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NMK at an osteochondrosis of cervical department of a backbone

The osteochondrosis of cervical department of a backbone (uncomplicated VBN or a disk hernia), on our data, was accompanied by disturbances of a cerebral circulation in the majority of observations.

Thus on vertebralnoj angiostsintigrafii blood flow disturbances on left pozvonochnoj arteries at 9 (47,4 %) patients, on right - at 3 (15,8 %) patients, on both pozvonochnym to arteries - at 7 (36,8 %) are taped. In total in two observations it is not taped blood flow disturbances on the PAS at an osteochondrosis of cervical department of a backbone. Character of disturbances of a cerebral circulation at patients with an osteochondrosis of cervical department of a backbone is specified in table 4.

Character of disturbances of a cerebral circulation at patients with

Table 4.

Osteochondrosis of cervical department of a backbone.

Character of disturbances

Cerebral circulation

Blood flow disturbances on

The left PAS (п=9)

Blood flow disturbances on the right PAS (п=3) Blood flow disturbances on both PASES

(п=6)

Depression of the venous

Blood flow on the left venous collectors and the left bulbar vein

9

(Depression on 10

45 %)

- -
Depression of the venous

Blood flow on the right venous collectors and the right bulbar vein

- 3 -
Blood flow depression on left SMA 5
Blood flow depression on left ZMA 5
Blood flow depression on right SMA 3
Blood flow depression on

Blood flow depression on right ZMA 3
The hypoperfusion centres in the left hemisphere of the head

Brain

2 - -
The hypoperfusion centres in both hemispheres

Brain

3 3 -
The hypoperfusion centres in a cerebellum tissue 2 3

At all patients with a blood flow pathology on left pozvonochnoj arteries by data VA sinusostsintigrafii are noted disturbances of a venous blood flow of a brain, in particular depression of venous outflow on the left venous

To collectors.

NMK at a pathology of the left PAS (п=9)

?

?

?

?

Blood flow depression on left SMA blood flow depression on left ZMA the hypoperfusion centres in the left hemisphere the hypoperfusion centres in both hemispheres the hypoperfusion centres in a cerebellum tissue

Fig.

of 9 Disturbances of a cerebral circulation at a pathology left pozvonochnoj arteries at patients with an osteochondrosis of cervical department

Depression degree made from JUdo 45 %. Blood flow disturbances on cerebral arteries are diagnosed for 5 patients from 9, at the same patients, according to OFEKT, the hypoperfusion centres in cortical areas of hemispheres of a brain are noted. In three observations both hemispheres have been amazed, in 2 - disturbances MK only in the left hemisphere are noted. Even in two observations the hypoperfusion centres in a cerebellum tissue are noted.

NMK at a pathology of the right PAS (п=3)

3 3

Venous distsirkuljatsija blood flow depression on right SMA blood flow depression on right ZMA the hypoperfusion centres in the right hemisphere the hypoperfusion centres in both hemispheres

?

?

?

Fig. of 10 Disturbances of a cerebral circulation at a pathology right pozvonochnoj arteries at patients with an osteochondrosis of cervical department

At blood flow depression on the right PAS of disturbance of a cerebral circulation are more expressed. In all observations the hypoperfusion centres (according to OFEKT) in is temporal-occipital areas of both hemispheres of a brain, in two observations - the hypoperfusion centres in a cerebellum tissue are taped. At VA and sinusostsintigrafii blood flow depression on SMA and ZMA, and also depression of outflow of blood on the right venous collectors and the right bulbar vein was defined.

At both pathological changes pozvonochnyh arteries the radiological picture was more homogeneous. In all observations, by data VA, blood flow depression on SMA and ZMA (in 2 observations-with of two parties, in 4 became perceptible

-On the right). Sinusostsintigrafija in all cases taped depression and assimmetriju a blood flow on venous collectors. According to OFEKT in all 7 cases the hypoperfusion centres in a cortex of both hemispheres of a brain are noted, in 3 observations there were hypoperfusion centres in a cerebellum.

Fig. of 11 Disturbances of a cerebral circulation at a pathology both pozvonochnyh arteries at patients with an osteochondrosis of cervical department

We result clinical observation:

Patient P, 43 years, has arrived in unit of neurosurgery MONIKI with complaints to a headache, unsteadiness of the gait, a little compelled position of a head, irritability, tearfulness.

An. morbi: the patient approximately within eight years considers itself, disease has begun with headaches, other specified semiology has gradually joined. It was treated at the therapist and the neurologist concerning a migraine, treatment unsuccessfully. Earlier it was not surveyed.

Ap. At і ї ае:Анамнез lives without features, from the transferred diseases notes children's infections, a pneumonia. The allergological anamnesis is not burdened.

Status presens: the General condition satisfactory. A constitution correct, integuments and visible mucous pure, usual colouring. Peripheric lymphonoduses are not enlarged.

In lungs breath vesicular, rhonchuses are not present. Pulse rhythmical, 82 blows 1 minute. Cardiac sounds are slightly muffled, hums are not present. A BP of 130 and 80 mm hg

Stomach at a palpation soft, painless, the liver and a lien are not enlarged.

Physiological departures without features, kidneys are not palpated, the symptom Pasternatsky is negative from both parties.

Status neurologicus: the Patient in consciousness, is contact, in a place and time is focused correctly.

Pupils D=S, are located on the centre. Movements of eyeballs in full. At research of functions of craniocerebral nerves of a pathology it is not taped. Movements of extremities in full, force of arms is identical. Suhozhilnye reflexes on arms D=S, live. Suhozhilnye reflexes standing D=S, live.

Pathological reflexes do not cause. Koordinantnye assays carries out well.

At a X-ray inspection the osteochondrosis of cervical department of a backbone with the most expressed changes in district CIY-CY1 On UZDG signs vertebrobaziljarnoj failures is taped it is not revealed.

On OFEKT (rice 12):

Radiological picture of the centre of an ischemia in bazalno - temporal departments of the right hemisphere against the taped reserves of collateral blood supply in the form of the hyperperfusion centres.

On a series from 9 tomograms with step of 14 mm in an axial plane and at secondary reconstruction in saggitalnoj and face-to-face planes the hypoperfusion centre in basally-temporal departments of the right hemisphere (korkovoyopodkorkovogo locatings) is taped. The small centres of a hypoperfusion in parietal areas of both hemispheres (more than the left hemisphere). On this background are noted plural ochazhki hypoperfusions in a cerebellum tissue, it is temporal - zatylochnnyh departments of both hemispheres. Expansion of ventricular system not

The conclusion: the Radiological picture of the centre of an ischemia in basally - temporal departments of the right hemisphere against the taped reserves of collateral blood supply in the form of the hyperperfusion centres.

At sinusostsintigrafii presence expressed assimetrii on distribution RFP on venous collectors is taped - the blood flow on left PS and SS, and also on the left internal bulbar vein is lowered.

Fig. 13 Sinusostsintigrafija patients of the Item

Blood flow depression on left PS and SS, and also on the left internal bulbar vein.

Thus, at an osteochondrosis of cervical department of the backbone, clinically not burdened vertebrobaziljarnoj insufficiency, in most cases observes disturbances of a cerebral circulation. The last are authentically more expressed at blood flow disturbances in pool of the right PAS or both pozvonochnyh arteries.

4.2.

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A source: TSATHLANOVA DIVIDING IVANOVNA. RADIAL DIAGNOSTICS of DISTURBANCES of the CEREBRAL CIRCULATION AT the PATHOLOGY of CERVICAL DEPARTMENT of the BACKBONE. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. Moscow - 2005. 2005

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  4. CHAPTER 4. DISTURBANCES of the CEREBRAL CIRCULATION AT the PATHOLOGY of CERVICAL DEPARTMENT of the BACKBONE.
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