[Clinical features of ischaemic stroke with cerebral venous insufficiency and its risk factors.]

Current research aimed to reveal clinical and neurological features of ischaemic stroke (IS) in patients suffering from cerebral venous insufficiency (CVI) combined with arterial hypertension (AH) and to identify its risk factors. Examination data of 112 patients with IS (aged 60-93 years old; mean age 72,1±2,6 years old, males - 39 (34,8%), females - 73 (65,2%), admitted at regional vascular center of St. Elizabeth City Hospital in Saint Petersburg, highlighted that cephalgic syndrome and vestibulocerebellar dysfunction occurred more frequently in stroke patients with CVI. Also CVI was more commonly diagnosed in patients with vertebrobasilar stroke. More severe disease course was registered in cardioembolic stroke, as compared to atherothrombotic stroke and patients without CVI. Following risk factors of CVI development in patients with IS and AH were detected: constitutional venous insufficiency and also chronic cerebrovascular insufficiency due to arterial hypertension, cerebral atherosclerosis and cervical dorsopathy.

[A role of the autonomic nervous system in cerebro-cardiac disorders]. / Rol' vegetativnoi nervnoi sistemy v razvitii tserebrokardial'nykh narushenii.

The authors consider anatomical/physiological characteristics and a role of different autonomic CNS regions, including insula cortex, amygdala complex, anterior cingulate cortex, ventral medial prefrontal cortex, hypothalamus and epiphysis, involved in the regulation of cardiovascular activity. The damage of these structures, e.g., due to the acute disturbance of cerebral blood circulation, led to arrhythmia, including fatal arrhythmia, in previously intact myocardium; systolic and diastolic dysfunction, ischemic changes considered in the frames of cerebro-cardial syndrome. On the cellular level, the disturbance of autonomic regulation resulted in catechol amine excitotoxicity, oxidative stress and free radical myocardium injury.

URGENT DIAGNOSTICS OF CEREBRAL VENOUS TROMBOSIS.

Investigations were carried out in 24 patients in order to evaluate information value of the data of clinical, laboratory, neuroradiological methods of research and develop the diagnostic algorithm in case of cerebral venous thrombosis (CVT). The main group consisted of 11 patients (7 male, 4 female, average age 49,1±4,3) with CVT. The comparison group included 13 patients (6 male, 7 female; average age 68,1±9,5) with ischemic stroke (IS) of moderate severity. There were revealed changes in blood and cerebrospinal fluid (CSF) as form of leukocytosis of blood and moderately increased cell count with elevated protein in CSF and blood in case of CTV. The authors noted an elevated protein in CSF and blood and leukocytosis with predominant lymphopenia in blood and neurophilic predominance in CSF within the reference range of CSF in patient with ischemic stroke. The epileptic attacks, meningeal syndromes, headaches were more often among clinical syndromes at CTV than in case of ischemic stroke. The algorithm of neuroimaging research methods and modes of MRI were determined and allowed an effective diagnostics of damages of venous sinuses, superficial and deep cerebral veins in case of urgent hospitalization of patients. It was possible to suggest the venous pathology in 7 (63,6%) cases due to SKT (without contrast) and in case of application of MR venography (2D TOFmode), there were revealed 100% of cases.

[Redistribution of fluid phases of the brain during an increase in blood osmolarity]. / Pereraspredelenie zhidkostnykh faz mozga pri uvelichenii osmoliarnosti krovi.

Intravenous injection of polyethylene glycol 400 to rats (1.5 mmole/100 g body weight) increases blood osmolarity, the total water content in the brain hemispheres exhibiting insignificant changes. Cellular dehydration is accompanied by an augmentation of the volume of extracellular fluid in the intact skull cavity. The increased blood content of the brain is pointed to be a 24% increase in the iron level in its tissues. Skull trepanation enhances the dehydrating effect of polyethylene glycol 400 but does not affect the blood content of the brain.

[Cerebral water and electrolytes during changes in the osmolarity and volume of the extracellular fluid]. / Voda i élektrolity mozga pri izmenenii osmoliarnosti i ob''ema vnekletochnoi zhidkosti.

The increase of osmolarity in the blood serum after administration of polyethylenglycol-400 (PEG) as well as the sharp increase of the renal loss of fluid under the influence of furosemide insignificantly affected the water contents in the white and grey brain substance. A slight dehydration of the grey substance occured on combination of osmotic gradient effect and the renal loss of fluid. Preservation of initial hydration of the brain within the skull on administration of PEG and furosemide is due to redistribution of the fluid phases: dehydration of cells is followed by an increase in the volume of sodium-containing tissue fluid where upon the amount of sodium and calcium in the tissue practically does not change.

[Ion excretion by the rat kidney in depressed reabsorption in proximal tubule and ascending protion of the loop of Henle]. / Vydelenie ionov pochkoi krysy pri ugnetenii reabsorbtsii v proksimal'nom kanal'tse i voskhodiashchem otdele petli Genle.

Simultaneous suppression of reabsorption in the proximal tubule with the aid of polyethylenglucole 400 (PEG) and in ascending part of Henle's loop with furosemide increased diuresis by 121 times and natri-uresis by 242 times on the average. The increase was based on changes in the tubule reabsorption and secretion. The changes of sodium and calcium excretion as well as excretion of potassium and magnesium were parallel. Excretion of sodium and calcium was lesser than the diuresis while that of magnesium and potassium exceeded it. Furosemide reduced the reabsorption of osmotically free water.