Application of therapeutic complex with cytoflavin pills, transcranial electrostimulation and magnetic-laser therapy in patients with vertebrobasilar insufficiency

2020 ◽  
pp. 37-43
Author(s):  
Elena Klocheva ◽  
Alfred Shiman ◽  
Svetlana Shoferova ◽  
Lyudmila Shiman ◽  
Mariya Marchenkova
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
High Efficiency ◽  
Circulatory Failure ◽  
Transcranial Electrical Stimulation ◽  
Vertebrobasilar Insufficiency ◽  
Hemodynamic Parameters ◽  
Hemodynamic State ◽  
Transcranial Electrostimulation ◽  
Magnetic Laser Therapy

An examination and treatment of 120 patients with circulatory failure in the vertebral-basilar basin was carried out. We studied the hemodynamic state of arterial and venous cerebral blood flow (ultrasound, magnetic resonance angiography, phlebography). We evaluated the dynamics of subjective and objective clinical, hemodynamic parameters before treatment and against the background of the combination therapy. The high efficiency of the influence of the treatment complex with the use of cytoflavin in tablets, transcranial electrical stimulation, magnetolaser effects on the dynamics of clinical and functional indicators, and a reduction in hospital stay in patients with circulatory failure in the WB has been shown to be highly effective.

scholarly journals Quantitative cerebral blood flow using xenon-enhanced CT after decompressive craniectomy in traumatic brain injury

2018 ◽  
Vol 129 (1) ◽  
pp. 241-246 ◽  
Author(s):  
Aditya Vedantam ◽  
Claudia S. Robertson ◽  
Shankar P. Gopinath
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Injury ◽  
Clinical Outcome ◽  
Decompressive Craniectomy ◽  
Decompressive Surgery ◽  
Hemodynamic Parameters ◽  
Enhanced Ct ◽  
The Mean

OBJECTIVEFew studies have reported on changes in quantitative cerebral blood flow (CBF) after decompressive craniectomy and the impact of these measures on clinical outcome. The aim of the present study was to evaluate global and regional CBF patterns in relation to cerebral hemodynamic parameters in patients after decompressive craniectomy for traumatic brain injury (TBI).METHODSThe authors studied clinical and imaging data of patients who underwent xenon-enhanced CT (XeCT) CBF studies after decompressive craniectomy for evacuation of a mass lesion and/or to relieve intractable intracranial hypertension. Cerebral hemodynamic parameters prior to decompressive craniectomy and at the time of the XeCT CBF study were recorded. Global and regional CBF after decompressive craniectomy was measured using XeCT. Regional cortical CBF was measured under the craniectomy defect as well as for each cerebral hemisphere. Associations between CBF, cerebral hemodynamics, and early clinical outcome were assessed.RESULTSTwenty-seven patients were included in this study. The majority of patients (88.9%) had an initial Glasgow Coma Scale score ≤ 8. The median time between injury and decompressive surgery was 9 hours. Primary decompressive surgery (within 24 hours) was performed in the majority of patients (n = 18, 66.7%). Six patients had died by the time of discharge. XeCT CBF studies were performed a median of 51 hours after decompressive surgery. The mean global CBF after decompressive craniectomy was 49.9 ± 21.3 ml/100 g/min. The mean cortical CBF under the craniectomy defect was 46.0 ± 21.7 ml/100 g/min. Patients who were dead at discharge had significantly lower postcraniectomy CBF under the craniectomy defect (30.1 ± 22.9 vs 50.6 ± 19.6 ml/100 g/min; p = 0.039). These patients also had lower global CBF (36.7 ± 23.4 vs 53.7 ± 19.7 ml/100 g/min; p = 0.09), as well as lower CBF for the ipsilateral (33.3 ± 27.2 vs 51.8 ± 19.7 ml/100 g/min; p = 0.07) and contralateral (36.7 ± 19.2 vs 55.2 ± 21.9 ml/100 g/min; p = 0.08) hemispheres, but these differences were not statistically significant. The patients who died also had significantly lower cerebral perfusion pressure (52 ± 17.4 vs 75.3 ± 10.9 mm Hg; p = 0.001).CONCLUSIONSIn the presence of global hypoperfusion, regional cerebral hypoperfusion under the craniectomy defect is associated with early mortality in patients with TBI. Further study is needed to determine the value of incorporating CBF studies into clinical decision making for severe traumatic brain injury.

Abstract TP446: Independent Measures of Cerebral Blood Flow in Asymptomatic Carotid Artery Disease.

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Randolph S Marshall ◽  
MaryKay Pavol ◽  
Ken Cheung ◽  
Isabelle Strom ◽  
Kevin Slane ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Function Analysis ◽  
Flow Regulation ◽  
Critical Element ◽  
Mean Flow ◽  
Blood Flow Regulation ◽  
Hemodynamic State ◽  
Transfer Function Analysis

Background: Cerebral blood flow (CBF) regulation is a critical element in cerebrovascular pathophysiology, particularly in large vessel disease. Different methods to assess hemodynamics may represent different aspects of blood flow regulation, however, uniquely affecting outcomes and management. We examined 4 different blood-flow related measures in patients with high-grade unilateral carotid disease, assessing asymmetry between the occluded vs non-occluded side, and the correlations among the measures. Methods: Thirty-three patients (age 50-93, 19M) with unilateral 80-100% ICA occlusion but no stroke underwent: 1) quantitative resting CBF using continuous arterial spin labeling (CASL) MRI, 2) mean flow velocity (MFV) in both middle cerebral arteries (MCAs) by transcranial Doppler, 3). Vasomotor reactivity (VMR) in response to 2 minutes of 5% CO2 inhalation, and 4) Dynamic cerebral autoregulation (DCA) using continuous insonation of both MCAs for 10 minutes at depth 56mm with a standard head frame. Phase shift (PS) between spontaneous oscillations in blood pressure (measured with finger photoplethysmography) and MCA MFV at frequencies .06-.12 Hz was calculated for each hemisphere using transfer function analysis. Lower PS indicated worse autoregulation. Paired T-tests and Pearson correlations were used to look for side-to-side differences within each measure, and correlations between measures (SPSS v.22). Results: CASL CBF (p=.001), MFV (p<.001), VMR (p=.008), and DCA (p=.047) all showed significantly lower values on the occluded side. The 4 measures were independent of each other on correlation analysis, even when controlling for age and anterior circle of Willis collateral (correlation coefficients all <0.40, p-values >0.09). Conclusions: These 4 measures showed high sensitivity to the occluded carotid artery, but appear to represent independent aspects of cerebral blood flow (CASL: resting gray matter CBF; MFV: whole-hemisphere CBF; VMR: cerebrovascular reserve, and DCA: homeostatic blood flow regulation) suggesting that any given measure only partially characterizes hemodynamic state. Further investigation will use these 4 measures to predict outcomes including vascular cognitive impairment.

Relationship between hemodynamic parameters and cerebral blood flow during cardiopulmonary resuscitation

Resuscitation ◽  
2020 ◽  
Vol 153 ◽  
pp. 20-27 ◽  
Author(s):  
Guillaume Debaty ◽  
Johanna Moore ◽  
Hélène Duhem ◽  
Carolina Rojas-Salvador ◽  
Bayert Salverda ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cardiopulmonary Resuscitation ◽  
Hemodynamic Parameters

scholarly journals Cerebral Circulatory Effects of a Dopaminergic Agonist (Apomorphine) in the Dog

1982 ◽  
Vol 2 (3) ◽  
pp. 369-372 ◽  
Author(s):  
Ph. Jauzac ◽  
A. Blasco ◽  
F. Vigoni ◽  
P. Valdiguie ◽  
A. Bès
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cerebral Circulation ◽  
Statistical Significance ◽  
Hemodynamic Parameters ◽  
Local Cerebral Blood Flow ◽  
Dopaminergic Agonist ◽  
Circulatory Effects ◽  
Heterogeneous Effects ◽  
Dopaminergic Stimulation

Dopaminergic influence upon cerebral circulation was studied in 12 adult mongrel dogs, local cerebral blood flow (lCBF) being measured by the microspheres method. The intravenous injection of apomorphine (0.1 mg/kg) produced heterogeneous effects on lCBF; an increase in lCBF reaching the level of statistical significance was observed in frontal and sensory motor cortices, whereas blood flow was not significantly altered in the other regions examined. When the animals are considered individually, a widespread response was generally observed. Local cerebral blood flow increased from 16% to 85% (depending on the regions examined) in 4 animals, and tended to decrease (particularly in the caudate nucleus) in the 8 others. These opposite effects cannot be related with changes in general metabolic or hemodynamic parameters (Paco2, Pao2, pH, and arterial pressure). It is thus concluded that the effect of dopaminergic stimulation upon cerebral circulation is more complex than previously reported. These effects could only be partly mediated via vascular receptors and could be the result of modifications of the local metabolic level.

scholarly journals Regional cerebral blood flow during an attack of vertebrobasilar insufficiency.

Stroke ◽  
1988 ◽  
Vol 19 (11) ◽  
pp. 1426-1430 ◽  
Author(s):  
F Sakai ◽  
K Ishii ◽  
H Igarashi ◽  
S Suzuki ◽  
N Kitai ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Vertebrobasilar Insufficiency ◽  
Regional Cerebral Blood

Intracranial atherosclerosis: From anatomy to pathophysiology

2017 ◽  
Vol 12 (3) ◽  
pp. 236-245 ◽  
Author(s):  
Yuehua Pu ◽  
Linfang Lan ◽  
Xinyi Leng ◽  
Lawrence KS Wong ◽  
Liping Liu
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Collateral Circulation ◽  
Future Research ◽  
Fractional Flow ◽  
Cerebral Hemodynamic ◽  
Flow Reserve ◽  
Atherosclerotic Stenosis ◽  
Computational Fluid Dynamics Analysis ◽  
Hemodynamic State

Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research. Summary of review The main methods to estimate cerebral blood flow including fractional flow assessed by signal intensity ratio, computational fluid dynamics analysis or pressure wire, quantitative magnetic resonance angiography. Fractional flow as a series cerebral hemodynamic parameters may reflect the status of collateral circulation and cerebral blood flow. But the accuracy of the methods was not validated. The method to calculate fractional flow reserve in cardiovascular disease cannot duplicate in cerebrovascular disease. Fractional flow measurement by floating a pressure guidewire across the intracranial stenosis was technically feasible and safe. In the future researches, a non-invasive method should be established to identify high-risk intracranial lesions and may help in decision-making. Conclusions The relationship between stenosis and cerebral blood flow was individualized. Cerebral hemodynamic criteria should be used to screen patients to endovascular treatment, which will optimize the diagnosis and treatment strategies for patients with symptomatic intracranial artery stenosis.

scholarly journals Evaluation of Hemodynamic Change by Indocyanine Green-FLOW 800 Videoangiography Mapping: Prediction of Hyperperfusion Syndrome in Patients with Moyamoya Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xin Zhang ◽  
Wei Ni ◽  
Rui Feng ◽  
Yanjiang Li ◽  
Yu Lei ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Indocyanine Green ◽  
Moyamoya Disease ◽  
Regional Cerebral Blood Flow ◽  
Hemodynamic Parameters ◽  
Regional Cerebral Blood ◽  
Hyperperfusion Syndrome ◽  
Symptomatic Group ◽  
Flow 800

Objective. Hyperperfusion syndrome (HPS) after bypass surgery for moyamoya disease (MMD) mainly results from redistribution of blood flow, which leads to poor outcomes, while effective methods to predict HPS are still lacking. Indocyanine green (ICG) videoangiography can assess regional cerebral blood flow changes semiquantitatively with the application of FLOW 800 software. The purpose of this study was to investigate whether the intraoperative evaluation of local hemodynamic changes around anastomotic sites using FLOW 800 videoangiography mapping can predict the incidence of HPS and clinical outcomes. Methods. Of the patients who were diagnosed with MMD in our hospital between August 2018 and December 2019, who underwent superficial temporal artery-middle cerebral artery bypass surgeries, we investigated 65 hemispheres (in 62 patients) in which intraoperative ICG analysis was performed using FLOW 800 (Zeiss Meditec, Oberkochen, Germany) to evaluate the local cerebral hemodynamics before and after anastomosis. Regions of interest were set at more than 2 points on the brain surface according to the location and situation of recipient arteries in the surgical area. Peak cerebral blood volume (CBV), regional cerebral blood flow (CBF), and time to peak (TTP) were calculated from the selected points. As the data were available intraoperatively, anastomoses were performed in a suitable area. According to the occurrence of HPS, patients were divided into the asymptomatic and symptomatic groups, from which hemodynamic parameters were compared. Furthermore, ROC analysis was performed to determine the diagnostic accuracy of change rates in CBV, CBF, and TTP (i.e., ΔCBV, ΔCBF, and ΔTTP) for predicting HPS. Results. Data from the 62 patients were analyzed, and all patients were closely assessed during hospitalization after the procedures. The values of ΔCBV and ΔCBF were significantly higher in the symptomatic group (p<0.01), while ΔTTP is slightly lower in the symptomatic group with no statistical differences (p=0.72). Hemodynamic parameters including ΔCBV and ΔCBF, calculated by FLOW 800, had high sensitivity and specificity according to the ROC curve (ΔCBV: AUC=0.743, 95% CI, 0.605–0.881, p=0.002; ΔCBF: AUC=0.852, 95% CI, 0.750–0.954, p<0.01), which could be used as predictors for HPS. Conclusions. Intraoperative ICG-FLOW 800 videoangiography mapping is a safe method which can reflect hemodynamic characteristics in the surgical area for MMD, the findings of which correlate with the occurrence of HPS. Parameters including ΔCBV and ΔCBF are proven to be efficient in the prediction of HPS.

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