA: TYPES, ETIOLOGY, PATHOGENESIS // Scientific Review. Medical Sciences. – 2021. – No. 2. – P. 53-55.
• Molov A.A., Shkhagumov K.Yu., Borukaeva I.Kh., Abazova Z.Kh. Adaptation of the brain and heart to lack of oxygen // Modern problems of science and education. – 2021. – No. 2.

Treatment with medications

Hypoxia is treated using medications from various groups:

• Analgesics. You can use any medications, but only after consulting a doctor. Usually pain is relieved with Akamol, Pentalgin, Bupranal or Anopyrine.
• Antidotes. Designed to get rid of hypoxia that occurs after poisoning. When intoxicating the body, medicinal drugs are used: “Flumazenil”, mushrooms – “Diazepam” or “Atropine”, heavy metals – “Cuprenil” or “Unithiol”, organic acids – “Almagel”, carbon monoxide – glucose.
• Dilatating bronchi. Most often it is recommended to use Truvent, Berodual, Atrovent and Salbumatol.
• Antispasmodics. The drugs are used if a stroke condition occurs as a result of the disease.
• Vitamins. In case of poisoning, the patient is prescribed K1, C and B6. The multivitamin complex is recommended for patients with any form of the disease.

Physiotherapeutic procedures

Indicated for any type of disease. Basic procedures - different types of oxygen therapy:

• inhalation;
• special cocktails;
• injections (sub- and percutaneous);
• oxygen barotherapy (during the procedure a person breathes compressed oxygen while in a specially equipped pressure chamber);
• oxygen baths.

In addition, the patient may be prescribed UHF, therapeutic massages, and magnetic therapy. People often turn to oriental medicine, where acupuncture, natural medicines and herbal teas are used, as well as special sets of physical exercises. The optimal treatment methods for the patient should only be prescribed by the attending physician. However, in any situation, it is advisable to buy an oxygen concentrator in order to restore health not only within the walls of a medical institution, but also at home.

Prevention

Prevention of AMS should first involve assessing the degree of risk individually for each participant going to high altitude (see table below).

For a low-risk individual, there is no need for prophylactic medications and participants should focus on following a gradual climb schedule. Thus, at altitudes of 3000 meters or more, participants should not increase the altitude of their overnight stop by more than 500 meters/day with a mandatory rest day. If it is impossible to comply with this requirement (relief and other factors do not allow it), it is recommended to arrange a rest day immediately before a large climb or immediately after it at the nearest point with the expectation that the total rate of climb over the period covered will be below 500 meters/day.

A stepped climb/pre-acclimatization significantly reduces the risk of developing mountain sickness, improves oxygenation/ventilation, and reduces the increase in pressure in the pulmonary artery during subsequent climbs.

Individuals at moderate/high risk of developing AMS are recommended to take the mountain sickness tablet Dexamethasone . Doses for adults are 2 mg every 6 hours or 4 mg every 12 hours. Higher doses (4 mg every 6 hours) should only be prescribed in high-risk situations. In this case, the duration of taking dexamethasone in order to avoid suppression of adrenal function/development of glucocorticoid intoxication should not exceed 10 days.

Acetazolamide ( Diacarb ) is also quite effective in preventing AMS (125 mg tablets 2 times a day). However, it is necessary to carefully monitor doses, since increasing them is accompanied by a high risk of side effects. Nifedipine , Tadalafil , Sildenafil are indicated for the prevention of high-altitude pulmonary edema .

The use of other drugs (coca tea, chewing coca leaves, leukotriene receptor blockers, antioxidants, phosphodiesterase inhibitors, Spironolactone / Sumatriptan , salicylic acid ) does not have a positive effect in the prevention of AMS.

Overhydration (increased drinking regimen) also did not demonstrate a positive effect in the prevention of AMS, but at the same time, the risk of hyponatremia .

Some authors believe that resistance to hypoxia is expressed during exercise in special masks, which, in their opinion, imitate hypoxic conditions.

The oxygen deprivation mask restricts the air flow entering the nose/mouth, thereby attempting to simulate the effect of training at high altitudes. At the same time, the mask has a mechanism for regulating the flow of air, which allows for altitudes from 900 to 5500 meters. According to the manufacturer, the use of masks allows you to achieve a significant increase in the key marker of growth in aerobic endurance - VO2max.

However, to date, the effectiveness of using training masks has been studied extremely poorly and many believe that a training mask has nothing to do with hiking in high altitudes. Despite the fact that it is difficult to breathe both at high altitudes and in a mask, the reasons for this are completely different: at high altitudes there is less oxygen in the air, but when using a mask, the oxygen does not become less. It is simply harder for a person to breathe. Therefore, masks cannot be considered a sports accessory that simulates hiking in the highlands. Rather, they can be considered as a simulator used to strengthen the inspiratory muscles involved in the act of inhalation.

Traditional methods

Patients are recommended to perform gymnastic exercises. Atherosclerosis can be treated with a mixture of ginger, honey and olive oil. If the patient suffers from cramps, then you need to use garlic tincture. To quickly increase hemoglobin levels, many advise eating a lot of buckwheat mixed with walnuts, ginger and honey,

Hypoxia is also often treated with herbal decoctions and infusions. Most often they use motherwort, chamomile, valerian, hawthorn and St. John's wort. You can restore the functioning of the respiratory system with licorice root, elderberry, plantain, coltsfoot and pine buds. And with the help of yarrow, wormwood or common dandelion they normalize the concentration of hemoglobin in the blood.