Cerebrovascular disease is characterized by damage to the blood vessels of the brain, as a result of which the supply of oxygen to brain cells is disrupted, oxygen starvation begins, and brain functions are disrupted.
The disease is treated in neurological clinics and centers, including the neurology clinic of the Yusupov Hospital. How cerebrovascular disease begins and what it is, a neurologist will tell you in more detail at a consultation.
Treatment
Treatment of the disease is carried out using complex therapy, which includes the following groups of drugs:
- antisclerotic drugs;
- antihypertensive drugs;
- hypoglycemic drugs;
- metabolism;
- antihypoxants;
- antioxidants;
- antispasmodics;
- anticoagulants;
- nootropics;
- vasodilators.
In advanced cases, the disease is severe, and drug treatment does not show high effectiveness. In this case, the neurologist decides to perform surgical treatment. During the operation, the surgeon removes blood clots and atherosclerotic plaques in the vessels that narrow the lumen of the vessel. Stenting, endarterectomy, balloon angioplasty, and extra-intracranial anastomosis can be performed. Such surgical interventions are performed in case of vascular obstruction, severe narrowing of the vessel, to remove atherosclerotic plaques and restore vascular patency.
Functional meaning of codes
Disease codes are used in hospital records not only for practical purposes to simplify filling out the form - they have important functional significance:
- Maintain medical confidentiality;
- They standardize the work of the organization’s accounting department, which calculates the amount of insurance payment based on the disease code;
- They allow you to reach an international level of work - even if the treatment was carried out abroad, the ICD diagnosis code is the same in all WHO member countries.
The coding system made it possible to optimize the collection and analysis of statistical information. It is especially necessary to identify the acceptable threshold of morbidity during epidemics, as well as to determine the mortality rate from a specific disease.
Symptoms and treatment, causes of development
Cerebrovascular disease (CVD) in the early stages of development is characterized by sleep disturbance in the patient (insomnia, sudden awakening in the middle of the night and inability to fall asleep after waking up), fatigue, low performance, memory loss, fussiness, absent-mindedness, and impaired thinking. The patient's condition worsens as the disease progresses. Severe headaches, dizziness, tinnitus, numbness and weakness in the limbs, impaired vision and hearing appear, the patient suffers from depression, and dementia may develop. All these symptoms indicate a cerebrovascular accident.
The causes of the disease are various factors:
- stroke – often causes the development of cerebrovascular disease;
- cerebral atherosclerosis is the most common cause of CVD development;
- chronic stress;
- smoking;
- alcoholism;
- excess weight;
- diabetes;
- pathology of the structure of blood vessels;
- diseases of the circulatory system;
- hypertension;
- tumors;
- infectious diseases;
- antiphospholipid syndrome;
- injury.
Treatment of CVD depends on the cause of the disorder and the severity of the disease. In some cases, surgery becomes the main treatment method.
The cause of the development of cerebrovascular disease is inflammatory processes in the vessels of the brain, affecting arteries and veins. The most common cause of the disease is cerebral atherosclerosis. Treatment of the disease begins with the elimination of increased risk factors:
- diabetes;
- cerebral atherosclerosis;
- arterial hypertension;
- elevated blood cholesterol.
Drug therapy and diet help restore the elasticity of blood vessels, improve blood circulation in the brain, and reduce the risk of developing cerebrovascular disease.
Line “Other” (code 31, 36)
It contains additional information in encrypted form. Here are some of them.
Code 31 means that a person needs long-term treatment, and although he was given a certificate of incapacity for work, he continues to be ill. In this case, he submits the primary sheet to the accounting department and receives benefits for the first part of the illness. In this document, the “Get Started” field is not filled in. And in the “Other” field there is code 31, which stands for “continues to hurt.”
Code 36 indicates the following situation. The employee, while on sick leave, missed his next doctor's appointment. And when he showed up (later than the appointed date), he was recognized as able to work. The ballot fields are filled in as follows:
- “Notes on violation of the regime” - worth 24 and the date of the missed appointment;
- “Exemption from work” - the period from the onset of illness to the date of the missed appointment is indicated;
- “Other” - costs 36;
- “Get Started” remains blank.
ATTENTION. The benefit for the ballot, in which code 36 is indicated in the “Other” field, is calculated as follows. From the onset of illness to the date preceding the absence - based on actual average earnings. For a day of failure to appear - in an amount not exceeding for a full calendar month the minimum wage established for the current year and multiplied by the regional coefficient (if any).
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Intracranial hypertension
Cerebrovascular disease is considered a collective term that covers various diseases that lead to impaired cerebral circulation. Such diseases can occur in both acute and chronic forms and belong to the class of cerebrovascular disorders. Intracranial hypertension is characterized by abnormally high intracranial pressure. Chronic intracranial hypertension most often refers to the idiopathic form of the disease; the cause of the development of the disorder remains unclear. Intracranial hypertension is common, often in people with neurological diseases.
Intracranial hypertension leads to impaired cerebral circulation and provokes the formation of secondary cerebral ischemia. Cerebrovascular diseases become the cause that leads to the development of intracranial hypertension. Increased intracranial pressure can lead to coma, sensory disturbances, speech disorders and other severe disorders. Intracranial hypertension is a severe complication of brain diseases.
Structure[edit | edit code]
The paper edition of ICD-10 consists of three volumes:
- Volume 1 contains the main classification, and also contains the section “Morphology of Neoplasms”, special lists for summary statistical developments, definitions and nomenclature rules;
- volume 2 contains instructions for use for users of the ICD;
- Volume 3 is an alphabetical index to the classification.
The structure of ICD-10 is based on the classification proposed by William Farr. His scheme was that, for all practical and epidemiological purposes, disease statistics should be grouped in a certain way:
- epidemic diseases;
- constitutional or general diseases;
- local diseases grouped by anatomical location;
- developmental diseases;
- injuries.
Classes I-XVII refer to diseases and other pathological conditions, class XIX - to injuries, poisoning and some other consequences of exposure to external factors. The remaining classes cover a range of concepts related to diagnostic data.
Heading blocks[edit | edit code]
Classes are divided into homogeneous “blocks” of three-digit headings. For example, in class I, the names of the blocks reflect the two axes of classification - transmission routes and a broad group of pathogenic microorganisms.
In Class II, the first axis is the nature of the neoplasms by location, although several three-digit rubrics are intended for important morphological types of neoplasms (eg, leukemia, lymphoma, melanoma, mesothelioma, Kaposi's sarcoma). The range of headings is given in parentheses after each block title.
Three-character headings[edit | edit code]
Within each block, some of the three-character categories are intended for only one disease, selected for its frequency, severity, and responsiveness to health services, while other three-character categories are for groups of diseases with some common characteristics. The block usually contains categories for “other” conditions, making it possible to classify a large number of different but rarely encountered conditions, as well as “unspecified” conditions.
Four-character subcategories[edit | edit code]
Most three-character categories are subdivided by the fourth digit after the decimal point, so that up to 10 additional subcategories can be used. If a three-character category is not subdivided, it is recommended to use the letter “X” to fill the fourth character space so that the codes have a standard size for statistical processing of data.
Four-character subcategories are used in any suitable way, defining, for example, different localizations or varieties of one disease.
The fourth character, .8, is usually used to indicate “other” conditions related to the three-character category, and the character, .9, is most often used to express the same concept as the name of the three-character category without adding any additional information.
Unused "U" codes[edit | edit code]
Codes U00-U49 should be used to temporarily indicate new diseases of unknown etiology. Codes U50 through U99 may be used for research purposes, such as testing an alternative subclassification for a special project. Codes U00 - U89 are used for special purposes and constitute the XXII class of diseases.
Encephalopathy
Discirculatory encephalopathy is characterized by diffuse or focal damage to the blood vessels of the brain. The disease leads to impairment of memory, thinking, attention; a serious complication of the disease is the development of dementia - dementia. The course of the disease is accompanied by various symptoms:
- impairment of motor activity;
- cerebellar dysfunction;
- affective disorders;
- sharp fluctuations in blood pressure;
- dizziness;
- disorders of chewing and swallowing food, other pseudobulbar disorders;
- at a late stage of the disease, patients experience fecal and urinary incontinence.
The cause of the disease is cerebral atherosclerosis, hypertension, various disorders leading to damage to the vascular system, blood diseases and other causes.
Links[edit | edit code]
- who.int/classifications/icd/en/ - official ICD-10 website on the World Health Organization (WHO) website (English)
- ICD-10. Volume 1. Part 1 (Russian) on the WHO website
- ICD-10. Volume 1. Part 2 (Russian) on the WHO website
- ICD-10. Volume 2 (Collection of instructions) (Russian) on the WHO website
- ICD-10. Volume 3. Part 1 (Russian) on the WHO website
- ICD-10. Volume 3. Part 2 (Russian) on the WHO website
- Class V ICD-10 (Mental disorders and behavioral disorders) (Russian) on the website of the Russian Society of Psychiatrists
- ICD-10 - online version (WHO) (English)
- ICD-10 online training direct access (WHO) (English)
- ICD-10-CM ICD-10-CM - Clinical Modification (American version) (English)
Statistics
Strokes, which are the cause of the development of CVD, lead to the death of a huge number of people every year; 40% of stroke survivors die or become disabled. Timely contact with a neurologist when symptoms of trouble appear, a healthy lifestyle, and a balanced diet reduce the risk of developing cerebrovascular disease.
The neurological clinic of the Yusupov Hospital provides care to people with cerebrovascular diseases. In the hospital you can undergo treatment for cerebrovascular disease and rehabilitation after illness. Doctors pay great attention to the prevention of the development of vascular diseases of the brain; the hospital has developed programs to restore the functions of a patient’s brain after a severe stroke, and treats dementia and chronic cerebrovascular disease. During the consultation, the doctor will explain what cerebrovascular disease is in humans, how the hospital provides drug treatment for cerebrovascular disease of the brain, and surgical treatment for cerebrovascular disease. The patient's medical history will be saved on a modern medium; upon completion of treatment, the patient will receive a full description of his treatment in the clinic. You can make an appointment with a doctor by calling the Yusupov Hospital.
WHO introduced urgent changes to ICD-10 for COVID-19
The World Health Organization has made urgent changes to the 10th and 11th revisions of the International Classification of Diseases, adding codes necessary to account for patients with COVID-19 diseases.
WHO has made changes:
1. In the section “Viral infection of unspecified localization (B34)” (class “Some infectious and parasitic diseases (A00-B99)”, subclass “Other viral diseases (B25-B34)” a clarification has been added that for the nosology “Coronavirus infection of unspecified localization "(code B34.2) the following values are excluded: "COVID-19, virus identified (U07.1)" and "COVID-19, virus not identified (U07.2)"
2. The subclass “Temporary designations for new diagnoses of unknown etiology or for use in emergency situations (U00-U49)” (class “Codes for special purposes (U00-U85)”) has been amended:
a) In the section “Severe acute respiratory syndrome (SARS) (U04)” a clarification has been added that for the nosology “Severe acute respiratory syndrome unspecified” (code U04.9) the following values have been excluded: “COVID-19, virus identified (U07.1) " and "COVID-19, virus not identified (U07.2)."
b) In the section “Use in emergency situations (U07)” new values have been added:
i. “COVID-19, virus identified” (code U07.1). Clarification: Use this code when COVID-19 has been confirmed by laboratory testing, regardless of the severity of clinical signs or symptoms. If necessary, indicate pneumonia or other manifestations of infection, use an additional code. Excluded: coronavirus infection, unspecified (B34.2), coronavirus as a cause of diseases classified elsewhere (B97.2), severe acute respiratory syndrome (SARS), unspecified (U04.9).
ii. “COVID-19, virus not identified” (code U07.2). Clarification: Use this code if COVID-19 is diagnosed clinically or epidemiologically but laboratory testing is inconclusive or unavailable. If necessary, indicate pneumonia or other manifestations of infection, use an additional code. Excluded: coronavirus infection, unspecified (B34.2), COVID-19: confirmed by laboratory tests (U07.1), special screening examination (Z11.5), suspected but excluded by negative laboratory results (Z03.8).
WHO has further clarified that codes U00-U49 should only be used for temporary coding of new diseases of uncertain etiology. To code COVID-19, the revised U07 category specification must be used. Developers of electronic systems need to ensure that this category and subcategories are available so that they can be used immediately as directed by WHO.
The Ministry of Health of Russia, in its letter No. 13-2/I/2-4335 dated April 8, 2020, signed by Deputy Minister Evgeny Kamkin, brought this information to regional health care institutions, federal health care institutions, FMBA, Federal Tax Service and Rosstat.
The disease code is incorrectly indicated on the sick leave certificate, what should I do?
According to the rules for preparing this type of medical document, corrections of errors when filling out are possible only on the part of the employer. This means that if the doctor incorrectly indicated the disease code in the document, and this error was discovered, you must contact the doctor to reissue the form . If the attending physician refuses to do this, you must contact the head physician. The old sheet must be returned to the doctor, so it is important to save it and provide it to the clinic. An incorrectly completed form on the part of the doctor is written off according to the rules of document flow.
Additional designations
Auxiliary three-digit codes are not often indicated on sick leave. They provide additional information that affects the calculation of temporary disability benefits. There are five such designations:
- 017 – indicated for sanatorium treatment;
- 018 – sanatorium and preventive treatment in connection with injury at work;
- 019 – inpatient treatment in research institutes or clinics;
- 020 – paid maternity leave;
- 021 - indicates if the diagnosis or injury was provoked by intoxication with alcohol or drugs.
If such information is not required, then the line “add. code" simply remains blank. The sick leave form has a column “other”, where important information is also indicated:
- Code 31 - indicated when the illness continues to close the old one and open a new one;
- 32 – means assignment of a disability group;
- 33 – change of disability group;
- 34 – death of the patient;
- 35 – indicated when refusing a medical examination;
- 36 – the patient is recognized as able to work (if the employee fails to appear, absenteeism will be considered);
- 37 – sent for home treatment after hospitalization.
Legislation defining the procedure for coding the cause of death
The Statistical Classifier SK 12.009-2016 “Causes of Death” currently in force in our republic was approved by Resolution of the National Statistical Committee of the Republic of Belarus No. 196 of December 23, 2021. This document was published in the public domain on the National Legal Internet Portal of the Republic of Belarus. Separate letters from the Ministry of Health explain the specifics of coding causes of death in ambiguous cases. For statistical accounting, the initial cause of death is necessary, that is, the disease or injury that led to a series of pathological processes that ended in death. It is equally important to accurately record the circumstances of the accident or act of violence that resulted in the fatal injury. This approach is based on the fact that to prevent death, it is most effective to act on the original cause. Thus, by providing the necessary assistance in a timely manner, it is possible to interrupt the chain of painful processes leading to death.
Rules for filling out sick leave
For sick leave, by order of the Ministry of Health and Social Development No. 624n, rules for filling out have been developed, failure to comply with which entails the invalidity of the document. Data is entered in Russian in large block letters in black ink or printed in machine text. You cannot go beyond the boundaries of the cells. Letters and numbers must be legible so that electronic scanning can recognize them.
Corrections by medical staff are not allowed; in case of an error, you will have to use a new sick leave form. If the cause of disability suddenly changes, the corresponding “changed code” column is filled in.
Classification according to ICD
Disability codes are placed on the sick leave to indicate the cause and nature of the disease, which affect the amount of payment. To fill out sick leave, they use the national code of the cause of disability with a two-digit or three-digit designation, as well as the international diagnosis system ICD 10. This is the latest version of the classification of diseases, which includes 21 sections. Each section is divided into general blocks of diagnoses. ICD codes are alphanumeric, such as B99 or V01.
National disease codes are divided into basic and additional. The main group includes 15 two-digit numbers that indicate a general characteristic of the disease without specifics.
What do the letters and numbers mean in the form 106у-10
Based on the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10), the Statistical Classifier SK 12.009-2016 “Causes of Death” was developed and legally approved in Belarus. It contains twenty classes of causes of mortality, designated by Roman numerals. All reasons are numbered in order. Within each class, individual diseases (causes of death) are provided with designations corresponding to ICD-10. They begin with a Latin letter followed by numbers.
Codes on the death certificate
For example, in class X “Respiratory diseases”, influenza is listed under number 164 and is designated by code J10, J11. In class XX “External causes of death”, an accident with a pedestrian injured as a result of a collision with a vehicle on a public road is numbered 308 and designated by code V03, V04.
When preparing for a funeral, it is important to have accurate information about what documents will be needed for the funeral.
Documents for burial and funeral
