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The article presents an analytical review of the results of domestic and foreign studies on chronic disorders of cerebral venous circulation, which is given less attention against the arterial system due to blurred manifestations, especially early, anatomical variability of the venous system, even in healthy, difficulty in diagnosis. When the balance of arterial and venous inflow is disturbed and this state exacerbates, irreversible changes evolve other structures of the cranial cavity — primarily in the brain (consistent with the concept of Monroe-Kelly). Chronic disorders of cerebral venous circulation may have different causes and varying degrees of severity. The equivalent of chronic cerebral venous insufficiency (SCVD), terminologically accepted in our country, in some countries is considered as chronic venous cerebrospinal insufficiency, which emphasizes the pathogenetic link of disorders of cerebral venous blood flow and extracranial veins, which is, in our opinion, is logical and reasonable. Recognition of chronic cerebrospinal venous insufficiency has aroused intense interest for a better understanding of the role of extracranial venous pathology and developmental options. Although the diagnosis was originally based on Doppler sonography, there are currently no diagnostic imaging methods, non-invasive or invasive, that can serve as the gold standard for detecting venous abnormalities indicative of chronic cerebrospinal venous insufficiency. The results of some studies are discussed, in particular, the hypothesis that chronic cerebrospinal venous insufficiency plays a role in the pathoge-nesis of multiple sclerosis or in many concomitant clinical manifestations. The affinity of the pathogenesis of idiopathic intracranial hypertension, Ménière’s disease, spondylotic vertebrobasilar insufficiency syndrome is analyzed. Attention is also focused on the other opinion of scientists when the increase in venous blood supply to the brain and other formations in the head cavity under certain conditions is considered as a compensatory reaction. The anatomical and physiological features of the venous system of the cranial cavity are considered, which substantiate the clinical manifestations of venous dysfunction, methods of diagnosis and treatment of pathology. Summarizing the above, chronic venous blood circulation in the cranial cavity, which is largely associated with problems of extracranial venous blood flow, not only in itself is a very characteristic syndrome complex t that adversely affects neurological functions due to cerebral hypoxia and metabolic changes, deteriorates the quality of life, but also has a negative impact on the course of the disease or has a pathogenetic link with other diseases, in particular, may be accompanied by different levels of blood pressure.
The article presents an analytical review of the results of domestic and foreign studies on chronic disorders of cerebral venous circulation, which is given less attention against the arterial system due to blurred manifestations, especially early, anatomical variability of the venous system, even in healthy, difficulty in diagnosis. When the balance of arterial and venous inflow is disturbed and this state exacerbates, irreversible changes evolve other structures of the cranial cavity — primarily in the brain (consistent with the concept of Monroe-Kelly). Chronic disorders of cerebral venous circulation may have different causes and varying degrees of severity. The equivalent of chronic cerebral venous insufficiency (SCVD), terminologically accepted in our country, in some countries is considered as chronic venous cerebrospinal insufficiency, which emphasizes the pathogenetic link of disorders of cerebral venous blood flow and extracranial veins, which is, in our opinion, is logical and reasonable. Recognition of chronic cerebrospinal venous insufficiency has aroused intense interest for a better understanding of the role of extracranial venous pathology and developmental options. Although the diagnosis was originally based on Doppler sonography, there are currently no diagnostic imaging methods, non-invasive or invasive, that can serve as the gold standard for detecting venous abnormalities indicative of chronic cerebrospinal venous insufficiency. The results of some studies are discussed, in particular, the hypothesis that chronic cerebrospinal venous insufficiency plays a role in the pathoge-nesis of multiple sclerosis or in many concomitant clinical manifestations. The affinity of the pathogenesis of idiopathic intracranial hypertension, Ménière’s disease, spondylotic vertebrobasilar insufficiency syndrome is analyzed. Attention is also focused on the other opinion of scientists when the increase in venous blood supply to the brain and other formations in the head cavity under certain conditions is considered as a compensatory reaction. The anatomical and physiological features of the venous system of the cranial cavity are considered, which substantiate the clinical manifestations of venous dysfunction, methods of diagnosis and treatment of pathology. Summarizing the above, chronic venous blood circulation in the cranial cavity, which is largely associated with problems of extracranial venous blood flow, not only in itself is a very characteristic syndrome complex t that adversely affects neurological functions due to cerebral hypoxia and metabolic changes, deteriorates the quality of life, but also has a negative impact on the course of the disease or has a pathogenetic link with other diseases, in particular, may be accompanied by different levels of blood pressure.
Aim: to investigate the features of CS DDC in patients with CCVDS in comparison with patients without clinical signs of chronic venous cerebral dysgemia, to substantiate comorbidity. Material and methods. In compliance with ethical norms, 2 groups of patients were examined: 125 patients have CCVDS and different levels of blood pressure (98 women, 27 men, average age 53.60±10.27ys), 28 similar patients, but without CCVDS (17 women and 11 men, 52.54±10.03 years old). General clinical and clinicalneurological examination, clinical assessment of the hypoglossal veins condition, MRI of the cervical spine, X-ray functional tests, MedStat programs. Results. The main group patients had a mixed headache, stiffness, limitation of movements and pain in the CS, irradiation in the upper limb aggravated by movements and forced positions; paresthesias and arm pain, which were significantly different from the control group except for tension headache. A significant difference in cerebral complaints – dizziness, transient visual and hearing impairments (<0.001). Limitation of mobility in the CS up to 30-45 degrees, tension, compaction and tenderness of the paravertebral muscles during palpation, usually asymmetric, expansion and fullness of the sublingual veins of patients in the main group were significantly different from the indicators of the control group (<0.001). According to the MRI and X-ray spondylography, the patients of the main group had structural changes in the spinal cord significantly worse than the control group (<0.001). Conclusions. Patients with CCVDS had significantly worse clinical, structural and dynamic changes in the cervical spine, which were significantly different from the indicators of patients without chronic brain venous dyshemia (<0.001). DDC of the cervical spine should be considered a significant comorbid factor of chronic cerebral venous blood flow disorders, which can be explained by anatomical and physiological dependences.
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