Vol 3, No 4 (2009)

Original articles

Diagnostic criteria for ischemic strokes of various pathogenic subtypes in patients with atherosclerosis and arterial hypertension

Bolotova T.A., Anufriev P.L.

Abstract

Results of postmortem morphological studies of 30 cases with multiple cerebral infarctions caused by atherosclerosis and arte rial hypertension (152 infarctions) were compared with the data of patients preceding clinical examination. The morphological study included determination of the localization, size, and degree of organization of all cerebral infarctions, as well as the assessment of atherosclerotic and hypertonic changes of the
heart and extra and intracerebral arteries. On retrospective ana lysis of the results of patients clinical examination, the following data were assessed: anamnesis, neurologic status, arterial pressure monitoring, CT/MRI, standard methods of clinical instrumental examination of the brain arterial system (ultrasound Doppler or duplex sonography, transcranial duplex sonography, and roentgen contrast angiography), as well as electrocardiography and echocardiography. As a result of this correlative study, pathogenic subtypes of 65 ischemic strokes and diagnostic criteria of these subtypes were determined.
Annals of Clinical and Experimental Neurology. 2009;3(4):
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Diffusion-weighted MRI and MR perfusion in an acute period of ischemic stroke

Krotenkova M.V., Suslin A.S., Tanashyan M.M., Konovalov R.N., Bryukhov V.V.

Abstract

In this study, most characteristic clinical and neuroimaging features of different subtypes of ischemic stroke (IS), such as different evolution rates during an acute period of the disease, were determined. Despite the lack of differences in the final size of the lesion, more frequent hemorrhagic transformation and the regress of ischemic penumbra in patients with cardioembolic stroke during the first week may be regarded as the evidence of
earlier recovery process in this subtype of IS. The obtained data allowed elaborating an algorithm of application of different MRI regimens for brain visualization in the context of examination and treatment of patients with acute IS.
Annals of Clinical and Experimental Neurology. 2009;3(4):
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Cerebral perfusion in the acute ischemic stroke: clinical and CT-perfusion assessment

Sergeev D.V., Krotenkova M.V., Piradov M.A.

Abstract

Assessment of cerebral perfusion in patients with acute ischemic stroke by means of perfusion CT (PCT) allows retrieving quantitative data on the cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT). Thirty patients at earliest stages (first 24 hrs) of ischemic supratentorial stroke were studied, of whom patients with moderate to severe stroke predominated (median NIHSS score of 11.5). PCT was performed on day 1, 3 and 10, and diffusion-weight ed MRI (DWI) on day 1. It was shown that cerebral ischemia in the acute stage was characterized by the decrease of CBF and CBV (10.0 ml/100g х min and 1.9 ml/100 g, respectively), and
the increase of MTT (11.3 s). CBV lesion correlates well with the DWI lesion (r=0.91), i.e. with irreversible ischemic tissue damage, and its size is smaller than the sizes of CBF and MTT lesions. This mismatch reflects the “penumbra” zone. The infarct “core” has decreased CBF and CBV, and elevated MTT, while the “penumbral” tissue has only decreased CBF and elevated MTT when compared to the normal hemisphere. The “penumbra” and the “core” differ by values of CBF and CBV, but this difference is shaded by day 3. Increase of CBV in the infarct “core” in the course of stroke indicates the restoration of blood flow. A prognostic index is elaborated which allows
predicting the transformation of ischemia into irreversible tissue damage: it is the decrease of CBV for more than 12% copared with the intact hemisphere.
Annals of Clinical and Experimental Neurology. 2009;3(4):
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Nervous system disorder in trichodesmotoxicosis

Rakhmonov R.A., Mirzoyeva S.M., Ganieva M.T.

Abstract

Trichodesmotoxicosis represents a disorder of the central nervous system that is little known to neurologists and results from toxic action of the alkaloids of the weed Trichodesma incanum. In the paper, main causes of occurrence of trichodesmotoxicosis in Tajikistan are analyzed, and biomorphological characteristics of Trichodesma incanum (ontogenesis, development, etc) are given. A detailed analysis of the spectrum of neurological disturbances, their severity and progression features in trichodesmoto-xicosis are presented. Discussed are medico;social problems of trichodesmotoxicosis in Tajikistan, risk factors for this condition and prophylactic measures.

 
Annals of Clinical and Experimental Neurology. 2009;3(4):
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Efficiency of delta-sleep inducing peptide in neurotransmitter metabolism disturbances

Dovedova E.L., Gershtein L.M.

Abstract

The effect of single delta;sleep inducing peptide (DSIP- 60 μg/kg body weight) administration on the parameters of rat brain metabolism under the conditions of chronic amphetamine (2.5 mg/kg body weight, 21 days) or Madopar-125 in a dose corresponding to 50 mg L;DOPA/kg body weight (30 days) was investigated. The neurotransmitter systems were evaluated based on the content of biogenic amines, their metabolites, and activity of neurotransmitter-catabolising enzymes: serotoninergic system was characterized by MAO A activity, serotonin (5’-OT) and 5’-hydroxyindolil acetic acid (5’-HIAA) content, and dopaminergic system by MAO B activity, dopamine (DA), noradrenalin (NA), and homovanilliс acid (HVA) content in the cortex and caudate nucleus of control and experimental rats. The changes in neurotransmitter metabolism parameters induced by DA-activating substances had certain specificity. Characteristics of the corrective effect of DSIP under the conditions of amphetamine or L;DOPA action were demonstrated depending on the type of a pharmacologic agent or brain structures. It is proposed that DSIP effect in vivo is based on the activation of serotonergic system and normalizes brain metabolism, which leads to adaptive behavior of animals. A possibility of using DSIP, by analogy with a drug Deltaran, for the treatment of depressions of various origin, cerebral ischemia, etc. is discussed.

 
Annals of Clinical and Experimental Neurology. 2009;3(4):
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Method of wavelet transform in neurology: analysis of time and frequency characteristics of typical and atypical discharges of nonconvulsive epilepsy

Gabova A.V., Kusnetsova G.D., Gnezditskii V.V., Bazyan A.S., Obukhov Y.V.

Abstract

Timefrequency dynamics and spatial characteristics of dischar ges of different types in patients with nonconvulsive epilepsy (n=23) were investigated. Modified wavelet transform was used for the analysis. In patients (n=11) with the diagnosis of childhood absence epilepsy, juvenile absence epilepsy or juveni le mioclonic epilepsy, the timefrequency dynamics of spikewa ve discharges were identical. Typical spikewave discharge arose in the frontal cortex with the short period of maximal frequency (5–6 Hz). The further frequency was 3–3.5 Hz with periodical (about 1 s) fluctuations. In another group of patients (n=12) with the diagnosis of nonconvulsive epilepsy the discharges of several types were observed, and they differed in duration, time frequency dynamics and activity localization with maximal amplitude in the cortex. Atypical discharges were different from typical ones: they had less ordered timefrequency structure and lacked the high frequency period in the frontal cortex. In some patients typical and atypical discharges, or two different forms of atypical discharges could be seen on the same EEG record. The obtained data show that the discharges’ timefrequency analysis with the help of the modified wavelet transform can be used for the classification of discharges of different types and are of value for differential diagnosis of nonconvulsive epilepsy.

 
Annals of Clinical and Experimental Neurology. 2009;3(4):
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Spinal chord sarcoidosis

Maximova M.Y.

Abstract

Sarcoidosis is a sуstemic disease from the group of granulomatoses which may run with affection of the nervous system. Clinical picture of the disease may vary and depends on a lesion location of granulomas. Cases of neurosarcoidosis with a rare location – intramedullary affection of the spinal chord – are reviewed.

 
Annals of Clinical and Experimental Neurology. 2009;3(4):
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