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NMK at stenosis VSA and the PAS

At 3 patients from 7 right VSA, the stenosis is diagnosed for 3 patients - left, in 1 observation - both VSA. At carrying out of the computer tomography executed at 5 patients in one case it is not taped disturbances of density of a cerebral tissue.

Expansion of ventricular system is noted at the patient with a stenosis of both internal carotids, at other patient with a stenosis left VSA on KT expansion of subarachnoidal clefts is taped.

At a stenosis left VSA at one patient on OFEKT presence of the plural centres of a hypoperfusion in is temporal-basal departments, frontooccipital and parietooccipital areas of the left hemisphere, expansion of lateral ventricles is taped.

Table 9

Character of disturbances of a cerebral blood flow at patients with stenosis VSA

Character of disturbances

Cerebral circulation

Blood flow disturbances on

Left VSA (п=3)

Blood flow disturbances on right VSA (п=3) Blood flow disturbances on both VSA

(п=1)

Depression of the venous

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

2 2
Depression of the venous

Blood flow on the right

To venous collectors and the right bulbar vein

1 1 1
Blood flow depression on left SMA 1 - ■ -
Blood flow depression on left ZMA 1 3 -
Blood flow depression on right SMA - 3 -
The hypoperfusion centres in the left hemisphere of the head

Brain

1
The hypoperfusion centres in both hemispheres

Brain

3 1 1

At the second patient with a similar pathology the hypoperfusion centres in right gemisfere a cerebellum are taped; the plural centres of a hypoperfusion in basally-temporal departments of both hemispheres of a cortical locating. The plural centres of a hypoperfusion in konveksitalnyh departments of temporal and parietal areas of both hemispheres.

At a stenosis right VSA at one patient OFEKT has not taped a pathology of blood supply of a brain. At two patients the plural centres of a hypoperfusion in frontally-basally-temporal departments of both hemispheres, and at one - a radiological picture of the large centre of an ischemic genesis in axial parietal area of the left hemisphere are taped.

At a stenosis of both carotids OFEKT has taped a radiological picture of disturbance of blood supply of a cerebral tissue of cortical character in frontally-basally-temporal departments of the left hemisphere.

Vertebralnaja angiostsintigrafija (VA), spent at the patient with a stenosis right SA with absence of a pathology of blood supply of a brain according to OFEKT, diagnosed blood flow depression on left PMA, ZMA and SMA and depression of outflow of blood on venous collectors at the left on 28 %. The similar picture has been noted and at the second patient with a stenosis right VSA to which it has been spent VA.

At sinusostsintigrafii in the given observation sharp depression of a blood flow on the right venous collectors - PS and SS, and also the right internal bulbar vein is noted.

We result clinical observation:

Patient S, 56 years, has arrived in unit of neurosurgery MONIKI with complaints to periodic giddiness, a headache, unsteadiness of a gait.

An. morbi: considers itself as the patient within five years, disease has begun with easy giddiness and headaches, gradually attacks were aggravated.

An. At і ї ае:Анамнез lives without features, suffers ischemic illness of heart, an idiopathic hypertensia. 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, 84 blows 1 minute. Cardiac sounds are slightly muffled, hums are not present. A BP of 160 and 100 mm hg

The stomach at a palpation soft, painless, a liver acts from under a costal arch on 5 sm, the lien is 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.

On UZDG: a bifurcation: the WASP + VSA on the right - 40 %-50 %

ОСА+ВСА At the left - 50 %-60 %

Asymmetry of the PAS - above LSK - S, it is lowered on the right.

KT: there are no changes of density of a cerebral tissue. Are dilated

Subarachnoidal clefts.

On OFEKT the large centre of a hypoperfusion in axial parietal area of the left hemisphere is noted; the centre of corticosubcortical localisation (an index
mezhpolusharnoj assimetrii = 7 %). A radiological picture of the centre of an ischemic genesis in the left temporal area.

Vertebralnaja angiostsintigrafija: assimetrii at distribution RFP on pozvonochnym to arteries - the blood flow in the right PAS is lowered; the linear cerebral blood flow on left ZMA and SMA is thus lowered

At sinusostsintigrafii the blood flow on the right venous collectors, and also the right internal bulbar vein is sharply lowered.

Thus, NMK at stenosis VSA, i.e. direct disturbance of a blood flow in pool VSA, are comparable to those at an osteochondrosis of cervical department of a backbone.

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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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