Zh Nevrol Psikhiatr
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Zh Nevrol Psikhiatr · Jan 2011
[The effect of carotid endarterectomy on cognitive disturbances in patients with atherosclerotic stenosis of carotid arteries].
Clinical and neuropsychological features of non-dementia cognitive disturbances were studied in 102 patients with atherosclerotic carotid stenosis. Cognitive disturbances were assessed after the carotid endarterectomy (CEAE). Mild cognitive impairment was found in 37 (36,3%) of patients, moderate cognitive impairment was diagnosed in 36 (35,3%)patients. ⋯ The data on the positive effect of CEAE on cognitive functions have been obtained. The positive changes were more distinct in patients with asymptomatic course of carotid stenosis. However CEAE may have a negative effect on cognitive functions in patients with moderate cognitive impairment of dysmnestic character and symptomatic carotid stenosis.
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Zh Nevrol Psikhiatr · Jan 2011
[The state of nociceptive and antinociceptive brain systems in patients with the pain form of diabetic polyneuropathy].
We studied 48 patients with the pain form of distal symmetric sensorimotor diabetic polyneuropathy (DPN) before and after polytherapy and 17 sex- and age-matched healthy people. Clinical/neurological, psychometric and neurophysiologic (recording of nociceptive flexor reflex (NFR) and exteroceptive suppression of involuntary muscle activity) methods were used. ⋯ The significant reduction of pain, increase of NFR thresholds and Pt/Rt coefficients were seen after the treatment with antidepressants (venlafaxine or pipofezine) in the combination with carbamazepine that suggests the strengthening of supraspinal and antinociceptive systems activity. Measuring of NFR parameters has a practical value for the assessment of the state of antinociceptive brain systems, intensity of pain syndrome, severity of comorbid anxiety-depression disorders and for the objectification of treatment efficacy in patients with DPN.
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Zh Nevrol Psikhiatr · Jan 2011
[Characteristics of ischemic stroke in patients with congenital anomalies of the circle of Willis].
The study included 76 patients with ischemic stroke in the carotid system (56 patients) and in the vertebrobasilar system (20 patients). The magnetic resonance angiography (MRA) revealed congenital anomalies of Willis circle in 31 patients. These anomalies were stratified as follows: back trifurcation of the internal carotid artery (ICA) (19 patients), anterior trifurcation of the ICA (4 patients), the combination of anterior trifurcation of the one of ICA and posterior trifurcation of the other ICA (4 patients), double back trifurcation of ICA (2 patients), the normal structure of the circle of Willis (45 patients). ⋯ Despite the lack of significant differences in the size of lesions in 2 groups, the foci in patients with the abnormalities of the circle of Willis were frequently localized in adjacent blood supply zones. The signs of vascular encephalopathy were seen as well. The data obtained suggest that the presence of anomalies in the circle of Willis is a risk factor, together with in the additional adversities, including iatrogenic factor, for the development of hemodynamic ischemic stroke.
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Zh Nevrol Psikhiatr · Jan 2011
[Immunological markers of severity and outcome of traumatic brain injury].
A microscopic immunological study of cerebral spinal fluid (CSF) of 100 patients with traumatic brain injury (TBI) of different severity was carried out in the 1st, 10th and 21st days after trauma. The content of antibodies to basic myelin protein (BMP) and phospholipids (PL) significantly differed from that in the control group (patients with soft tissue head injuries without TBI) and was significantly higher in patients with severe TBI. The level of antibodies to BMP in the CSF was strongly correlated with scores on the Glasgow Coma Scale in the 1st day after TBI and the degree of recovery of neurological status in the 21st day. ⋯ The correlation between antibodies to BMP and antibodies to PL was weak. The different diagnostic value of antibodies to BMP and to PL in the most acute period of TBI was found. In conclusion, content of antibodies to BMP may be used as a marker of TBI severity and outcome while the significant elevation of antibodies to PL indicates the severity of vascular complications of trauma.
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Zh Nevrol Psikhiatr · Jan 2011
Controlled Clinical Trial[Efficacy of gabapentin in the treatment of professional polyneuropathy].