Vol 8, No 1 (2014)

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Full Issue

Original articles

Risk factors for cerebrovascular disease according to the screening of middle-aged population of Ulyanovsk

Mashin V.V., Belova L.A., Saprygina L.V., Kravchenko M.A., Varakin Y.Y., Gnedovskaya E.V., Suslina Z.A.


The planning and assessment of therapeutic and preventive measures aimed at decreasing the burden of cardiovascular diseases (CVD) are impossible without reliable information concerning basic epidemiologic characteristics and risk factors (RF) for these disorders. This study aimed at investigating the prevalence of risk factors for CVD among people aged 40–59 years old. As a part of a general population screening 157 males and 343 females underwent standardized examination. Data obtained from the study suggest the following prevalence of RF: positive family history of cardiovascular diseases – 17%, hypertension – 47%, ischemic heart disease – 9%, diabetes – 3.4%, atrial fibrillation – 1.8%, transient ischemic attacks – 1.4%, hypertensive cerebral crisis – 5.6%. Behavioural risk factors, such as smoking, alcohol abuse and low physical activity, were also assessed. Differences in frequency of risk factors detection depending on sex, age and education have been furthermore demonstrated. These data substantiate the necessity of improving the effectiveness of preventive measures among people aged 40–59 years old, and might be used for planning and assessment of the therapeutic and preventive care.

Annals of Clinical and Experimental Neurology. 2014;8(1):4-9
pages 4-9 views

Cerebral perfusion changes in patients with carotid artery stenosis after surgical revascularization

Sergeeva A.N., Konovalov R.N., Sergeev D.V., Suslin A.S., Skrylev S.I., Krotenkova M.V., Piradov M.A.


Assessment of cerebral perfusion and collateral circulation in patients with carotid stenosis might have prognostic value for effective blood flow restoration after carotid revascularization. To evaluate the changes of cerebral perfusion we studied 41 patients with moderate and severe carotid stenosis before and after surgical or endovascular treatment. Perfusion CT at the level of basal ganglia was performed in 17 patients with moderate (50–69%) and 24 patients with severe (70–99%) carotid stenosis for 3 times: before intervention (transluminal angioplasty with stenting or carotid endarterectomy), 3 to 7 days and 1 to 3 months after treatment. Additionally, single CT perfusion study was done in 39 patients without carotid stenosis (control group). We found that surgical recanalization of internal carotid artery may aid restoring cerebral blood flow characteristics in the MCA area to the levels similar to those in control group (namely, decrease of MTT and CBV and increase of CBF). However, in anterior and posterior watershed zones, which are known to be the most vulnerable by chronic hypoperfusion, blood flow normalization was seen only in patients with complete circle of Willis and with moderate carotid stenosis.Thus, prognostic factors for inadequate blood flow restoration in patients with carotid artery stenosis after revascularization include severe stenosis (>70%) and incomplete circle of Willis.

Annals of Clinical and Experimental Neurology. 2014;8(1):10-16
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Neurological manifestation of vitamin В12-deficiency anemia

Zyrina G.V.


Aim of this study was to learn frequency and features of neurological signs in patients with vitamin В12-deficiency anemia. 52 patients were observed. 30 patients (57%) had clinical signs of funicular myelosis. It was manifested by sensory disorders, achille and knee reflexes changes, walking disturbances. Complete reduction of neurological signs is possible only in mild grade of funicular myelosis.

Annals of Clinical and Experimental Neurology. 2014;8(1):17-21
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Longitudinal cortex reorganization and white matter tracts structural changes analysis in relapsing-remitting multiple sclerosis patients with hand palsy

Kulikova S.N., Peresedova A.V., Krotenkova M.V., Bryukhov V.V., Trifonova O.V., Zavalishin I.A.


Motor disorders are a frequent syndrome in multiple sclerosis (MS), leading to severe disability, possibly associated with inefficiency of adaptive mechanisms, probably because of widespread structural changes. Hand palsy with fine motor skills damage influences greatly on quality of life, because hand function plays an important role in everyday activities and working practices. Thus the aim of the study was to investigate functional and structural features of hand palsy in homogenous sample of MS patients during the relapse and in three months. Data were acquired from 25 relapsing-remitting MS patients during relapse also characterized by unilateral light hand palsy, and in three months. 12 age-matched healthy controls entered the control group. All patients underwent neurologica examination, including nine-hole peg test and dynamometry, and magnetic resonance imaging of cervical spine and brain, including functional MRI and diffusion tensor imaging (DTI) sequences. All patients had lesions in spinal cord on cervical spine MRI. fMRI data analysis during relapse showed differently directed activation changes and allowed to divide all patients in two subgroups. These subgroups differed from each other and control group by deep sensitivity and DTI values. In three months patients in the first subgroup had less complete fine motor skills recovery, which was accompanied also by preservation of activation changes and deep sensitivity asymmetry in comparison with the second subgroup. Received data allow us to assume that clinically similar palsy, caused by spinal cord lesion, could be characterized by greater or lesser sensation impairment contribution. In three months heterogeneous structural and functional changes were observed, depending, possibly, on initially different pathologic mechanisms. Revealed differences should be taken into consideration while rehabilitation planning.

Annals of Clinical and Experimental Neurology. 2014;8(1):22-29
pages 22-29 views

Oxidation of blood lipoproteins in patients with cerebrovascular diseases

Fedorova T.N., Maksimova M.Y., Varakin Y.Y., Gornostaeva G.V., Logvinenko A.A., Gnedovskaya E.V., Suslina Z.A.


An comparative analysis of oxidation of low density lipoproteins/verylow density lipoproteins, and a clinical severity of acute and chronic cerebrovascular diseases was performed. To assess the intensity of lipid peroxidation we estimated several kinetic parameters of ferrous iron-induced chemiluminescence.
In this article we present the results of the clinical and biochemical assessment of 412 patients with wide spectrum of cerebrovascular diseases, such as acute stroke (n=179), chronic cerebrovascular disease (n=105), hypertensive crisis (n=60), hypertension without cerebral symptoms (n=47), and initial stages of chronic cerebrovascular insufficiency (n=21). We showed that lipid oxidation becomes evident even on the early stages of cerebrovascular diseases, and then progresses gradually following clinical severity of the disease, and the intensity of the peroxidation rises significantly in chronic and acute forms of cerebrovascular diseases.

Annals of Clinical and Experimental Neurology. 2014;8(1):30-33
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Expression of Pgp in cells of neurovascular unit in perinatal hypoxic-ischemic brain injury

Morgun A.V., Taranushenko T.E., Malinovskaya N.A., Okuneva O.S., Ustinova S.I., Karpova L.N., Salmina A.B., Pozhilenkova E.A., Laletin D.I., Frolova O.V., Reusheva N.V., Trufanova L.V.


We have studied peculiarities of P-glycoprotein (Pgp) expression on neuronal, astroglial and endothelial cells in newborn rats (P10) underwent perinatal hypoxic-ischemic brain damage. Expression of Pgp was markedly elevated in all the cells tested reaching the highest levels in astrocytes (4 hrs after injury) followed by increased levels in neuronal and endothelial cells (12 hrs after injury). The possible role of Pgp in pathogenesis of perinatal brain injury is discussed.

Annals of Clinical and Experimental Neurology. 2014;8(1):40-43
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Features of in vitro, in silico and transgenic models of Alzheimer’s disease

Kolobov V.V., Storozheva Z.I.


The review examines the current in vitro, in silico and trangenic experimental models of Alzheimer’s disease, is widely used for comprehensive studies of the pathogenesis of chronic neurodegenerative process. The experimental model should have a constructive, face and predictive validity, i.e. it must be established based on the known mechanisms of the pathogenesis of the disease and to ensure the development of symptoms characteristic of the disease, the severity of the past shall be reduced by the action of pharmacological agents already tested. Noted that transgenic models have high face and proven constructive validity.

Annals of Clinical and Experimental Neurology. 2014;8(1):34-39
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Statins and ischemic stroke prevention and treatment

Fonyakin A.V., Geraskina L.A.


In the article on the basis of the literature and results of numerous randomized placebo controlled trials current strategies of statins usage in primary and second prevention are presented. Particular attention is devoted to efficacy and perspectives of statins in acute stroke management. Summary recommendations on the statins usage in stroke prevention and medication have been stated.

Annals of Clinical and Experimental Neurology. 2014;8(1):49-55
pages 49-55 views


Principles of intracranial pressure monitoring

Krylov V.V., Petrikov S.S., Solodov A.A.


This article devoted to the diagnosis of intracranial hypertension in patients with intracranial hemorrhages. The persistent increase of intracranial pressure leads to disruption of cerebral perfusion, brain edema and ischemia. In this regard, fast correction of intracranial hypertension is one of the important tasks of intensive care patients with intracranial hemorrhages. The paper details the modern principles of measuring intracranial pressure.

Annals of Clinical and Experimental Neurology. 2014;8(1):44-48
pages 44-48 views

Clinical analysis

Clinical manifestations of internal carotid artery dissection

Kalashnikova L.A., Dobrynina L.A.


Dissection is the blood entrance from the lumen to vascular wall through the intimal tear. Dissections more often occur in internal carotid artery (ICA). The blood accumulating within the wall (intramural hematoma) may lead to: 1) the compression of the arterial lumen resulting in cerebral ischemia; 2) perivascular nerve damage causing headache, neck pain and Horner syndrome; 3) block of the ostiums of the arteries arising from ICA and supplying cranial nerves with consequent ischemia of these nerves. In this paper we present medical histories of three our patients (out of 88) with ICA dissection and different clinical manifestations. The questions of diagnosis, differential diagnosis and treatment of the ICA dissection are discussed.

Annals of Clinical and Experimental Neurology. 2014;8(1):56-60
pages 56-60 views

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