Grigoreva E.V.,Sklifosovsky Scientific Research Institute of Emergency Care |
Lukyanchikov V.A.,Sklifosovsky Scientific Research Institute of Emergency Care |
Tokarev A.S.,Sklifosovsky Scientific Research Institute of Emergency Care |
Krylov V.V.,Sklifosovsky Scientific Research Institute of Emergency Care
Zhurnal Nevrologii i Psihiatrii imeni S.S. Korsakova | Year: 2014
Objective. To evaluate the influence of the EICMA on the circulation of the brain in patients with unilateral occlusion of the internal carotid artery (ICA) in the late postoperative period using CT perfusion. Material and methods. Ten patients with unilateral internal carotid artery occlusion and stenosis of the opposite ICA 50—60%, with a history of a single ischemic stroke were examined. All patients underwent pre-and postoperative CT angiography of the brachiocephalic and intracranial arteries and CT perfusion. We also compared the results of neurological examinations preoperatively and during the year after the intervention. Results. The neurological data during the first year after surgery demonstrated an improvement of neurological status and quality of life in all patients. Preoperative CT perfusion showed the patchy decrease in the cerebral blood flow (CBF) to 18 ml/100 g/min (average of 44—56 ml/100 g/min) and increase in the mean transit time (MTT) to 7.2 s (normally less 6c) in all cases on the side of occlusion. The most susceptible to chronic ischemic changes was the frontal region, temporal and parietooccipital regions were affected to a lesser extent. Due to stenosis of the opposite ICA, minimum CBF of the cortex in the opposite hemisphere was 24 ml/100 g/min and MTT was increased to 5.6 s. Six months after the applying of EICMA, the significant improvement of CT perfusion was noted on the side of the anastomosis in all patients: an increase in CBF (at least 44 ml/100 g/min) and MTT reduction (up to 6.1s in the frontal region), as well as the «synchronization» of CBF and CBV in similar areas of the cerebral cortex of the right and left hemisphere. Conclusion. CT perfusion in the late postoperative period after applying EICMA in patients with unilateral ICA occlusion demonstrates not only changes of the cerebral perfusion on the side of the occlusion, but also the increased collateral blood flow of the cortex in both hemispheres, which significantly improves brain blood flow generally within 6—12 months after surgery. © 2014, Media Sphera. All rights reserved.
Khubutiya V.Sh.,Sklifosovsky Scientific Research Institute of Emergency Care |
Luzhnikov E.A.,Sklifosovsky Scientific Research Institute of Emergency Care |
Tadzhiev I.Ya.,Sklifosovsky Scientific Research Institute of Emergency Care |
Kabanova S.A.,Sklifosovsky Scientific Research Institute of Emergency Care |
Goldfarb Yu.S.,Sklifosovsky Scientific Research Institute of Emergency Care
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk | Year: 2013
In the formation and development of the national specialized toxicological service the important role was played by legislative initiatives, distinguished with continuity and improvement of the quality of care in acute poisoning, principles of interaction of units of service. Since the beginning of the organization of specialized toxicological service in the country, without taking into account the regional regulations, there were published over thirty ones, impact and significance of which can be very positively evaluated by formed a unique and authoritative national school of clinical toxicology, with its wealth of organizational, methodological and diagnostic and treatment practices, valuable scientific and human resources.