Cerebrovascular reactivity in carotid and vertebrobasilar circulative pools at the initial manifestations of chronic cerebral ischemia
DOI:
https://doi.org/10.15587/2313-8416.2016.60858Keywords:
cerebrovascular reactivity, initial manifestations, chronic cerebral ischemiaAbstract
Cerebrovascular pathology is one of the main causes of mortality and disability of population all over the world. It is important not only to reveal the vascular risk factors in proper time but also to define the intensity of its influence on the functional and structural integrity of cerebral vessels.
The aim of research was to study the state and to assess an importance of cerebrovascular reactivity in carotid and vertebrobasilar cerebral pools in patients with initial manifestations of the chronic cerebral ischemia (CCI) depending on the degree of brain lesion.
Materials and methods. We examined 173 persons (44 men and 129 women) of the mean age 50,0±0,46 years old with the initial manifestations of CCI. Patients were divided in two groups depending on the presence of neurovisualizative changes in brain possibly of the vascular origin and the patients of the 2 group were divided in two subgroups (A and B) according to the presence of cerebral atrophy. All patients underwent the general clinical, clinic-neurological, clinic- instrumental and clinic-laboratory examinations. For the study of cerebrovascular reactivity (CVR) in carotid and vertebrobasilar circulatory pools was carried out transcranial duplex scanning using the metabolic tension tests of the different directions.
Results and its discussion. Patients of different groups statistically significantly (р<0,001) differed on indices IR received during metabolic vasodilatatory and vasoconstrictive trials in carotid and vertebrobasilar pools. With the growth of degree of brain lesion at the initial CCI manifestations there was observed the decrease of the reactivity index as the response on metabolic stimuli within autoregulatory diapason in both circulative pools. The response on vasodilatatory tests was less on the force of reaction than the response on vasoconstrictive stimuli. In vertebral arteries (V4) the reaction on metabolic stimuli of different directions (hypercapnia, hypocapnia) was essentially less intensive than in the medial cerebral artery.
Conclusion. The CVR indices in patients with initial CCI manifestations have clinicоdiagnostic importance even within autoregulatory diapason because with approximation of reactivity indices to the one or another limits of diapason we can make suppositions about the degree of tension of the compensatory mechanisms oriented on the support of homeostasis of the central bloodstream in both circulative pools. It is necessary to emphasize that the reactivity of vessels of vertebrobasilar pool was more open to metabolic stimuli comparing with the carotid pool
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