scholarly journals Arterial hypertension and brain damage. New targets of therapy

2014 ◽  
Vol 11 (4) ◽  
pp. 68-70
Author(s):  
S N Yanishevskiy ◽  
D A Mirnaya ◽  
R V Andreyev

Objective: to assess the feasibility of ARBs to reduce hypoperfusion of the brain that develops in patients with arterial hypertension of 1-2 degrees. Material and methods. A study of changes in the ultrasonic Doppler index (RI resistivity index and pulsatility index PI) and the structure of neurological symptoms in patients with arterial hypertension of 1-2 degrees (n=86) due to 53-week olmesartan medoxomil reception (Cardosal®). Results. Patients with arterial hypertension of 1-2 degrees have diagnosed diffuse neurological symptoms and mild cognitive impairment. Doppler ultrasound revealed an increase in peripheral resistance index in the internal carotid and middle cerebral arteries, compared with patients without hypertension. Through 53 weeks therapy of olmesartan medoxomil (Cardosal®) observed a statistically significant decrease in peripheral vascular resistance (p

2014 ◽  
Vol 59 (No. 7) ◽  
pp. 343-348 ◽  
Author(s):  
W. Brudnicki ◽  
B. Skoczylas ◽  
R. Jablonski ◽  
W. Nowicki ◽  
A. Brudnicki ◽  
...  

The brain arteries derived from 50 adult degu individuals of both sexes were injected with synthetic latex introduced with a syringe into the left ventricle of the heart under constant pressure. After fixation in 5% formalin and brain preparation, it was found that the sources of the brain’s supply of blood are vertebral arteries and the basilar artery formed as a result of their anastomosis. The basilar artery gave rise to caudal cerebellar arteries and then divided into two branches which formed the arterial circle of the brain. The internal carotid arteries in degus, except for one case, were heavily reduced and did not play an important role in the blood supply to the brain. The arterial circle of the brain in 48% of the cases was open from the rostral side. Variation was identified in the anatomy and the pattern of the arteries of the base of the brain in the degu which involved an asymmetry of the descent of caudal cerebellar arteries (6.0%), rostral cerebellar arteries (8%) as well as middle cerebral arteries (12%). In 6% of the individuals double middle cerebral arteries were found. In one out of 50 cases there was observed a reduction in the left vertebral artery and the appearance of the internal carotid artery on the same side. In that case the left part of the arterial circle of the brain was supplied with blood by an internal carotid artery, which was present only in that animal.


2015 ◽  
Vol 137 (11) ◽  
Author(s):  
Christine L. de Lancea ◽  
Tim David ◽  
Jordi Alastruey ◽  
Richard G. Brown

Blood flow through a vessel depends upon compliance and resistance. Resistance changes dynamically due to vasoconstriction and vasodilation as a result of metabolic activity, thus allowing for more or less flow to a particular area. The structure responsible for directing blood to the different areas of the brain and supplying the increase flow is the cerebral arterial circle (CAC). A series of 1D equations were utilized to model propagating flow and pressure waves from the left ventricle of the heart to the CAC. The focus of the current research was to understand the collateral capability of the circle. This was done by decreasing the peripheral resistance in each of the efferent arteries, up to 10% both unilaterally and bilaterally. The collateral patterns were then analyzed. After the initial 60 simulations, it became apparent that flow could increase beyond the scope of a 10% reduction and still be within in vivo conditions. Simulations with higher percentage decreases were performed such that the same amount of flow increase would be induced through each of the efferent arteries separately, same flow tests (SFTs), as well as those that were found to allow for the maximum flow increase through the stimulated artery, maximum flow tests (MFTs). The collateral pattern depended upon which efferent artery was stimulation and if the stimulation was unilaterally or bilaterally induced. With the same amount of flow increase through each of the efferent arteries, the MCAs (middle cerebral arteries) had the largest impact on the collateral capability of the circle, both unilaterally and bilaterally.


Author(s):  
Novikova I.N. ◽  
Popova T.F. ◽  
Gribacheva I.A. ◽  
Petrova E.V. ◽  
Marushchak A.A. ◽  
...  

Moya-Moya disease is a rare progressive chronic cer-ebrovascular disease characterized by a narrowing of the lumen of the intracranial segments of the internal carotid arteries, as well as the initial segments of the anterior and middle cerebral arteries with the devel-opment of a network of small vascular anastomoses. Violations of blood supply due to occlusion lead to the development of ischemic strokes in the correspond-ing pools, and ruptures of vascular anastomoses - to the development of hemorrhagic strokes, causing a variety of neurological disorders. The article presents a clinical case of Moya-Moya disease in a 31-year-old patient. The disease was manifested by acute disorders of cerebral circulation in ischemic and hemorrhagic types. The diagnosis was made in accordance with the diagnostic criteria of the disease based on the data of endovascular cerebral angiography.


1980 ◽  
Vol 53 (3) ◽  
pp. 300-304 ◽  
Author(s):  
Toshisuke Sakaki ◽  
Kazuhiko Kinugawa ◽  
Tatsuo Tanigake ◽  
Seiji Miyamoto ◽  
Kikuo Kyoi ◽  
...  

✓ Embolism from an aneurysm is one of the mechanisms involved in the pathogenesis of ischemic symptoms associated with intracranial aneurysms. Four cases are reported in which aneurysms of the internal carotid arteries and middle cerebral arteries were the source of emboli resulting in cerebral infarction. In the treatment of these aneurysms, it is best to clip the neck of the aneurysm with great care to avoid embolism due to extrusion of clot into the distal artery.


Author(s):  
Pietro Fiaschi ◽  
Marcello Scala ◽  
Gianluca Piatelli ◽  
Domenico Tortora ◽  
Francesca Secci ◽  
...  

Abstract Moyamoya vasculopathy is a rare chronic cerebrovascular disorder characterized by the stenosis of the terminal branches of the internal carotid arteries and the proximal tracts of anterior and middle cerebral arteries. Although surgical revascularization does not significantly change the underlying pathogenic mechanisms, it plays a pivotal role in the management of affected individuals, allowing to decrease the risk of ischemic and hemorrhagic complications. Surgical approaches may be direct (extracranial-intracranial bypass), indirect, or a combination of the two. Several indirect techniques classifiable according to the tissue (muscle, periosteum, galea, dura mater, and extracranial tissues) or vessel (artery) used as a source of blood supply are currently available. In this study, we reviewed the pertinent literature and analyzed the advantages, disadvantages, and pitfalls of the most relevant indirect revascularization techniques. We discussed the technical aspects and the therapeutical implications of each procedure, providing a current state-of-the-art overview on the limits and pitfalls of indirect revascularization in the treatment of moyamoya vasculopathy.


1991 ◽  
Vol 32 (6) ◽  
pp. 488-491 ◽  
Author(s):  
P. N. Jayakumar ◽  
B. Y. T. Arya ◽  
M. K. Vasudev

The cerebral angiograms of 8 patients with childhood moyamoya disease showed that the common findings were stenosis/occlusion of the supraclinoid internal carotid artery and the proximal segments of the anterior and middle cerebral arteries and basal moyamoya. The volume of basal moyamoya and its collateral supply depended upon the stage of the disease. Leptomeningeal collaterals were frequent in the later stages. Stenotic lesions in the posterior circulation were seen in a majority (75%) of patients. A feature unique to the study was evidence of intracranial small-vessel disease and stenotic cervical internal carotid artery in half of the cases. The disease in the ethnic caucasian Indians seems largely similar to the classical disease frequently reported in the Japanese literature.


2014 ◽  
Vol 05 (04) ◽  
pp. 417-419 ◽  
Author(s):  
Olalekan Oyinloye ◽  
Donald Nzeh ◽  
Ayodeji Yusuf ◽  
Emmanuel Sanya

ABSTRACTCannabis is the most widely used illicit drug among adolescents and young adults. Despite its widespread use, only a few reports exist on the association of cannabis use and stroke. A 26-year-old Nigerian male, developed right-sided ischemic stroke few hours after smoking three wraps of cannabis. He had smoked cannabis consistently for the past 4 years prior to the development of the stroke. Known stroke etiology and abuse of other illicit drugs were ruled out from history and investigations. Neuroimaging studies of the brain revealed infarcts in basal ganglia secondary to occlusion of blood flow in the left anterior and middle cerebral arteries. The mechanism of stroke in this patient was thought to be a cannabis-induced vasculopathy. Many cases of stroke in the young are increasingly being seen in hospitals in resource scarce countries. There seems to be a predilection for the basal ganglia in ischemic stroke following cannabis abuse. Therefore, cannabis abuse should be considered in young adults with basal ganglia infarcts, after excluding other known etiologies.


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