Clinical and neuroimaging features of chronic cerebral ischemia in polycythemia vera

2021 ◽  
pp. 58-62
Author(s):  
G. V. Zyrina ◽  
T. A. Slyusa

The purpose of the study. To study clinical and neuroimaging features of chronic cerebral ischemia (CCI) in polycythemia vera (PV).Materials and methods. 66 patients with PV were examined – the main group (43 men, 23 women; mean age 62.0 ± 3.4 years), of which 64 (97.0%) patients were diagnosed with CCI. The comparison group consisted of 85 patients with CCI (34 men, 51 women; mean age 67.7 ± 4.6 years), who developed against the background of cerebral vascular atherosclerosis and arterial hypertension. To identify cognitive disorders, we used Mini Mental State Examination (MMSE). Insomnia was studied in accordance with the criteria of the International Classification of Sleep ICDS‑22005. The quality of sleep was determined using a questionnaire from the Federal Somnological Center. Neuroimaging (MRI of the brain) was performed on Siemens Symphony 1.5 T and GE Signa 1.5 T tomographs.Results. Subjective symptoms CCI are characterized by a greater representation of asthenic and insomniac disorders. Transient ischemic attacks in patients with PV are significantly more common than in the comparison group, their frequency depends on the duration of PV. The revealed changes in MRI of the brain in the majority of PV patients with CCI are characteristic of multiinfarction vascular encephalopathy; in the comparison group, changes that characteristic for subcortical arteriosclerotic encephalopathy were more often recorded.

2021 ◽  
Vol 27 (3) ◽  
pp. 351-364
Author(s):  
E. D. Yakovchuk ◽  
G. O. Penina

Objective. The aim of the study was to analyze cognitive functions, emotional disorders, the quality of life with the application of the International Classification of Functioning (ICF) in patients with chronic cerebrovascular diseases, dyscirculatory (vascular) encephalopathy II stage in the Komi Republic. Design and methods. In the clinics of the Komi Republic, we examined 126 people (mean age — 65,8 ± 10,1 years; women comprised 76 participants, 60,3 %, p ≤ 0,05) with dyscirculatory (vascular) encephalopathy. Complaints and anamnesis were analyzed, somatic and neurological status, cognitive functions, emotional status, and sleep were assessed. Results. Out of 126 patients, 44,5 % patients are employed (56 people). Among non-working patients with an established group of disability, 35,7 % (in 14,3 % disability 2nd degree (10 people), in 21,4 % — disability 3rd degree (15 people), p ≤ 0,05). Among the workers, 3 people (5,3%) had disability 3rd degree. Hypertension (HTN) I stage was detected in 10,6 %, HTN II stage — in 44,4 %, HTN III stage — in 45 % (p ≤ 0,05); 27,8 % had history of ischemic heart disease, 7,2 % — myocardial infarction, 19,1% — cerebrovascular accident, 8,6% — heart rhythm disturbances, 15,8 % — significant stenosis of the brachiocephalic arteries. Based on memory function assessment by ICF, none demonstrated normal results. Mild cognitive impairment was usually found, and there was no case of dementia. Dysfunction in the domain of blood pressure function was found in all patients. The dysfunction of blood vessels was found in all patients with chronic cerebral ischemia II stage. Daily activities were reduced due to the physical dysfunction. According to the total assessment of health status by the SF-36 scale, the physical and mental components of health were similarly decreased. Conclusions. The SF-36 (questionnaire for assessing the quality of life) and ICF (International Classification of Functioning, Disabilities and Health) complement each other. Cognitive scales are the basic tools for examination of patients with chronic cerebral ischemia, making diagnosis according to ICF, and treating cognitive, physical and emotional disorders in dyscirculatory (vascular) encephalopathy.


Author(s):  
Lyubov A. Cherevaschenko ◽  
L. YU. Dadova ◽  
Nikolay N. Kulikov ◽  
Anatolii T. Tereshin ◽  
Igor A. Cherevashchenko

Background. Treatment of chronic cerebral ischemia should be aimed both to the main etiological factor and to the pathogenetic mechanisms of cerebral ischemia and hypoxia. The action of ozone therapy is characterized with a multilateral positive effect on the main aspects of chronic cerebral ischemia pathogenesis, such as chronic cerebral hypoxia, impaired microcirculation, rheological disorders, and activation of lipid peroxidation. The use of iodine-bromine baths in chronic cerebral ischemia has been proved to be accompanied by an improvement in cerebral circulation, normalization of the brain bioelectric processes, an initially impaired condition of the autonomic nervous system, and an increase in the level of adaptive capabilities of the body. Aim: to develop effective pathogenetically substantiated methods for the combined use of iodine-bromine baths and ozone therapy in patients with chronic cerebral ischemia to increase the effectiveness of health resort treatment. Methods. In accordance with the tasks set in the work, 90 patients with chronic cerebral ischemia of the degree 1, who were randomized into three treatment groups, were examined and treated. Patients of the control group (n = 30) received iodine-bromine baths, patients of the comparison group (n = 30) received ozone therapy, patients of the main group (n = 30) received iodine-bromine baths and ozone therapy. Examination of patients included Doppler ultrasound, electroencephalography, rheoencephalography, сardiointervalography, lipid metabolism studies, fibrinogen content studies. Results. As a result of treatment, the improvement of clinical symptoms and the normalization of biochemical and neurophysiological parameters were noted in patients of all treatment groups. Overall efficiency (improvement and significant improvement) was 53.3% in the control group, in the comparison group it was 63.3%, and 73.3% in the main group. Conclusion. The authors proved the practicability of rehabilitative treatment of early forms of vascular diseases of the brain at the stage of sanatorium and resort rehabilitation, which is due to significant compensatory reserves and high plasticity of the structural and functional formations of the brain with preserved ability to develop nonspecific elements of the nervous tissue and restore reversibly damaged structures.


2018 ◽  
Vol 99 (2) ◽  
pp. 260-264 ◽  
Author(s):  
M A Pokachalova ◽  
M V Silyutina

The present literature review presents current views on pathophysiologic aspects of the formation and progression of cognitive disorders in chronic heart failure in elderly patients. Advanced age itself is an important predictor of the development of cardiovascular, neurodegenerative and other diseases. Involutive changes of cardiovascular system are known to potentiate the development of chronic heart failure. Heart failure in older people usually develops gradually. Formation of the cognitive deficit in heart disease is associated with chronic cerebral ischemia as well as a cascade of neurochemical processes occurring in the brain, eventually forming a vicious circle. Often the symptoms of cerebral ischemia due to reduced stroke volume occur much earlier than congestion signs in other organs and systems. Chronic cerebral ischemia that occurs due to violation of cerebral hemodynamics, is associated with both extracerebral and intracerebral causes, which in turn contributes to the development of chronic brain hypoxia and aggravation of cognitive dysfunction. Thus, the features of the development and course of disease in people of older age groups indicate that in geriatric practice existing diagnostic schemes are not always applicable. When observing patients of elderly and senile age with chronic heart failure, during the assessment of their condition and running diagnostic tests, special attention should be payed to the earliest detection of cognitive dysfunction signs in order to correct the patient's treatment and improve quality of life.


2008 ◽  
Vol 7 (5-1) ◽  
pp. 252-259
Author(s):  
N. F. Musina

Multiple sclerosis (MS) — autoimmune disease of CNS, characterized by myelin destruction and axonal damage. To study cognitive functions, the authors used the Mini-Mental State Examination (MMSE), the frontal assessment battery, the procedure developed by A.R. Luriya, neurophysiological characteristics. 71 patients were underwent magnetic resonance imaging. The aim of the study was to analyse the parameters of neuropsychological method, cognitive evoked potentials P300 and the role of brain atrophy in MS. The cognitive functions, the activity of the disease and the expression of brain atrophy are bound by the certain way.


Author(s):  
N.P. Pavliuk

One of the major problems in modern health care are cerebrovascular disease, which occupy a leading place in the structure of mortality and disability in the population. Among the many clinical features of chronic ischemia of the brain is a key manifestation of cognitive impairment that often determine the severity of condition and quality of life of the patient and his relatives. Diagnosis of cognitive impairment is very important, as the timely appointment of therapy may prevent or at least delay the development of dementia.


Author(s):  
Sravanth Kumar Ramakuri ◽  
Chinmay Chakraboirty ◽  
Anudeep Peddi ◽  
Bharat Gupta

In recent years, a vast research is concentrated towards the development of electroencephalography (EEG)-based human-computer interface in order to enhance the quality of life for medical as well as nonmedical applications. The EEG is an important measurement of brain activity and has great potential in helping in the diagnosis and treatment of mental and brain neuro-degenerative diseases and abnormalities. In this chapter, the authors discuss the classification of EEG signals as a key issue in biomedical research for identification and evaluation of the brain activity. Identification of various types of EEG signals is a complicated problem, requiring the analysis of large sets of EEG data. Representative features from a large dataset play an important role in classifying EEG signals in the field of biomedical signal processing. So, to reduce the above problem, this research uses three methods to classify through feature extraction and classification schemes.


1989 ◽  
Vol 69 (3_suppl) ◽  
pp. 1177-1178 ◽  
Author(s):  
Arthur MacNeill Horton ◽  
Stephanie Heller ◽  
Juhan Anilan ◽  
Antonio E. Puente

Modest intercorrelations between scores on the Mini-Mental State Examination and the Brain Age Quotient were obtained for 30 men in a VA medical program for alcoholic dependency. rs with age and education were small. As the two measures are reasonably different, they may be applied to advantage in studies of behavioral intervention.


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