The aim of our study was to study leukocyte apoptosis and to establish its relationship with changes of cognitive function in patients with chronic brain ischemia (CBI) and hydrocephalus (HC). A comprehensive examination of 110 patients with CBI and HC was performed. Indicators of apoptosis, mitochondrial dysfunction, intracellular oxidative stress were studied by cytofluorimetric method. Significantly higher indicators of ANV+-, PI+-, APK+- and Mito+-cells in the presence of HC. In the group of men, the inverse correlation between the content of AnV+-cells and the result of the MoCA-test — r = –0.42; p = 0.006, in women — r = –0.51; p = 0.005. A significant relationship was found between the content of APK+- and ANV+- cells (r = 0.67, p = 0.003) and between the number of APK+- and PI+-cells (r = 0.73, p = 0.002) in patients aged 60—74. In patients with dementia progression, a moderate relationship was found between the level of cognitive functioning and the proportion of cells in the early stage (ANV+-cells) (r = –0.50; p = 0.026) and late (PI+-cells) (r = –0.30; p = 0.041) apoptosis. In the group of patients with mild and moderate cognitive deficits, correlations between the MoCA scale result and the content of ANV+-cells were recorded at the level of moderate — (r = –0.37; p = 0.040) and PI+-cells at the level of weak (r = –0.24; p = 0.049). Significantly (p < 0.05) higher content of leukocytes in the stage of apoptosis and necrosis and leukocytes with increased content of intracellular APK and with reduced mitochondrial potential compared to patients without HC was found in patients with CBI with HC. There is a significant difference between the values of indicators in middle-aged and elderly patients and indicators of patients older 74 years. The progression of neurological and cognitive deficits was accompanied by an increase of the production of ANV+-, APK+- and Mito+-cells. The highest proportion of ANV+- and PI+-cells was detected in the presence of a combination of dementia, extrapyramidal syndrome and gait apraxia in patients with CBI with HC.
The article describes a clinical case report of a young patient with ischemic stroke on the background of antiphospholipid syndrome (APLS). The uniqueness of this case lies in the complex diagnostic search that we performed. On admission, the patient had general cerebral, general infectious and focal syndromes. We suspected encephalitis due to the peculiarities of the onset of the disease and the results of computed tomography. However, after the results of lumbar puncture, the diagnosis of encephalitis required careful differential diagnosis. We performed an extensive diagnostic search. Based on clinical-laboratory, instrumental and immunological data the patient had the following final diagnosis: “Ischemic cardioembolic stroke in the right middle cerebral artery pool (15.10.17) (ICD 11: 8B11.5). Acute period with left pyramidal reflex insufficiency and changes in magnetic resonance imaging. Systemic lupus erythematous (ICD 11: 4A40.0), subacute course, activity II, with the lesion of skin (transient erythematous rash), kidneys (proteinuria, transient impaired renal function), lungs (bilateral pleurisy with immunological disorders). Secondary APLS (ICD 11: 4A45) (Acute iliofemoral thrombosis, May 2017; chronic thrombosis of the inferior vena cava, iliac veins, positive IgG to cardiolipin, beta 2 glycoproteins). Thus, we have to link thrombotic complications in young patients with APLS and to examine the patients for antiphospholipid antibody presence.
Neuromyelitis optica (Devic’s disease) is a demyelinating disease of central nervous system. This disease is progressive and might be fatal. The authors have analyzed data of domestic and foreign literature on research issue. The idea of modern laboratory and instrumental survey methods was summarized, because clinical manifestation of the disease may be non-specific and differential searching might be extremely wide. The modern schemes of treatment of described syndrome are represented. As an illustration we used own clinical observation confirmed by the results of neuroimaging. The practical orientation of the represented scientific report is proved. Key words neuromiyelitis optica, differential diagnosis, antibodies to aquaporin-4, demyelinating diseases
Background. Literature sources report conflicting results regarding the severity of clinical symptoms of hydrocephalus (HC) and their association with cerebral arterial blood flow (CABF); most studies do not show a direct relationship, while some suggest a link between clinical severity and progressive decrease in CABF. The study of hemodynamic changes in the brain of patients with chronic brain ischemia (CBI), elucidation of their relationship with cognitive impairments helps to improve diagnostic approaches and optimize the prognosis of the disease. The purpose of this study is to investigate the state of cerebral hemodynamics and to establish its relationship with changes in cognitive functions in patients with CBI and HC. Materials and Methods. A comprehensive examination of 110 patients with CBI and HC was performed. The localization of the HC and results of Montreal Cognitive Test (MoCA scale) were taken into account. Computed tomography of the brain was performed with subsequent determination of morphometric parameters and indices. The state of cerebral blood flow and structural changes of blood vessels were studied using transcranial colorcoded duplex ultrasonography (TCCS) of intracranial vessels and extracranial divisions. Microsoft Excel 2011 and Statistica were used for statistical processing of the results. Results. It was found that there was a significantly larger diameter of both common carotid arteries (CCA), thickness of complex intima\media (CIM), maximum systolic velocity (Vs), velocity at the end of the diastolic cycle (Vd), as well as peripheral resistance (IR) in left CCA (p <0,05) in patients with CBI and HC compared with patients with CBI without HC. Significantly larger diameter of left internal carotid artery (ICA), Vs, Vd and IR was revealed; Vs and Vd in the right ICA; Vd in the extracranial devision of vertebral artery (VA) in patients with HC. A significant relationship was found between the following blood flow
Структурно-морфометричні особливості головного мозку у пацієнтів, які перенесли аневризмальний субарахноїдальний крововилив Резюме. Актуальність. Вивчення структурних змін головного мозку після перенесеного аневризмального субарахноїдального крововиливу (аСАК), з'ясування їх зв'язку з функціональним станом пацієнта, когнітивними та психоемоційними розладами сприяє удосконаленню діагностичних підходів та оптимізації прогнозування перебігу захворювання. Мета роботи: оцінити структурно-морфометричні зміни головного мозку у пацієнтів у відновному та резидуальному періодах аСАК. Матеріали та методи. Проведено комплексне обстеження 114 пацієнтів у відновному та резидуальному періодах аСАК. Враховували клініко-анатомічну форму крововиливу, дані Монреальського когнітивного тесту, значення індексу Бартел та модифікованої шкали Ренкіна, оцінку психоемоційної сфери за госпітальною шкалою тривожності і депресії. Оцінювали дані комп'ютерної томографії головного мозку з подальшим визначенням морфометричних показників та індексів.
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