RESUMO
A comparative analysis of 2 groups of patients: 97 people with vertebro-basilar insufficiency (VBI), mean age 48,14+/-10,45 years, and 54 people with the vertebrogenic syndrome of spinal artery (VSSA), mean age 41,66+/-10,98 years, were studied. All patients underwent a neurological examination with the assessment of clinical symptoms (in scores) on the scale of vertebral-basilar deficiency (Hoffenberth, 1990), ultrasonic dopplerography and transcranial dopplerography of cerebral vessels with functional loading tests (hypo- and hyperventilation, ortho- and antiorthostatics, head rotations). Differential clinical and dopplerographic characteristics of these pathological states were singled out. Psychoemotional distress, static or dynamic overloading and cervical trauma significantly dominated in the anamnesis of patients with VSSA, while the patients with VBD more frequently had vascular risk factors. In patients with VSSA, the total score on the Hoffenberth scale was 5-7 and that of objective neurological symptoms was less than 2. In patients with VBD, these scores were >8 and >2, respectively (p=0,001).The dopplerographic examination revealed signs of the combined lesion on different levels of vertebral-basilar (hemodynamically significant) and carotid (more frequently, hemodynamically nonsignificant) basins in patients with VBD. Dopplerographic signs of the hemodynamically nonsignificant lesion of spinal artery on the extracranial level were found in patients with VSSA. The isolated vertebrogenic compression does not lead to the blood flow deficiency in the vertebral-basilar basin but in the course of time, with the addition of lesions of other cerebral arteries, VSSA may transform to VBD.
Assuntos
Circulação Cerebrovascular/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Artéria Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/fisiopatologia , Adulto , Idoso , Diagnóstico Diferencial , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Síndrome , Ultrassonografia Doppler Transcraniana , Artéria Vertebral/fisiopatologia , Insuficiência Vertebrobasilar/diagnóstico , Adulto JovemRESUMO
Neurology symptoms and Doppler figures before and after cytoflavin course therapy have been studied in a group of 52 patients with chronical insufficiency of cerebral blood circulation mostly in the vertebrîbasilar vessel region. Cytoflavin infusions reliably reduced neurologic disorder symptoms, improved cerebrovascular reaction, and extended compensation possibilities of blood circulation in the vertebrobasilar region. The results of investigation proved the efficacy, safety and good tolerance of cytoflavin in patients.
Assuntos
Circulação Cerebrovascular/efeitos dos fármacos , Mononucleotídeo de Flavina/administração & dosagem , Inosina Difosfato/administração & dosagem , Niacinamida/administração & dosagem , Succinatos/administração & dosagem , Insuficiência Vertebrobasilar/tratamento farmacológico , Encéfalo/irrigação sanguínea , Combinação de Medicamentos , Feminino , Mononucleotídeo de Flavina/efeitos adversos , Humanos , Inosina Difosfato/efeitos adversos , Masculino , Pessoa de Meia-Idade , Niacinamida/efeitos adversos , Succinatos/efeitos adversos , Ultrassonografia , Insuficiência Vertebrobasilar/diagnóstico por imagem , Insuficiência Vertebrobasilar/fisiopatologiaRESUMO
Short-term and long-term outcomes of basal brain activity were estimated in 20 epileptic patients with a medical history of callosotomy. Patients with malignant courses selected for callosotomy retained the high capacity of cerebral electric activity after surgery. In spite of limitations of bilateral synchronized irradiation of electric discharges in the brain, patients had the high power of cerebral electric genesis. A clinical study revealed the decrease of the number of seizures and their severity in patients who underwent the surgery. Thus, callosotomy plays only a palliative role in epileptic processes. Of primary importance is individual selection of anti-epileptic drugs to support cell mechanisms of epilepsy and improvement of treatment outcomes.