DYSCIRCULATORY ENCEPHALOPATHY IN GENERAL MEDICAL PRACTICE: MODERN CONCEPTS OF DIAGNOSIS AND MANAGEMENT.
Keywords:
Dyscirculatory encephalopathy; chronic cerebral ischemia; cerebral small vessel disease; cognitive impairment; vascular dementia; leukoaraiosis; executive dysfunction; cerebral microangiopathy; neuroimaging; vascular depression.Abstract
Dyscirculatory encephalopathy (DE) is a progressive chronic cerebrovascular disorder resulting from long-term cerebral hypoperfusion and small vessel disease. It represents a major cause of cognitive decline, gait disturbances, emotional disorders, and vascular dementia in elderly patients. The present article analyzes contemporary concepts of DE pathogenesis, emphasizing the role of cerebral microangiopathy, white matter damage, and cortico-subcortical disconnection. Clinical manifestations, including executive dysfunction, vascular depression, and motor impairment, are discussed according to disease stages. Diagnostic principles are outlined with particular attention to neuropsychological screening and modern neuroimaging standards for small vessel disease. Current treatment strategies focus on vascular risk factor modification, hemodynamic stabilization, and pathogenetic therapy aimed at improving cerebral microcirculation and neuronal metabolism. Early recognition and comprehensive management in general medical practice are essential to slow progression and reduce the risk of vascular dementia.
