THE IMPORTANCE OF HEMODYNAMIC FACTORS IN DIFFERENT FORMS OF ATHEROSCLEROTIC LESION OF THE GREAT ARTERIES OF THE HEAD

D.N. Dzhibladze, D.Yu. Barkhatov, Yu.M. Nikitin
Research Institute of Neurology, Russian Academy of Medical Sciences,
Moscow, Russia

Altogether 107 patients with occlusive lesion of the internal carotid arteries (ICA) were examined in order to evaluate the functional hemodynamic reserve. Of these, 64 patients had unilateral occlusion of the ICA and 43 presented with atherosclerotic stenosis of the ICA off the acute stage of stroke. The examination was carried out using transcranial Doppler (TCD) in conjunction with the functional tests (orthostatic, antiorthostatic, hypercapnic, nitroglycerin) influencing different pathophysiological mechanisms of autoregulation of cerebral circulation. The patients with ICA occlusions and stenoses were found to have changes in the blood flow in the middle cerebral arteries and in the parameters of the hemodynamic reserve. The practical importance of hemodynamic reserve measurements for the treatment policy has been demonstrated with special reference to a clinical case report. TCD in combination with a complex of the functional tests is a reliable method of evaluating the function of cerebral circulation. The study of the response of cerebral vessels to the physical, chemical and pharmacological tests enables to unravel the mechanisms of autoregulation of cerebral circulation and to delineate indications for surgical treatment.

P. 36-47

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