REMODELING OF CEREBRAL ARTERIES IN DYSCIRCULATORY ENCEPHALOPATHY WITH ARTERIAL HYPERTENSION AND STROKE IN PATIENTS WITH RADIATION ANAMNESIS

Abstract

Aim. To assess the specifics of brachiocephalic arteries (BCA) remodeling in patients with dyscirculatory encephalopathy (DE) with arterial hypertension (AH), and the prevalence among them of stroke according to anamnesis of ionizing radiation (IR). Material and methods. Totally, 536 Chernobyl liquidators included (main group) and 402 patients without radiation anamnesis (comparison group) with DE and AH; stroke had 109 liquidators and 50 comparisons. Duplex BCA scan was done, with velocity parameters of cerebral flow, anatomic configuration changes, intraluminal masses, vessel wall abnormalities. Then we checked the relation of BCA changes with stroke anamnesis. Results. The study of IR influence on BCA remodeling in liquidators with DE living in Altai Region, showed than even in DE of 1st grade they show systemic reaction of vascular endothelium with IMC thickening in 2 or more BCA (68,7%) with formation (in 91,1%) of atherosclerotic plaques. There is connection of DE with the development and severity of BCA remodeling markers: stenosis (19,6%) and pathological tortuosity (10,7%) of carotid arteries, combined with BCA lesion (21,9%). In the absence of radiation anamnesis the process of BCA remodeling starts only in DE of 2nd grade, is related to AH and is parallel to its progression. Conclusion. Liquidators have stroke 1,6 times more frequently than those not contacted with IR. Markers of BCA remodeling before stroke in liquidators are: thickening of IMC in 2 and more arteries (96,3%), heterogenic atheromas (100%), carotid arteries stenoses (93,5%), combination of BCA lesion (88,1%); in general population: thickening of IMC in 2 and more vessels (79,4%), plaques (100%), in lesser extent (64,0%) stenosis of carotid arteries.