[The catamnesis of patients with stenosis of the internal carotid artery who have undergone carotid endarterectomy and of unoperated patients]. / Katemnez bol'nykh so stenozom vnutrennei sonnoi arterii, podvergavshikhsia karotidnoi éndarteréktomii, i neoperirovannykh bol'nykh.

Investigation of catamnesis of 100 patients with atherosclerotic carotid artery stenosis (50 were operated and 50--non-operated) revealed, that in some cases carotid endarterectomy prevented repeated cerebrovascular disorders and had prophylactic significance. The frequency of repeated stroke in the group of non-operated patients was 3 times higher than in the group of operated patients. In operated cases no more TIAS were observed, but they persisted in non-operated cases.

[Cerebrovascular disorders in various types of the subclavian steal syndrome]. / Narusheniia mozgovogo krovoobrashcheniia pri razlichnykh variantakh podkliuchichnogo stil-sindroma.

A total of 51 patients with the subclavian steal-syndrome (SSS) were examined for the clinical picture comparatively to the angiography and ultrasound dopplerography (USDG) data. The clinical manifestations of cerebral circulatory disorders were studied not only in the isolated SSS but also in its different variants realized in association with concomitant lesions of the other branches of the aortic arch. Rarely occurring variants of the SSS were revealed; some of them were discovered for the first time. The types of collateral circulation to compensate for arm blood supply in the SSS were specified using the authors' material. The studies have confirmed that USDG is a fairly informative method of diagnosing the SSS.

[Endarterectomy in arteriosclerotic stenosis of the internal carotid artery]. / Endarteréktomiia pri ateroskleroticheskom stenoze vnutrennei sonnoi arterii.

The efficacy of carotid endarterectomy (CE) was estimated in 50 patients with stenosis of the internal carotid artery due to atherosclerosis. In addition to neurological investigations, all the patients were subjected to USDG of the head vessels, cerebral angiography and CT of the brain. Patients with the signs of cerebral circulation disorders or those who suffered ischemic brain stroke with a reversible neurological deficit were the most prospective candidates for CE. According to the cerebral angiography data, the degree of stenosis ranged from 50 to 90%. Surgical intervention was performed within different times after derangement of brain circulation, most frequently from 3 months to 1 year. The overwhelming majority of the patients suffered operations without any complications. The lethality amounted to 4% (because of acute cardiovascular failure and myocardial infarction). The total mortality and morbidity due to brain stroke were 5.9%. Indications for carotid endarterectomy in stenosis of the ICA are under consideration.

[Clinical and pathogenetic problems of a minor stroke in arteriosclerosis]. / Nekotorye voprosy kliniki i patogeneza malogo insul'ta pri ateroskleroze.

The authors have studied clinical manifestations in 47 patients with cerebral stroke in whom neurological symptomatology completely regressed within 1-21 days. The underlying disease in all patients was atherosclerosis. Impairment of the blood circulation most often involved the carotid bed. Comparison of the findings provided by angiography and computerized tomography conducted in patients with minor stroke, patients with transient impairments of the cerebral circulation, and those with stroke characterized by stable neurological deficiency revealed definite differences between the groups. Certain questions related to the pathogenesis of minor stroke in patients with atherosclerosis are discussed.

[Cerebral hemodynamics in stenoses of the internal carotid artery]. / Tserebral'naia gemodinamika pri stenozakh vnutrennei sonnoi arterii.

The cerebral hemodynamics was studied in 51 patients with varying severity of stenoses of the internal carotid artery (ICA) expressed in transient disorders of the cerebral blood flow or ischemic strokes. To study the cerebral blood flow (CBF), the authors used the 133Xe-inhalational method; in their analysis they also considered the findings of clinical, angiographic and computer-aided tomographic examinations, as well as the rheological parameters of the blood. It has been established that the main characteristics of the cerebral hemodynamics in patients with ICA stenoses are a moderate diffuse reduction of the CBF in both hemispheres of the brain without a clear-cut interhemispherical asymmetry, the absence of the dependence of the CBF on the degree of ICA stenoses, inverse correlation between the degree of the total narrowing of the lumen of all main arteries of the head and parameters of the CBF, as well as a sharper decrease in the CBF in cases where the total stenosis of the main arteries of the head exceeds 40%. The article deals with the pathogenesis of cerebral circulation impairments in ICA stenoses and the selection of the tactics of treating patients.

[Methods of angiography and cerebral blood flow determination in evaluating the status of the collateral circulation]. / Metody angiografii i opredeleniia mozgovogo krovotoka v otsenke sostoianiia kollateral'nogo krovosnabzheniia.

It is a known fact that the value of the cerebral blood flow (CBF) in the hemisphere where the internal carotid artery (ICA) is occluded may serve as a quantitative parameter of the collateral blood supply (CBS). Comparison of the findings obtained by cerebral panangiography (CPAG) versus inhalational studies of the CBF in 38 patients with occluded ICA has demonstrated that although CPAG is quite adequate for assessing the status of the collateral blood circulation routes, a more optimal method for evaluating the status of the CBS is measurement of the CBF since in at least half the cases CPAG yields inaccurate information about the CBS in patients with impaired cerebral blood circulation. The studied methods are not competitive but should be used in conjunction for obtaining the most complete information about the cerebral hemodynamics which is particularly important to consider in making decisions about the advisability of surgical intervention.

[Hemodynamic risk factors of secondary brain infarcts in patients with occlusion of the internal carotid artery]. / Gemodinamicheskie faktory riska povtornykh infarktov mozga u bol'nykh s zakuporkoi vnutrennei sonnoi arterii.

Study of the cerebral hemodynamics in 52 patients with occlusion of the internal carotid artery made it possible to ascertain the factors responsible for a bilateral decrease in the cerebral blood flow. The identification of the causes of a decreased cerebral blood supply in this pathology may contribute to timely rational treatment of patients and to reducing the risk of repeated cerebral infarction.

[Role of mitral valve prolapse in the pathogenesis of cerebral infarction]. / O roli prolapsa mitral'nogo klapana v patogeneze infakta mozga.

Two young patients with mitral valve prolapse and an ischemic disorder of the cerebral circulation were examined. The authors discuss the role of mitral valve prolapse in the pathogenesis of ischemic cerebral stroke in young patients.

[Feasibility of ultrasonic dopplerography in determination of the pathogenesis of transient cerebral circulatory disorders]. / Vozmozhnosti ul'trazvukovoi dopplerografii v opredelenii patogeneza prekhodiashchikh narushenii mozgovogo krovoobrashcheniia.

For specifying the pathogenesis of transient cerebrovascular disorders and the importance of occlusive lesions in the major cerebral vessels in this form of cerebrovascular pathology a new simple and safe method--ultrasonic dopplerography--was used in 87 patients. Subsequent cerebral angiography showed that the comparative reliability of this method in occlusions of the carotid and vertebral arteries reached 92.3%, and in their stenoses 76.6%. This makes it possible to recommend the ultrasonic dopplerography method for broad use in the conditions of both polyclinics and hospitals for examining patients with signs of transient cerebrovascular insufficiency.

[Clinical forms of epileptic seizures in ischemic circulatory disorders in the mixed blood supply zone of the anterior and middle cerebral arteries]. / Klinicheskie formy épilepticheskikh pripadkov pri ishemicheskikh rasstroistvakh krovoobrashcheniia v zone smezhnogo krovosnabzheniia perednei i srednei mozgovykh arterii.

A clinical analysis of focal epileptic attacks in 18 patients with ischemic disturbances of blood circulation in the zone of mixed blood supply by the frontal and median cerebral arteries was carried out. The epileptic attacks observed were found to be due to irritation of the frontal adversive and pre-moter fields. Focal clonic convulsions in the foot due to irritation of the brain paracentral lobule were also observed. The versatility of the clinical forms of the epileptic attacks was determined mainly by the involvement of particular cytoarchitectonic fields of the frontal lobe of the brain (8th, 6th, 4th) belonging to the zone of mixed blood supply by the frontal and median cerebral arteries and provided with blood by different cortical branches of those arteries. Clinico-angiographic and clinico-morphological comparisons showed that in most patients with focal epileptic attacks there was combined involvement of the internal carotid arteries.

[Differentiated methods of treating atherosclerotic patients at the Kislovodsk health resort at early periods after transient cerebral circulatory disorders]. / Differentsirovannye metody lecheniia na Kislovodskom kurorte bol'nykh aterosklerozom v rannie sroki posle prekhodiashchikh narushenii mozgovogo krovoobrashcheniia.

A dynamic examination of 135 patients with transient disorders of cerebral circulation (TDCC) was conducted in conditions of a sanatorium-resort treatment in Kislovodsk in early stages following the last attack (from 2-3 months). The method of a phasic examination and treatment was accomplished according to the following principle: polyclinic -- hospital -- resort -- polyclinic. Apart from the clinical dynamic examinations such methods as EEG, REG studies of blood coagulation and basic metabolism, and if necessary angio- and dopplerosonography were used. During their stay at the resort diadynamic currents werer used according to the method of a weak effect on the projection of spinal arteries, sinusoidal modulated currents on the cervical sympathetic nodes and plexus, carbon dioxide Narzan baths, and terrain cure. A significant improvement was seen in 10, improvement in 115, insignificant improvement in 9 patients. One patient showed no changes.

[Syndromology of a vascular lesion of the oral regions of the brain stem]. / K sindromologii sosudistogo porazheniia oral'nykh otdelov stvola mozga.

Nineteen patients with a history of circulatory brain disorders in the oral areas of the brain stem showed, along with known neurological syndromes, psychopathological conditions (peduncular hallucinosis, oneiroid and deliriously changed consciousness) and other more rare syndromes (hypersomnia, akinetical states with mutism and intellectual and memory impairment). Apart from describing the clinical picture of these conditions, the pathogenetical mechanisms underlying the syndromes are suggested.

[Role of arterio-arterial embolisms in the pathogenesis of cerebral circulatory disorders]. / Znachenie arterio-arterial'nykh émbolii v patogeneze narushenii mozgovogo krovoobrashcehniia.

The authors studied 52 patients with brain infarctions and transient disorders of cerebral circulation, which in the opinion of the authors developed as a result of arterio-arterial embolism. Besides, 16 post-mortem cases with arterio-arterial embolism were studied as well. On the basis of clinico-angiographical, clinico-laboratory and clinico-anatomical correlations, the authors come to the conclusion that this mechanism is frequently the main link in the pathogenesis of distrubed cerebral circulation. Embologenic materials in the development of brain infarctions are most often particles of parietal or obturating thrombi in the magistral cerebral vessels. In patients with transient disorders of cerebral circulation most likely embolism of the minor cerebral vessels by thrombocytic aggregates. The authors discuss the functional properties of thrombocytes in the pathogenesis of transient disorders of cerebral circulation and the feasibility of the use of antiaggregates for preventive purposes.

[Secondary stem syndrome following infarcts and hemorrhages into the cerebral hemispheres]. / O vtorichnom stvolovom sindrome pri infarktakh i krovoizliianiiakh v bol'shikh polushariiakh golovnogo mozga.

The authors analyse the significance of some factors for the development of a clinical, electroencephalographic and electrocardiographic picture of the secondary dysfunction of stem brain structures in patients suffering from strokes with a hemispheric localization of the focus. A great complexity and different influences of the course of stages of the secondary stem syndrome are stressed. Attention is drawn to the expedience of using repeated EEG recording in the acute phase of a stroke for diagnostic purposes.

[Emergency medical services for acute cerebral circulatory disorders]. / Skoraia meditsinskaia pomoshch' pri ostrykh narusheniiakh mozgovogo krovoobrashcheniia.

An analysis of annual reports of the station of ambulance and emergency medical aid during the past 6 years demonstrated a significant increase in the number of patients with acute cerebral circulation disorders due to reorganization of ambulance medical aid services. The authors discuss some scientific-methodological organizational problems of neurological emergency medical services, the tasks of specialized neurological teams questions of the diagnosis of brain stroke and the necessary level of eupplementary studies and treatment measures in the prehospital stage. A certain importance is allocated to a continuity of patient treatment in the hospital and perfection of the system of hospital care to patients with acute disorders of cerebral circulation.

[Autonomic paroxysms (of the stenocardia type) in vascular lesions primarily of the medio-basal portions of the temporal lobes of the brain]. / Vegetativnye paroksizmy (tipa stenokardii) pri sosudistom porazhenii preimushchestvenno medio-bazal'nykh otdelov visochnykh dolei golovnogo mozga

In patients with vascular brain pathology the authors observed cases of temporal epilepsy in the clinical picture of which prevailed (and sometimes were isolated) vegetative-vascular "stenocardia" paroxysms. Such clinical states made it possible to suggest that in this contingent there was stenocardia proper. Stenocardiac paroxysms, due to cerebral pathology, were in combination with affective, mnestic and other psychopathological and neurological symptoms, indicating to an involvement into the vascular process of cortical representations of vegetative functions in the temporal area: hippocamp, amygdalar nucleus and their connections with the diencephalo-stem structures.

[The pathogenesis of the opticopyramidal syndrome in carotid artery occlusions]. / K patogenezu optiko-piramidnogo sindroma pri okkliuzii sonnykh arterii

The paper is concerned with the results of fluorescent angiographies of the eye fundus in 24 patients with occlusions of the carotid arteries verified by angiographic methods. A comparison of clinical data, cerebral and fluorescent angiography of the eye ground revealed in the majority of the patients visual disturbances and a retardation of retinal circulation. It is assumed that the insufficiency of retinal circulation may be one of the pathogenetical mechanisms in the development of the optico-pyramidal syndrome in occulusions of the carotid artery.