[The current pathogenetic approach to the diagnosis of atrophic brain processes of traumatic origin and after endomicrosurgical interventions]. / Suchasnyi patohenetychnyi pidkhid do diahnostyky atrofichnykh protsesiv holovnoho mozku travmatychnoho henezu ta pislia endomikrokhirurhichnykh vtruchan'.

Results have been analyzed of examination of 35 male patients aged 18-15 years. Of these, 25 presented with sequelae of closed craniocerebral injury (vegetovascular disorders presenting with rare epileptiform fits), 10 subjects--after having had their hematomas removed by endomicrosurgical techniques. All patients underwent computerized tomography of the brain and ultrasonic dopplerography of brain vessels. Shown in the paper is a high informative value of the above-named techniques in studying pathogenesis of intracranial hypertension, judging about the condition of brain tissue, liquor-containing and venous systems of the brain.

[A new approach to the treatment of patients with circulatory encephalopathy]. / Novyi pidkhid do likuvannia khvorykh na dystsyrkuliatornu entsefalopatiiu.

Effects were studied of vincamin and tanakan in 68 patients with stage I, II and III discirculatory encephalopathy (as per WHO classification 1981). In 52% of the patients atherosclerosis of brain vessels was associated with arterial hypertension (group I), in 48 per cent venous discirculatory encephalopathy was diagnosable against the background of arterial hypertension (group IIA-20%) and arterial hypotension (group IIB-26%). Both tanakan and vincamin were found to be effective in group I patients; however, in stage III condition their effectiveness was no better than 42 and 15% respectively, which fact might be due to organic changes in the vascular wall. Tanakan appeared to be more beneficial in group II patients since venous dystonia is considered to be the main pathogenetic link in this context, and tanakan is known to improve the venous outflow from the cranial cavity. Almost in one-third of group IIB patients vincamin worsened general health status, especially so in stage III discirculatory encephalopathy, which fact may be related to peculiar effect of the drug on the arterial link of brain blood supply.

[The hemodynamic aspects in predicting the course of hemorrhagic stroke (based on ultrasonic dopplerographic data)]. / Hemodynamichni aspekty u prohnozuvanni perebihu hemorahichnoho insul'tu (za danymi ul'trazvukovoï doplerohrafii.

A comparative analysis was performed of clinical-neurological-hemodynamic-structural changes in the acute phase of hemorrhagic insult (HI) in 56 patients who ranged from 19 to 59 years old. Intracerebral hematomas (ICH) appeared to be more commonly seen. Main emphasis was put on potentialities of Doppler Sonography (DS) in hemodynamic assessment of cerebral bloodflow condition in patients with hemorrhagic insult. Parenchymal hemorrhage was found out to play the greatest pathogenetic part in the time course of cerebral decompensation in HI, with subarachnoidal hemorrhage making a lesser contribution. ICH leads to compression of brain tissue, whereas extravasal compression of cerebral arteries imitates secondary ischemia of the artery vascularization area. Spasm that occurs in these circumstances enhances the above abnormalities. Comparatively rapid regression of neurologic and above symptomatology was noted to occur in those HI patients demonstrating the following DS criteria: 1) location of moderate acceleration of cerebral venous outflow in the projection of ICH or straight brain sinus; 2) absence of cerebral artery compression and preservation of adequate blood-flow in the arteries of the base of the brain.

[The role of collateral cerebral blood flow in the course of atherosclerotic circulatory encephalopathy]. / Rol' kolateral'noho krovotoku holovnoho mozku v perebihu aterosklerotychnoï dystsyrkuliatornoï entsefalopatiï.

The paper is concerned with a study into compensatory capabilities of cerebral hemodynamics in patients with atherosclerotic dyscirculatory encephalopathy in constricting lesions of major arteries of the head. A detailed analysis is provided of hemodynamic mechanisms of the natural collateral's work, viz., via anterior communicating artery and conditions for creation of suprablock anastomosis with the internal carotid artery being occluded. The paper also addresses the advantages and disadvantages of compensatory collaterals in the course of the medical condition in question.

[Brain function in patients with atherosclerotic circulatory encephalopathy]. / Funktsional'nyi stan holovnoho mozku u khvorykh na aterosklerotychnu dystsyrkuliatornu entsefalopatiiu.

Based on the analysis of findings from clinical and paraclinical investigations (ultrasonic vascular diagnosis, electroencephalography, computerized tomography, angiography) in 244 patients with atherosclerotic dyscirculatory encephalopathy, functional status was studied as were structural alterations in the brain tissue in stenosing lesions of precerebral arteries. The first clinical manifestations of atherosclerotic dyscirculatory encephalopathy in the presence of damage to the vestibular-basilar system were found to be dysfunction of column structures of vestibular apparatus, reticular formation and posterior longitudinal fascicle, and, in the presence of damage to the carotid area, -- dysfunction of cortex of frontal, parietal and temporal lobes of the brain.

[The clinico-instrumental characteristics of the lesions of the precerebral arteries in patients with atherosclerotic circulatory encephalopathy]. / Kliniko-instrumental'na kharakterystyka urazhennia pretserebral'nykh arterii u khvorykh na aterosklerotychnu dystsyrkuliatornu entsefalopatiu.

Results have been analysed of comprehensive evaluation of 175 patients with discirculatory encephalopathy of atherosclerotic genesis, consisting of inspection of the neck vessels projection, study of neurological status, ultrasonic investigation of the major brain arteries structure and hemodynamics, their angiographic features. At stage I discirculatory encephalopathy subjective complaints predominated, being caused by syndrome of thoracic outlet, steal syndrome, stenosing lesions of brachiocephalic arteries. Encountered more frequently in the middle-aged and elderly patients were affections of several major brain arteries. Specific weight of correlation between ultrasonic investigation and angiography in stenosing lesions of brachiocephalic arteries in patients with discirculatory encephalopathy constituted 84-100%. Therefore patients with discirculatory encephalopathy of atherosclerotic genesis require ultrasonic investigation of brachiocephalic arteries with the purpose of finding out exactly the pathological process and choosing the tactics of treatment.

[The correlation of the clinical and the computed tomographic changes in patients with atherosclerotic circulatory encephalopathy]. / Koreliatsiia klinichnykh ta komp'iuterno-tomohrafichnykh zmin u khvorykh na ateroslerotychnu dystsyrkuliatornu entsefalopatiiu.

Correlation has been carried out between hemodynamic, structural and clinical changes in stenotic lesions of major brain arteries in 175 patients with atherosclerotic dyscirculatory encephalopathy. The paper analyses the results of ultrasonic and radioopaque diagnosis of vascular lesions of the head and neck, those of clinical, neurological observations and data from computerized tomography scans of the brain. Topographic connections have been established between hemodynamic, structural and neurological manifestations of the disease. It was not infrequently that moderately severe hydrocephaly as one of the manifestations of atrophy of the brain in these patients outstripped brain infarction. Vascular aspect is considered of paresthesias in the extremities by monotype in lesions of major arteries of one of the extremities.

[Chronic coronary insufficiency in the genesis of atherosclerotic circulation encephalopathy]. / Znachennia khronichnoi koronarnoi nedostatnosti v henezi aterosklerotychnoi dystsyrkuliatornoi entsefalopatii.

The interconnection between coronary insufficiency and cerebral discirculation in the genesis of discirculatory encephalopathy has been established. Almost in every fifth patient with discirculatory encephalopathy, or ischemic heart disease, combined damage to the coronary arteries and brachiocephalic trunk was diagnosed.

[Role of deficient cerebral circulation in selecting the treatment methods for patients with circulatory encephalopathy]. / Rol defitsytu tserebralnoihemodynamiky u vybori taktyky likuvannia khvorykh na dystsyrkuliatornu entsefalopatiiu.

The results of studying the pathophysiologic mechanisms of the impairement in cerebral circulation in 244 patients with atherosclerotic discirculatory encephalopathy with the use of the ultrasound and radiopaque investigation, electroencephalography and computed tomography of the brain are presented. The prevalent role of vascular damage of the brachiocephalic trunk in the genesis of the different stages of atherosclerotic discirculatory encephalopathy is noted. The influence of arterio-venous cerebral hemodynamics on the development and progressing of discirculatory encephalopathy was established. The topographic correlations of the basin of the arteries affected and neurologic and morphologic signs of discirculatory encephalopathy were revealed.