The article analyzes the state of cerebral venous hemodynamics in the acute period of ischemic stroke based on the results of clinical neurological, Dopplerographic, neuroimaging and cerebrospinal fluid examination of patients with different amounts of brain matter damage. Factors for predicting the development of moderate or severe cerebral venous dyscirculation have been identified. Attention is paid to the importance of a comprehensive examination of patients with assessment of cerebral venous blood flow in the acute period of ischemic stroke.
The article analyzes results of a Doppler study of brachiocephalic vessels in the acute period of ischemic stroke. The role of the venous link of blood flow in maintaining the intracerebral constant in the acute period of ischemic stroke was revealed. The features of the reactivity of cerebral venous hemodynamics in patients with different volumes of brain damage during the formation of ischemic foci of various localization are shown. Attention is paid to the importance of a comprehensive assessment of cerebral venous circulation in the acute period of ischemic stroke. It was shown that in patients with ischemic stroke involving one or two lobes of one hemisphere of the brain, there was a significant increase in the size of the areas and a significant decrease in the speed indicators in the internal jugular and vertebral veins, respectively, the localization of the ischemic focus. It was found that in hemispheric ischemic strokes with signs of cerebral edema, cerebral blood flow disturbances were maximal and were accompanied by a paradoxical reaction of hemodynamic compensatory mechanisms, but no lateralization of dysgemia was observed according to the focus of ischemia.
Infantile hemangioma is one of the most common benign tumors of infancy. The natural evolution includes rapid growth followed by gradual involution. Airway hemangiomas are not that common, but they can lead to dyspnoea, as well as to life-threatening complications.
Two children aged 3 months were admitted to the Pediatric Department with difficulties in breathing and with biphasic stridor. They had previously been hospitalized because of the same symptoms and misdiagnosed as having an upper respiratory tract infection. The previous treatment included intravenous or inhaled corticosteroids, without any significant improvement. Laryngoscopy was performed for both of the children. There was a mass in the subglottic area with the appearance of a hemangioma causing significant airway stenosis. We started treatment with propranolol at a dose of 1 mg/kg/day twice daily. The dose was gradually increased up to 3 mg/kg/day, under close monitoring. In the first 7 to 10 days after initiation of treatment, we observed a significant improvement of the respiratory distress. The second laryngoscopy showed an almost complete involution of the mass in the subglottis.
The focus of this article will be primarily on the clinical presentation and the therapeutic response of subglottic hemangioma, along with a literature review on the subject.
The article presents the review of Russian and foreign literature, with the aim to summarize the results of the researches for the purpose of identification of the most perspective modern techniques of non‑invasive measurement of intracranial pressure. The methods of assessment of intracranial pressure based on morphological and functional features of intracranial organs are described: transcranial Doppler imaging, evaluation of tympanic membrane displacement, evaluation of blood pressure in retinal veins, evaluation of optic nerve diameter, CT imaging and magnetic resonance tomography. The attention is paid to merits and demerits of the presented methods, a possibility of their use in clinical practice.
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