Preview

Cardiovascular Therapy and Prevention

Advanced search

Clinical assessment of the complex instrumental examination in cerebrovascular disease patients

Abstract

Aim. To compare clinical manifestations of cerebrovascular disease (CerVD) with the results of modern instrumental examination methods, using the semi-quantitative approach. Material and methods. In total, 40 CerVD patients with ischemic stroke in anamnesis or discirculatory encephalopathy were examined. All participants underwent duplex scanning (DS) of neck and head vessels, magnetic resonance angiography (MRA) of cerebral vessels and positron emission tomography (PET) of the brain. The observed disturbances were coded as “mild” (+), “moderate” (++), or “severe” (+++). Results. Clinical manifestations of CerVD correlated with PET-diagnosed cerebral perfusion disturbances. In 50 % of the cases, cerebral atherosclerosis in CerVD patients was characterised by combined pathology of carotid and vertebro-basilar arteries (CA, VBA), while isolated VBA pathology was relatively rare (10 %). The first-affected segments were extracranial vessels (35 %) or extracranial and intracranial vessels (27 %). A strong correlation between clinical CerVD symptoms and morphological vascular changes at DS and MRA was observed in 45 %. Conclusion. Among CerVD patients, complex instrumental examination could help in assessment of the disease severity, prognosis and therapy choice.

About the Author

B. M. Lipovetsky
Human Brain Institute, Russian Academy of Sciences. St. Petersburg
Russian Federation


References

1. А. В. Покровский Что должен делать невролог, чтобы спасти часть больных от ишемического инсульта? Ж неврол психиат 2004; 11: Приложение “Инсульт”: стр. 4—6.

2. Ostergaard L, Johannsen P , Host-Poulsen P, et al. Cerebral blood flow measurements by magnetic resonance imaging bolus tracking: comparison with (15-O) water positron emission tomography in humans. J Cereb Blood Flow Metab 1998; 18: 935—40.

3. Fujita H, Meyer E, Reutens D, et al. Cerebral (15-O) water clearance in humans determined by positron emission tomography. J Cereb Blood Flow Metab 1997; 17: 73—9.

4. Б. М. Липовецкий, Г. В. Катае ва, А. Д. Коротков Сравнительная оценка регионарного мозгового кровотока у больных с перенесенным мозговым инсультом, дисциркуляторной энцефалопатией и ишемической болезнью сердца. Ж неврол психиат 2002; Приложение “Инсульт”: 27—31.

5. Derdeyn C, Videen T, Simmons N, et al. Count-based PET-method for predicting ischemic stroke in patients with symptomatic carotid arterial occlusion. Radiology 1999; 212: 499—506.

6. Grohn O, Lukkarinen J, Oja J, et al. Noninvasive detection of cerebral hypoperfusion and reversible ischemia from reductions in the magnetic resonance imaging relaxation time. J Cereb Blood Flow Metab 1998; 18: 911—20.

7. А. В. Покровский, Н. Н. Яхно, Г. Н. Кунцевич и др. Особенности внутримозговой гемодинамики при окклюзионных поражениях магистральных артерий мозга. Ж неврол психиат 1989; 9: 7—11.

8. Е. А. Широков, В. Б. Симоненко, Б. С. Виленский Профилактика ишемического инсульта и концепция гемодинамического резерва. Клин мед 1998; 3: 26—8.

9. И. В. Ганнушкина Патофизиологические механизмы нарушения мозгового кровообращения и новые направления в их профилактике и лечении. Ж неврол психиат 1996; 1: 14—8.

10. Carolei A, Totaro R, Baldassarre M. Physiopathology of cerebral circulation. Clinica Terapeutica 1996; 147: 353—8

11. Hudetz A. Blood flow in the cerebral capillary network: a review emphasizing observations with intravital microscopy. Microcirculation 1997; 4: 233—52.

12. Б. М. Липовецкий, Г. В. Катаева, А. Д. Коротков Влияние симвастатина на мозговое кровообращение. Невролог ж 2003; 3: 38—42.


Review

For citations:


Lipovetsky B.M. Clinical assessment of the complex instrumental examination in cerebrovascular disease patients. Cardiovascular Therapy and Prevention. 2010;9(3):85-89. (In Russ.)

Views: 416


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)