Brain disorders: functional and structural changes in damaged brain and logic for restore it

Дисертація Лущик У.Б. на здобуття наукового ступеня доктора медичних наук за спеціальністю 14.01.15 (нервові хвороби) на тему: Особливості змін артеріального та венозного кровозабезпечення головного мозку в діагностиці та лікуванні цереброваскулярних захворювань у осіб різного віку.

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.

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.

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.

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.