Cerebral amyloid angiopathy (CAA) is a specific variant of cerebral small vessel disease, associated with high risk of spontaneous intracerebral bleedings, cognitive disorders and hemorrhagic complications of antithrombotic and thrombolytic therapy. One of key markers of CAA is a relatively rare neurovisual phenomenon – cortical superficial siderosis (CSS). Two clinical cases of CAA with CSS are described in the present paper. In the first case, typical CAA complication were observed: intracerebral bleeding and cognitive disorders. In the second case, CAA was symptom-free. Analysis of clinical cases and literature data shows phenotypic heterogeneity of CAA and confirms advisability of routine use of paramagnetic conditions of MRT to examine patients with cerebrovascular disease.
Introduction: The majority of patients with severe COVID-19 suffer from delirium as the main sign of encephalopathy associated with this viral infection. The aim of this study was to identify early markers of the development of this condition. Materials: The prospective cohort-based study included patients with community-acquired pneumonia and confirmed pulmonary tissue infiltration based on CT data, with a lesion consisting of at least 25% of one lung. The main group included patients who have developed acute encephalopathy (10 patients, 3 (30%) women; average age, 47.9 ± 7.3 years). The control group included patients who at discharge did not have acute encephalopathy (20 patients, 11 (55%) women; average age, 51.0 ± 10.5 years). The study collected clinical examination data, comprehensive laboratory data, neurophysiological data, pulse oximetry and CT data to identify the predictors of acute encephalopathy (study ClinicalTrials.gov identifier NCT04405544). Results: Data analysis showed a significant relationship between encephalopathy with the degree of lung tissue damage, arterial hypertension, and type 2 diabetes mellitus, as well as with D-dimer, LDH, and lymphopenia. Conclusions: The development of encephalopathy is secondary to the severity of the patient’s condition since a more severe course of the coronavirus infection leads to hypoxic brain damage.
К числу перспективных подходов к определению реабилитационного потенциала пациентов, перенесших ишемический инсульт (ИИ), относится оценка микроструктурной целостности вещества мозга методом диффузионно-тензорной магнитно-резонансной томографии (МРТ; Diffusion Tensor Imaging, DTI), основным показателем которой служит фракционная анизотропия (ФА). Роль интактного полушария в процессе реабилитации после ИИ остается предметом споров. Гипотеза исследования заключается в том, что создание диффузионно-перфузионной модели (ДПМ), основанной на оценке ФА в комплексе с данными о скорости мозгового кровотока (СМК) и влиянии очага, позволит прогнозировать неврологический статус пациентов к концу острого периода ИИ. Цель исследования-изучение роли диффузионно-перфузионных характеристик интактного полушария в определении реабилитационного потенциала в остром периоде ИИ и построение прогностической ДПМ.
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