05/10/2021 | Category Symptoms of cervical osteochondrosis
Many who had an ultrasound of the neck saw in the conclusion the phrase “impaired venous outflow.” Let us immediately note that if this is discovered, this is already good, it means that the doctor looked carefully, not in a hurry, and did not miss anything. Sometimes there is no such record, although in fact there is a problem. The lack of recording may be due to various reasons, including due to outdated equipment; we will not dwell on this, but further we will describe the factors and symptoms by which it can be understood that the venous outflow is impaired, even if this is not indicated by the ultrasound results.
What is a venous outflow disorder?
First of all, let's understand the anatomy. Imagine a spine. Veins run next to it, through which blood should flow freely from the head down. If the vertebrae are displaced, then the veins can be pinched, deformed, and because of this their capacity is reduced. Blood accumulates in the posterior cranial fossa.
With normal intracranial pressure, there is no outflow of blood through the compressed vessels. In order for the outflow to be restored, the blood must flow with greater pressure, that is, the pressure must increase. We all know that increasing blood pressure is not beneficial for the body, to put it mildly, and here it is a necessary measure to restore blood circulation, otherwise more serious problems will arise.
In the long term, stagnation of blood and impaired circulation in the brain are fraught with many bad consequences, but there is no need to be afraid. The human body is excellent at recovering on its own, plus it informs in advance about possible problems with unpleasant and even painful sensations. Therefore, you need to listen to your body and simply help it be healthy, which is not difficult to do.
After an increase in pressure, a sharp outflow occurs through the posterior or jugular veins. Changes in the condition of the jugular veins are easier to see on an ultrasound than changes in the vessels near the spine, on the back of the neck.
Helpful advice
When you go for an ultrasound, be sure to ask to look at the jugular veins. If they write to you that they are dilated, this is an accurate sign of venous stagnation and circulatory disorders in the brain.
Reference. It is more difficult to see a similar sign of a disorder in the spine. Therefore, it may be that the problem is already there, but it is not yet visible when examining the back of the neck.
The jugular veins dilate and lose elasticity when large volumes of blood are dumped through them. As a result, blood circulation worsens even more, and the body signals this with pain.
Disorders of the venous circulation of the brain
Classification. The following chronic and acute variants of venous circulation in the brain are distinguished. Chronic include venous congestion and venous encephalopathy, acute include venous hemorrhage, thrombosis of the veins and venous sinuses, thrombophlebitis.
Venous stagnation. The most common form of venous circulation disorder is due to various reasons: cardiac and cardiopulmonary failure, respiratory diseases (bronchitis, bronchiectasis, bronchial asthma, emphysema, etc.); compression of extracranial veins (internal jugular, innominate, superior vena cava), struma, arterial aneurysm, tumor in the neck; neoplasms of the brain, membranes and skull, arachnoiditis, traumatic brain injury, thrombosis of the veins and sinuses of the dura mater, compression of the veins with cerebral edema and craniostenosis. With venous stagnation, metabolic changes and brain hypoxia occur, venous and intracranial pressure increases, and cerebral edema develops. More often, milder disorders occur in the form of changes in the tone of the cerebral veins, which is detected using orbital plethysmography and rheography.
Clinical manifestations. A dull headache, more pronounced in the morning, increases with movements of the head to the sides, changes in atmospheric pressure, changes in ambient temperature, after excitement, drinking alcohol, etc., there is a hum or noise in the head, cyanotic lips, cheeks, ears, nose , mucous membranes of the oral cavity, swelling of the lower eyelids, especially in the morning, dilation of the veins in the fundus. Venous pressure ranges from 55 to 80 mmH2O, arterial pressure is usually within normal limits. Stupefaction, dizziness, darkening of the eyes, fainting, and numbness of the extremities are observed. Epileptic seizures and mental disorders are possible. With severe venous stagnation, patients are unable to lower their heads and remain in a horizontal position.
Measurements of pressure in the ulnar vein, radiography of the skull (increased development of diploic veins, graduates and veins of the dura mater), and phlebography are of diagnostic value in venous pathology.
Venous encephalopathy. With venous encephalopathy, the following syndromes are distinguished: hypertensive (pseudotumorous), diffuse small-focal brain damage, bettolepsy and asthenic.
Bettolepsy, or cough epilepsy, develops with chronic bronchitis and emphysema, pneumosclerosis, bronchial asthma, especially with cardiopulmonary failure. A persistent cough may result in sudden loss of consciousness (syncope).
Venous hemorrhages. Capillary-venous hemorrhages in the brain and capillary-venous stasis are observed in hypertension. Venous stroke occurs in patients with heart failure, traumatic brain injury, brain tumor, infectious and toxic brain lesions. Clinical manifestations develop slowly: confusion, speech disorders, diplopia, pyramidal reflexes, hemiparesis, hemihypesthesia, damage to cranial nerves.
Thrombosis of cerebral veins. It occurs in the practice of clinicians of many specialties as a complication of various inflammatory processes, infectious diseases, operations, abortions, pregnancy, childbirth, skull trauma, “blue” heart defects, etc. Changes in the walls of the veins, a slowdown in the speed of blood flow and increased blood clotting play a role in the pathogenesis, as well as a change in the colloidal properties of endothelial cells, which contributes to the aggregation of blood cells. Often, thrombosis of the cerebral veins is combined with thrombosis of the sinuses of the brain, as well as the veins of the lower extremities.
Clinical manifestations. Cerebral vein thrombosis usually develops gradually. Headache, nausea, vomiting, meningeal symptoms, congestive optic discs, increased body temperature, and increased ESR appear. In the cerebrospinal fluid, mild pleocytosis and an increase in protein content, sometimes blood, are detected. Characterized by confusion, partial motor-type seizures, and less commonly generalized convulsions. Depending on the location of the venous lesion, focal symptoms occur: aphasia, alexia, hemianopsia, flaccid or spastic paresis or paralysis, and sensory disturbances. The outcome is often favorable, focal symptoms often undergo significant or even complete regression, but there are relapses of the disease. A slow chronic course over many months and even years is possible. Sometimes there are consequences in the form of mental disorders, aphasia, convulsive seizures and paresis of the limbs.
Thrombosis of the dural sinuses. Usually develops when infection penetrates into them from a nearby focus (furuncles or carbuncles of the scalp, face, erysipelas, etc., purulent osteomyelitis of the skull bones, purulent acute and chronic otitis media, mastoiditis, purulent processes in the orbit, paranasal sinuses) along the brain and diploic veins. In addition, phlebitis and thrombosis of the dural sinuses can occur hematogenously with thrombophlebitis of the veins of the extremities or pelvis and during septic processes. Thrombosis of the cerebral sinuses is sometimes accompanied by thrombophlebitis of the retinal veins, purulent meningitis, brain abscesses, etc. Sinus thrombosis can also occur with chronic infections (tuberculosis), malignant tumors and other diseases that occur with cachexia, in debilitated patients and in old age.
Clinical manifestations. Low-grade or sometimes very high, stable or fluctuating body temperature, headache, vomiting, leukocytosis in the blood, increased intracranial pressure. With thrombosis of the sinuses of the convexital surface of the brain, general cerebral symptoms predominate; in the sinuses of the base of the brain, signs of damage to the cranial nerves predominate. Drowsiness develops, sometimes, on the contrary, motor restlessness, insomnia, delirium, epileptic seizures, rigidity of the neck muscles, Kernig's symptom, hyperesthesia to visual, auditory and skin stimuli, and sometimes trismus. Focal symptoms of brain damage correspond to the location of the sinus. Swelling and cyanosis of the face or mastoid area are noted. In the fundus, dilated veins and swelling of the optic discs are detected. The cerebrospinal fluid is clear or xanthochromic, sometimes with an admixture of red blood cells; moderate pleocytosis is noted. Septic thrombosis of the dural sinuses is manifested by chills and very high remitting temperature. With thrombosis of the superior sagittal sinus, epileptic seizures of the motor type, hemi- and paraplegia or paresis occur.
Symptoms of thrombosis of the transverse or sigmoid sinus: headache, bradycardia, sometimes double vision, septic temperature, chills, stupor, turning into a soporous and even comatose state, sometimes delirium and agitation, anti-pain position of the head with an inclination to the painful side, meningeal phenomena, leukocytosis in blood. The jugular vein may be involved in the process. In this case, swelling of the tissue surrounding the vein and signs of damage to the glossopharyngeal, vagus, accessory and hypoglossal nerves occur.
Symptoms of cavernous sinus thrombosis: exophthalmos, swelling and venous hyperemia of the eyelids, orbits, forehead, root of the nose, dilation of the fundus veins (congestion), pain and hyperesthesia in the area of innervation of the superior branch of the trigeminal nerve, chemosis of the conjunctiva, ophthalmoplegia - paralysis or paresis of muscles, innervated by the III, IV, VI cranial nerves, stupor, delirium, sometimes coma, metabolic and endocrine dysfunction.
Complications: purulent meningitis, metastatic abscesses in the lungs, septic pneumonia.
Thrombophlebitis of the cerebral veins. With thrombophlebitis of the cerebral veins, the temperature rises to subfebrile levels with periodic rises to 38–39 °C. Patients complain of headache, nausea, and vomiting. Observed stupor, stuporous state, epileptic seizures, paresis of the limbs; in the fundus – swelling and dilation of veins; in the blood - leukocytosis; in the cerebrospinal fluid - slight pleocytosis, an increase in the amount of protein and positive protein reactions, sometimes an admixture of erythrocytes.
Symptoms of impaired venous outflow
Headache
The most common symptom is pain due to increased intracranial pressure. The blood does not leave the head on time, and new portions of it continue to flow - the pressure rises, the body signals this with a headache.
A case from the practice of Dr. Shishonin
The man was diagnosed with migraine and prescribed medication. The patient took the pills with discipline, but there was no noticeable improvement. Migraine attacks did not become less frequent and were often as severe as before starting to take the drugs. The attack was very difficult to relieve with analgesics; you had to take the maximum allowable doses, and even they did not always work. The pain went away on its own after some time.
Dr. Shishonin recommended going for an ultrasound under the compulsory medical insurance policy and asking to look at the jugular veins. An ultrasound showed that they were dilated. The cause of the migraine became clear - increased intracranial pressure.
After conservative non-drug treatment, improvement occurred within two months.
Extreme migraine
A very painful symptom occurs due to loss of elasticity of the jugular veins. Up to a certain point they can withstand the increased load, and then they can no longer cope. Swelling appears in the brain stem. They are not yet dangerous to human life and health, but they cause severe pain in the ternary nerve.
This is an extreme degree of migraine, it is almost impossible to tolerate and difficult to relieve with analgesics. A person becomes incapacitated, no matter how strong his will is. In addition, nausea occurs, the patient is physically unable to drink liquids or eat food. A migraine can last a day and goes away on its own when the pressure rises to such an extent that blood discharge does occur. If such conditions are repeated frequently, it becomes potentially dangerous.
Ptosis of the eyelid
A case from the practice of Dr. Shishonin
The person suddenly developed ptosis and the mobility of the eyelid was impaired. The hospital carried out a full examination - a microstroke was not confirmed, and no tumor was found.
An ultrasound scan examined the veins in the neck and revealed gross venous congestion. Conservative treatment without pills gave results after six months. If a person had paid attention to the headaches that he often had earlier, the problem could have been solved faster.
Labored breathing
This symptom itself is ambiguous; there can be many reasons. But if it is accompanied by regular pain in the back of the head or temples, then the cause is most likely venous stagnation.
Lack of air due to a violation of venous outflow can occur either unexpectedly and without cause (not during physical activity, not in a stuffy room), or, as they say, out of the blue - during a walk, in a well-ventilated room. If such situations recur, and under different conditions, you need to check and treat the neck first.
What else you need to know about symptoms
There are many signs of circulatory problems. Any discomfort in the head, neck, chest, or upper back may indicate this problem. You need to undergo an examination, and in any case it will be useful to do simple exercises. Unlike pills, carefully performed gymnastics and gentle self-massage have no side effects, that is, in any case the condition will not worsen.
The main principle of the doctor is Primum non nocere (“First of all, do no harm”). Therefore, Dr. Shishonin recommends making maximum use of the natural recovery abilities inherent in our body.
How does CVI manifest?
The disease often develops unnoticed. The first signs of venous insufficiency may be heaviness in the legs, swelling that appears in the evening, and cramps. Spider veins may form. The further course of the disease may be accompanied by dryness and darkening of the skin, and the formation of characteristic spots. While walking, pain and characteristic squeezing are felt in the legs; with prolonged immobility, discomfort is also felt.
Lack of timely treatment for CVI can lead to the development of thrombosis, which can be life-threatening, or a trophic ulcer.
The classification of the disease includes several stages, from a small cosmetic defect and swelling of the lower leg, to noticeable skin changes and the appearance of an ulcer. Seeing a doctor in the early stages of the disease will help restore the health of your legs, avoiding surgical intervention.
How can you help yourself without pills?
There are two simple ways. The first can be used by each person independently without preparation. The second one is a little more difficult, but regular viewers and readers of Dr. Shishonin will master it very quickly.
It is better to use both methods: working on the points on the sides of the front of the neck, and working under the back of the head. This way, you will not only get rid of headaches and other symptoms of impaired venous outflow, but you will also feel more energetic, your mood and memory will improve. The main thing is to regularly devote time to yourself and help your body recover. The capabilities of the human body are almost limitless, but you need to develop them by doing gymnastics and self-massage.
Self-massage in the collarbone area
Working out certain points improves blood flow through the jugular veins. This will help immediately reduce or completely eliminate headaches caused by blood stagnation. If you do this self-massage regularly, the veins will become more elastic, resilient and begin to work like pumps, draining blood from the head in time. Accordingly, headaches will stop without taking medications. This is important because any drugs have side effects, including those delayed over time. It is imperative to use the body’s natural ability to heal itself.
Self-massage technique step by step:
- Place two fingers in the middle of the collarbone - just above the jugular fossa.
- Lightly press on the point - the pressure should not be strong, but should feel pleasant.
- Start working the point with circular rotations clockwise or counterclockwise - whichever is more comfortable for you.
- Do 20-30 rotations.
- Move to the other side of the neck and repeat steps 1-4.
Important! Please note again that you cannot put pressure on the point. Throughout the self-massage there should be pleasant sensations, and after its completion - a feeling of vigor or pleasant relaxation (depending on the time of day). This is a marker that you are doing everything right.
How often to perform
Everything is individual here. For some, it will help the first time and the headache will subside for a long time, for others, several sessions in a row are needed, and then maintain the condition of the veins with preventive self-massage.
If you have a diagnosed migraine, you need to start working on the point as soon as the first signs of pain appear. As soon as there is the slightest hint of imminent pain, we immediately do it. This will certainly reduce the intensity of pain and will most likely stop its further development. That is, a terrible migraine attack, for which even pills don’t help, simply won’t happen, your head will hurt a little, but it will go away after working on the clavicular point.
To prevent migraines, if they happen several times a month or a year, it is useful to do self-massage every week. This will help maintain the elasticity of the veins and blood vessels, so the blood will circulate correctly, without stagnation. The risk of not only headaches, but also increased intracranial pressure will be reduced.
What contributes to the disease
CVI is caused by the characteristics of the circulatory system. To rise through blood vessels, blood must resist gravity. Its rise is caused by a diaphragm, the main function of which is to create a pressure difference. Help in overcoming gravitational forces is also provided by muscles, by contracting which the vein is compressed and, thus, blood is pushed through. Valves located on the walls prevent it from flowing back.
Failure in the activity of any component of this complex system impairs the outflow of blood, the vessels become overcrowded, and the pressure in them increases. Thus, venous insufficiency of the lower extremities develops.
The development of such a disease can be facilitated by:
- low mobility;
- genetic predisposition;
- obesity;
- increased intra-abdominal pressure, which can be caused by lifting heavy things, tight clothing, severe coughing and even constipation;
- overheating of the legs;
- pregnancy;
- taking hormonal contraceptives;
- heavy loads when playing sports;
- varicose veins, vascular injuries and other pathological changes in the functioning of the circulatory system of the lower extremities, previously suffered.
Working out the back of the neck
As we have already found out, the problem arises due to compression of blood vessels, which is a consequence of the incorrect position of the vertebrae. Gymnastics will help solve and even more so prevent such a situation. For urgent help, you can gently influence the vessels. Let's take a closer look at how to do all this.
Gymnastics for the neck
Gymnastics should be performed regularly. Spend just 3-5 minutes a day and you will almost 100% protect yourself from headaches. A bonus is the prevention of high blood pressure – both intracranial and arterial.
There are many sets of exercises for the neck; you can see in detail, with step-by-step instructions and explanations, in Dr. Shishonin’s publications on cervical osteochondrosis. You've probably already read these articles and watched the videos, so let's briefly remind you. Tilts and rotations of the head, movements of the neck should not be performed abruptly, but carefully, so that there are pleasant sensations similar to those you experience when stretching after sleep.
Triggering a reflex response
The back of the neck can be treated with a piece of ice. The temperature effect causes a reflex reaction of the vessels: they react by restoring their shape. Dr. Shishonin spoke in detail about these techniques in specialized articles on cervical osteochondrosis.
Here we just remind you that you need to work with ice carefully. Don’t be afraid, you physically won’t be able to harm yourself, but don’t overdo it, otherwise the effect will be worse than from a delicate influence.
