Clinical characteristics of transient vision disorders and arterial hypertension.
Keywords:transient visual disorders, blindness, arterial hypertension, hypoxic-ischemic encephalopathy, transient ischemic attacks
A study of 104 patients with a transient ischemic attacks (TIA) in the form of visual disorders was conducted to assess the factors that affect the development and probable localization of TIA. Neurological and ophthalmological status, structural characteristics of the brain and major arteries of the head (MAH) with the use of magnetic resonance therapy (MRT) and ultrasonic dopplerography were assessed. The age of patients ranged from 33 to 79 years (65.4 years in average). The control group consisted of 46 patients with an average age of 67.8 years without cerebral ischemic events and visual disorders. During the MRI, the presence of microstructural pathology of the brain was assessed; “leukoaraiosis” was considered; foci up to 2-3 mm that are vascular by genesis. Significant differences in the frequency of TIA occurrence in terms of gender were not detected in all age subgroups. In young patients with TIA, arterial hypertension was associated with signs of microstructural pathology (MSP) of the brain in 85.58% cases. TIA localization did not correlate with the grade of structural disorders of the MAH and the nature of retinopathy in all age groups. Frequency of TIA tended to increase (in the a. ophthalmica pool) with an increase in the grade of stenosis of the MAH and retinopathy. The control group had retinopathy of the 1st stage in 12 or 26.09%, showing a qualitative difference with the group of study. The study did not reveal any differences in the frequency of TIA (according to presentations to a medical institution) in patients of different age groups, which indicates the influence of others factors that are not related to aging, such as TIA factors. The state of the MAH and microcirculation of vessels are their markers and probable causative factors. Determination of markers for the prognosis of the development of cortical TIA or TIA in a. ophthalmica pools are still an open issue, as well as the chances of the TIA development in other areas of cerebral blood supply. Thus, according to clinical and anamnestic data, transient ischemia in the patients, who have applied to medical institutions with complaints of transient vision disorder (impairment) and who have been diagnosed with TIA is detected mainly in the a. ophthalmica blood supply pool (89 or 85.58%), more rarely (in 15 or 14.42%) in the cortical areas of visual analyzer without gender and age differences. All age groups had TIA associated with MAH structure impairment, retinopathy, MSP of the brain (in 82% of men and 67% of women), this leads to the interpretation of such TIA as non-random events preceded by systemic disorders, which are the basis for the prediction and prevention of such conditions.
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