Predictive and preventive strategies to advance the treatments of cardiovascular and cerebrovascular diseases: the Ukrainian context.

Despite great efforts in treatments of cardiovascular diseases, the field requires innovative strategies because of high rates of morbidity, mortality and disability, indicating evident deficits in predictive vascular diagnosis and individualized treatment approaches. Talking about the vascular system, currently, physicians are not provided with integrated medical approaches to diagnose and treat vascular diseases. Only an individual global approach to the analysis of all segments in the vascular system of a patient allows finding the optimal way for vascular disease treatment.

[The current pathogenetic approach to the diagnosis of atrophic brain processes of traumatic origin and after endomicrosurgical interventions].

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.

[A new approach to the treatment of patients with circulatory encephalopathy].

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.

[The hemodynamic aspects in predicting the course of hemorrhagic stroke (based on ultrasonic dopplerographic data)].

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.

[The role of collateral cerebral blood flow in the course of atherosclerotic circulatory encephalopathy].

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.

[Brain function in patients with atherosclerotic circulatory encephalopathy].

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].

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.

[The correlation of the clinical and the computed tomographic changes in patients with atherosclerotic circulatory encephalopathy].

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.

[Chronic coronary insufficiency in the genesis of atherosclerotic circulation encephalopathy].

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].

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.