Vol 4, No 3 (2010)

The status of cognitive functions in 129 patients after stroke with deep hemispheric lesions was investigated. In the vast majority of patients abnormalities (predominantly mild or moderate) of the auditory-speech (95%) and the visual (83%) memory were observed. Mild and moderate abnormalities of the direct auditory-speech memory were predominant (85.6%), and delayed reproduction was mostly affected in severe disturbances. Moderate-to-severe abnormalities of attention and moderate abnormalities of the dynamics of mental processes prevailed in patients with right hemispheric lesions. As the result of complex therapy, memory mprovement was observed in 65% of patients, improvement in the attention focusing in 72%, and improvement in the dynamics of mental processes in 55% of patients.

For revealing correlations between cerebral atherosclerosis and different forms of concomitant pathology, the following groups of patients were examined: arterial hypertension (n = 80), disorders of the autonomous nervous system (n = 212), endocrine pathology (n = 453), chronic liver diseases (n = 45), obesity (n = 35), syringomyelia (n = 97), cerebral atherosclerosis without comcomitant pathology (n = 51), persons with status dysraphicus (n = 35), and healthy controls (n = 50). Duplex scanning of the brachiocephal arteries was used. The initial atherosclerotic lesions were revealed in 32,7% of cases, stenosis <50% in 33,9%, and stenosis 50% in 18,2%. We found significant reverse relationships between age at onset of cerebral atherosclerosis and arterial hypertension (ρ = –0.73), obesity (ρ = –0.70), syringomyelia (ρ = – 0.90), status dysraphicus (ρ = –0.72), and liver disorders (ρ = –0.67). Correlations were revealed between atheroma evolution rate and presence of endocrine pathology (hormone levels in hypothyreosis), combination of cataract and diabetes, severity of arterial hypertension, combination of arterial hypertension and obstructive sleep apnea, severity of status dysraphicus and trophic disturbances in syringomyelia. In patients with anatomic disconnection of the Willis circle, blood flow deficiency at the extracranial stenosis level occurred in the case of 40–50% stenosis, while in patients with normal collateral flows it occurred only in the case of 60–70% stenosis.

Neurophysiological characteristics of chronic headaches in patients with arterial hypertension were studied using brainstem auditory evoked potentials, visual evoked potentials and blink reflex. In patients with arterial hypertension suffering from chronic headaches, signs of brainstem dysfunction were revealed, which was accompanied by impairments of ascending afferent input and dysfunction of upper structures (thalamus and cortex), including impairment of functioning of the antinociceptive system of supraspinal level. These abnormalities result in the formation of a specific clinical pattern in the studied group of patients.