The value of atherosclerotic stenizing lesions of the brachiocephalous arteries in the formation of cognitive impairment

Author:

Khasanova D.R., Zhitkova Yu.V., Gasparyan A.A.

Place of publication:

NEUROLOGY. NEUROPSYCHIATRY. Psychosomatics, 2015

The influence of the nature of the atherosclerotic stenizing lesion on the clinical picture of cognitive impairment (KN) has not been sufficiently studied.

The purpose of the study is to assess the effect of the degree and localization of the atherosclerotic stenosis process on cerebral perfusion and the state of cognitive functions.

Patients and methods. 123 patients were examined (65 men and 58 women) aged 50 to 75 years old, having stenoses of brachiocephalous arteries at least 40%, without arterial hypertension, diabetes mellitus or other systemic vascular pathology. The structural state of the substance of the brain and the state of cerebral blood flow were evaluated using magnetic resonance imaging and magnetic resonance angiography. To determine the changes in the white matter, the P. Scheltens scale et al. The localization and degree of the stenosis process was evaluated by extracronal and transcranial duplex scanning by the method of extracranial and transcranial. Prince was determined using a set of neuropsychological scales. The Hamilton depression was also used.

Ascension and discussion. Most of the brachiocephalous arteries examined against the background of atherosclerosis revealed varying severity of the Prince. The most severe KNs were associated with the defeat of the parietal and frontal lobes. A reliable deterioration of cognitive functions was observed as the percentage of stenosis increases: with stenosis in the carotid system, more severe KNs were observed than with stenosis in the vertebral basin. In addition, in patients with combined stenosis and tandem stenosis, more pronounced KN were noted compared to patients with stenosis of the same artery. It is shown that cerebral atherosclerosis is one of the main risk factors for the development of Prince. The influence of not only degrees is noted, but also to a greater extent localization of stenosis on the occurrence of KN, accompanied by the development of perfusion deficiency in specific vascular pools. Determining the nature of the stenosis process will allow to predict the development of KN in patients with atherosclerosis and choose the appropriate treatment tactics.

Key words: atherosclerosis; stenosis of brachiocephalous arteries; Cognitive disorders.