Cerebral Hemodynamics In Patients Research Articles

Impact of different blood pressure targets on cerebral hemodynamics in septic shock: A prospective pilot study protocol-SEPSIS-BRAIN.

Septic shock, a life-threatening condition, can result in cerebral dysfunction and heightened mortality rates. In these patients, disturbances in cerebral hemodynamics, as reflected by impairment of myogenic cerebral autoregulation (CA), metabolic regulation, expressed by critical closing pressure (CrCP) and reductions in intracranial compliance (ICC), can adversely impact septic shock outcomes. The general recommendation is to maintain a target mean arterial pressure (MAP) of 65 mmHg but the effect of different MAP targets on cerebral hemodynamics in these patients is not clear and optimal targets might be dependent on the status of CA. This protocol aims to assess the cerebral hemodynamics profile at different pressure targets in septic shock patients. Prospective, non-randomized, single-center trial, which will study cerebral hemodynamics in patients with septic shock within 48 hours of its onset. Patients will be studied at their baseline MAP and at three MAP targets (T1: 65, T2: 75, T3: 85 mmHg). Cerebral hemodynamics will be assessed by transcranial Doppler (TCD) and a skull micro-deformation sensor (B4C). Dynamic CA will be expressed by the autoregulation index (ARI), calculated by transfer function analysis, using fluctuations of MAP as input and corresponding oscillations in cerebral blood velocity (CBv). The instantaneous relationship between arterial blood pressure and CBv will be used to estimate CrCP and resistance-area product (RAP) for each cardiac cycle using the first harmonic method. The B4C will access ICC by intracranial pressure waveforms (P2/P1). The primary aim is to assess cerebral hemodynamics (ARI, CrCP, RAP, and P2/P1) at different targets of MAP in septic shock patients. Our secondary objective is to assess cerebral hemodynamics at 65mmHg (target recommended by guidelines). In addition, we will assess the correlation between markers of organ dysfunction (such as lactate levels, vasoactive drugs usage, SOFA score, and delirium) and CA. The results of this study may help to understand the effect of the recommended MAP and variations in blood pressure in patients with septic shock and impaired CA and ICC. Furthermore, the results can assist large trials in establishing new hypotheses about neurological management in this group of patients. Approval was obtained from the local Ethics Committee (28134720.1.0000.0048). It is anticipated that the results of this study will be presented at national and international conferences and will be published in peer-reviewed journals in 2024 and 2025. Trial registration number: NCT05833607. https://clinicaltrials.gov/study/NCT05833607.

Effect of Positional Changes on Cerebral Perfusion in Parkinson's Disease Patients With Orthostatic Hypotension.

Orthostatic hypotension (OH) is one of the most common autonomic dysfunctions in Parkinson's disease (PD) patients. However, many patients with OH are asymptomatic. Conversely, orthostatic dizziness (OD) is not always associated with OH. We investigated the effects of positional changes on cerebral perfusion in patients with PD and OH. We enrolled 42 patients, comprising 31 PD patients and 11 healthy controls. All the subjects underwent the following clinical assessments: the OH questionnaire, head-up tilt test (HUTT) with transcranial Doppler (TCD), near-infrared spectroscopy, measurement of the change in oxygenated hemoglobin (ΔHboxy) during the squat-to-stand test (SST), measurement of the time derivative of total hemoglobin (DHbtot), and time taken to reach the peak (peak time [PT]) of DHbtot after restanding. The mean flow velocity change (ΔMFV) in the TCD during the HUTT failed to differentiate between the PD-OH(+) and PD-OH(-) groups. The change in oxygenated hemoglobin ΔHboxy was greater in the PD-OH(+) group, which persisted for 9 min until the end of the HUTT only in the left hemisphere. During SST, PT was significantly delayed in the left hemisphere in PD-OH(+) patients. Although TCD demonstrated no significant difference in ΔMFV, the parameters measured by near-infrared spectroscopy, such as ΔHboxy during HUTT and PT during the SST, significantly increased ΔHboxy or delayed PT in the left hemisphere of PD-OH(+). Positional changes have a detrimental effect on cerebral hemodynamics in patients with PD and OH, especially in the left hemisphere.

Characteristics of cerebral hemodynamics in patients with chronic HBV- and HCV-associated hepatitis

Objective. To study the characteristics of cerebral hemodynamics in patients with chronic viral hepatitis (CVH) associated with HBV (CVHB) and HCV (CVHC) infection. Subjects and methods. The investigation involved 69 patients with CVHB and 71 patients with CVHC. The control group consisted of 50 apparently healthy individuals compared with the sex- and age-matched study group. All the patients underwent extracranial Doppler imaging of the common, internal carotid and vertebral arteries, as well as transcranial Doppler ultrasound of blood flow in the area of the M1 segment of the middle cerebral artery using a Vivid-7 (GE) ultrasound machine. Results. The patients with CVH showed remodeling of the vascular bed in the cerebral arteries: great vessel lumen expansion, decreased blood flow velocity in the carotid basin and middle cerebral artery, as well as reduced elasticity and increased stiffness of the vascular wall.

Clinical and diagnostic features of repeated mild traumatic brain injuries

Repeated mild traumatic brain injury (TBI) leads to new changes and exacerbates the existing ones caused by the primary trauma. The pathogenetic mechanisms of repeated TBI are the result of traumatic effects and their cumulation. They cause various morphological and functional changes in the brain. Objective — to improve the diagnosis of pathological changes in patients with repeated mild traumatic brain injury. Materials and methods. The study involved 199 patients with a history of repeated mild TBI. Men predominated among them — 158 (79.40 %). There were 80 (40.20 %) patients of youthful age (17—24 years), 78 (39.20 %) of young age (25—44 years), and 41 (20.60 %) of middle-aged (45—60 years). The number of repeated TBIs per patient ranged from two to five. All patients were examined in the remote period of TBI. The control group consisted of 30 people aged 18 to 50 years (mean age — (33.11 ± 3.09) years) who had no history of TBI. Cognitive impairment (CI) was assessed by neuropsychological examination using the Mini-Mental State Examination (MMSE), the Frontal Area Battery (FAB), and the clock drawing test. Methods of neuropsychological analysis, neuroimaging and neurophysiological methods were used. The data of clinical and neurological examinations and studies of cognitive functions were analyzed, structural changes of the brain and cerebrospinal tract were established on the basis of neuroimaging studies of the brain, and the peculiarities of cerebral hemodynamics in patients with mild repeated TBI were determined. The characteristics of neurophysiological changes in patients are given based on the study of the features of electroencephalographic changes and the study of cognitive evoked potentials of the brain. The immune status was evaluated in patients who had repeated mild TBI. Results. Repeated TBI in our study was observed in the form of mild concussions and brain contusions. Their number in one patient ranged from 1 to 5. Clinical manifestations of repeated mild TBI had peculiarities: cephalalgic, cerebral and cerebrospinal hypertensive syndrome, cognitive impairment, diffuse neurological symptoms, and pyramidal insufficiency prevailed in the clinical picture. Only in the main group were cases of a combination of three to eight neurological syndromes detected. A decrease in cognitive function was found in patients with repeated mild TBI compared to the control group according to neuropsychological testing. The analysis of cognitive evoked potentials revealed an increase in the latent period of the cognitive complex P300 in patients with repeated TBI compared with the control group, indicating a decrease in cognitive function. More frequent CP was detected in the main group. The use of modern neuroimaging methods revealed that patients with repeated TBI had increased width of the lateral ventricles on both sides, ventricle III, and the cavity of the septum compared with the control group, as well as a higher frequency of expansion of the septum and convexity of the subarachnoid spaces. Patients with repeated mild TBI are characterised by an increase in blood flow velocity in the extracranial parts of the carotid basin and a decrease in velocity in the vessels of the vertebrobasilar basin with a change in vascular resistance, in the segments of the intracranial part of the carotid basin — a decrease in blood flow velocity without a change in vascular resistance. Disorders of venous cerebral circulation (increased velocity in the internal jugular vein and Rosenthal veins) were recorded in the majority of the main group. According to the data of the CEG, in patients with repeated TBI against the background of diffuse changes in brain bioelectrical activity, focal changes in the left hemisphere of the brain are more common. Dominant arrhythmia was recorded in 97.78 % of patients in the main group. The amplitude of arrhythmia in patients with repeated TBI is lower compared to the control group, and the frequency of arrhythmic oscillations is higher. Conclusions. The use of clinical and diagnostic control allows to prevent the development of damage and obtain objective information about the state of the brain and its structures.

Immediate effect of Bhastrika Pranayama on cerebral hemodynamics in patient with depression: A case report

BackgroundDepression is a common mental disorder with increasing prevalence in India, which involves cognitive impairment as well. Pharmacological management of depression has many adverse effects, which provides symptomatic relief to the patients, with little to no improvement in cognitive impairment or cerebral hemodynamics. This necessitates the exploration of complementary and alternative treatment modalities. Yoga, in particular Bhastrika pranyama, has been utilized as a complementary practice for various conditions, but evidence of its impact on depression and cerebral hemodynamics is limited. Case detailsA 66-year-old male, previously diagnosed with depression, was admitted to our inpatient hospital for a holistic approach to his condition, combining yoga and naturopathy as part of his treatment. During his stay, he participated in a ten-minute Bhastrika pranayama intervention, conducted under supervision. To evaluate cerebral hemodynamics, a 16-channel functional near-infrared spectroscopy (fNIRS) device was used and changes in oxygenated hemoglobin (oxyHb), deoxygenated hemoglobin (deoxyHb), and total hemoglobin (Total Hb) was recorded. ResultsFollowing the practice of Bhastrika Pranayama, the results indicated a rise in bilateral oxygenated hemoglobin (OxyHb) levels during and immediately after the practice, particularly in the prefrontal cortex region. Simultaneously, a decrease in deoxygenated hemoglobin (DeoxyHb) was observed during the practice, with a slight subsequent increase after the Bhastrika Pranayama session. ConclusionThese preliminary findings indicate that Bhastrika pranayama may have an immediate positive impact on cerebral hemodynamics in patients with depression. Further research with larger sample sizes and controlled studies is needed to confirm and generalize these observations.

Changes in cerebral hemodynamic parameters for patients with encephalopathies of different genesis

Mental function impairment is a common sign of encephalopathies, which various factors, including neurological disorders and cerebral hemodynamics, can cause.The purpose of the study was to establish changes in cerebral hemodynamic parameters in patients with encephalopathies of various origins.Material and methods. 520 patients with chronic traumatic encephalopathy (CTE, n=145), vascular encephalopathy in chronic brain ischemia (CVE, n=145), chronic alcoholic encephalopathy (CAE, n=102) and post-infectious encephalopathy (PIE, n=128) were examined. The patients were receiving inpatient treatment on the basis of the communal non-profit enterprise "Ternopil Regional Clinical Psychoneurological Hospital" during the period of 2021-2022. The cerebral blood flow was assessed using transcranial doppler scanning of intracranial and extracranial brachiocephalic vessels on a Philips HDI device.Research results. The most frequent disorders of cerebral hemodynamics in patients with CTE are the following: insufficient blood flow (44.83%), angiospasm (44.14%) and stenosis (40.69%); in patients with CVE – stenosis (67.59%), insufficient blood flow (66.21%) and venous stasis (64.83%); in patients with CAE – insufficient blood flow (32.35%), angiospasm (31.37%) and venous stasis (30.39%); in patients with PIE - angiospasm (45.31%), blood flow insufficiency (37.50%) and vertebro-basilar insufficiency (30.47%). Comparing the parameters of cerebral hemodynamics in patients with encephalopathies of various genesis, it was established that angiospasm in patients with CVE was recorded more often (by 23.11%) than in patients with CAE. A similar trend was noted in patients with CTE and PIE relative to the CAE group. The frequency of registration of blood flow insufficiency in patients with CVE probably exceeded the data of groups of CTE, CAE, and PIE (by 21.38, 33.86, and 28.71%, respectively). At the same time, the presence of changes within two distribution zones - carotid cerebral and vertebral-basilar in patients with CVE probably exceeded the data of the CAE and PIE groups. Regarding the comparison of the characteristics of stenoses, the frequency of detection of this phenomenon in patients with CTE probably exceeded the data of the CTE, CAE, and PIE groups (by 26.90, 53.86, and 64.46%, respectively). At the same time, the proportion of patients with significant stenosis in the CTE group probably exceeded the data of the CVE, CAE and PIE groups. The highest frequency of registration of venous stasis was established in patients with CTE (64.83%), which probably exceeded the data of the CTE, CAE and PIE groups. Vertebro-basilar insufficiency was not detected in patients with CAE, and in the PIE group its frequency of registration was 14.61% higher than the data of the CVE group and 18.06% higher than the data of the CTE group.Conclusions. The obtained results indicate the heterogeneity and polymorphism of the parameters of cerebral hemodynamics in patients with encephalopathies of various genesis, which requires further research to find possible relationships between them and cognitive dysfunction.

Three-Dimensional Arterial Spin Labeling for the Evaluation of the Cerebral Hemodynamics in Ischemic and Hemorrhagic Moyamoya Disease

Introduction: Moyamoya disease (MMD) is a vascular disease with significant risk of mortality due to ischemia or hemorrhage in the brain. The goal of the study was to explore three-dimensional arterial spin labeling (3D-ASL) to improve evaluation of cerebral hemodynamics in patients with MMD. Methods: Our study included 54 cases of ischemic MMD and 42 cases of hemorrhagic MMD. Dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) and 3D-ASL were performed at 3.0 T. Based on these scans, cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) were calculated and compared between patients with different disease subtypes. Receiver operating characteristics analysis was used to assess the diagnostic sensitivity and specificity of different imaging procedures and parameters. Results: Our data suggested that CBF in the lesion area was more severely reduced in patients with hemorrhagic MMD than in those with ischemic MMD. The CBF parameter in 3D-ASL diagnosed hemorrhagic and ischemic MMD with a significant sensitivity and specificity of 80.59% and 57.41%, respectively, with an area under the curve (AUC) of 0.75. We also found that the relative CBF of 3D-ASL was more pronounced decreased and the relative MTT and TTP of DSC-PWI were significantly increased in patients with hemorrhagic MMD than those with ischemic MMD. Specificity and sensitivity and AUC of 3D-ASL were better than the comparison of absolute values from DSC-PWI scans. Conclusion: Our study indicated that 3D-ASL is powerful in differentiating patients with cerebral ischemic or hemorrhagic MMD, providing another diagnostic tool that could potentially improve precision medicine to monitoring MMD patients.

Personalised simulation of hemodynamics in cerebrovascular disease: lessons learned from a study of diagnostic accuracy.

Intracranial atherosclerotic disease (ICAD) poses a significant risk of subsequent stroke but current prevention strategies are limited. Mechanistic simulations of brain hemodynamics offer an alternative precision medicine approach by utilising individual patient characteristics. For clinical use, however, current simulation frameworks have insufficient validation. In this study, we performed the first quantitative validation of a simulation-based precision medicine framework to assess cerebral hemodynamics in patients with ICAD against clinical standard perfusion imaging. In a retrospective analysis, we used a 0-dimensional simulation model to detect brain areas that are hemodynamically vulnerable to subsequent stroke. The main outcome measures were sensitivity, specificity, and area under the receiver operating characteristics curve (ROC AUC) of the simulation to identify brain areas vulnerable to subsequent stroke as defined by quantitative measurements of relative mean transit time (relMTT) from dynamic susceptibility contrast MRI (DSC-MRI). In 68 subjects with unilateral stenosis >70% of the internal carotid artery (ICA) or middle cerebral artery (MCA), the sensitivity and specificity of the simulation were 0.65 and 0.67, respectively. The ROC AUC was 0.68. The low-to-moderate accuracy of the simulation may be attributed to assumptions of Newtonian blood flow, rigid vessel walls, and the use of time-of-flight MRI for geometric representation of subject vasculature. Future simulation approaches should focus on integrating additional patient data, increasing accessibility of precision medicine tools to clinicians, addressing disease burden disparities amongst different populations, and quantifying patient benefit. Our results underscore the need for further improvement of mechanistic simulations of brain hemodynamics to foster the translation of the technology to clinical practice.

THE SEVERITY OF NEUROLOGICAL DEFICIT IN PATIENTS WITH ISCHEMIC STROKE ON THE NIHSS SCALE DEPENDING ON THE STATUS OF COVID-19

This article discusses the severity of neurological deficit in patients with ischemic stroke on the NIHSS scale depending on the status of COVID-19. Based on the current situation, the need for a full-fledged dynamic study of the state of cerebral hemodynamics in terms of the relationship of these indicators with the results of neuro-immunological examinations and neuroimaging data, as well as determining the effect of cerebral blood flow reserves, as a parameter of functional plasticity of cerebral hemodynamics in patients with stroke against the background of COVID-19 is undeniable and unequivocally relevant from the point of view of practical neurology.

CHARACTERISTICS OF CEREBRAL HEMODYNAMICS IN PATIENTS WITH POST-COVID SYNDROME

This article discusses the characteristics of cerebral hemodynamics in patients with post-COVID syndrome. In a comprehensive clinical examination of patients, the generally accepted clinical examination of the somatic status, laboratory research methods, and instrumental research methods (USDG of the arteries and veins of the head and neck) were used.

STATE OF CEREBRAL HEMODYNAMICS IN PATIENTS WITH LACUNAR STROKE

This article discusses the state of cerebral hemodynamics in patients with lacunar stroke. To evaluate and compare the state of cerebral hemodynamics in patients with lacunar stroke and hemorrhagic stroke of the brain. Therefore, conducting a detailed study on the diagnosis and treatment of lacunar cerebral infarction against the background of arterial hypertension, taking into account its subtypes, remains extremely relevant and has not yet been solved.

Co administration of oxiracetam and monosialotetrahexosylganglioside for the treatment of patients with craniocerebral injury, and their effect on serum S100 proteins and neuron specific enolase

Purpose: To determine the efficacy of oxiracetam plus monosialotetrahexosylganglioside (GM1) in the treatment of craniocerebral injury, and its effect on serum S100 proteins and neuron-specific enolase (NSE).
 Methods: A total of eighty patients with severe craniocerebral injury admitted to Shengli Oilfield Central Hospital between January 2020 and December 2021 were selected for the study, and assigned 1:1 to control group (GM1 only, 2 mL daily through intravenous drip) and study group (GM1, 2 mL daily through intravenous drip, in combination with oxiracetam, and 4 g dissolved in 100ml of saline daily through intravenous drip). The treatment duration was two months.
 Results: Baseline patient characteristics were comparable between the two groups (p > 0.05). GM1 plus oxiracetam produced better restoration of cranial functions of patients after craniocerebral injury when compared with GM1 alone, as evidenced by the significantly lower S100 proteins and NSE levels of the study group than the corresponding parameters of the control group after 1, 2, 3, and 7 days of treatment (p < 0.05). More significant mitigation of inflammatory reactions was observed in patients co-administered GM1 and oxiracetam than in those who received GM1 only, as shown by the lower serum concentrations of inflammatory factors {(c-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and neuropeptide Y (NPY)} in the study group as compared with the control group (p < 0.05). A few patients experienced minor adverse reactions such as gastrointestinal discomfort, nausea and vomiting, dizziness and headache, and rash during treatment (p > 0.05).
 Conclusion: Co-administration of oxiracetam and GM1 is a viable strategy for the treatment of patients with craniocerebral injury, as it significantly lowers the levels of serum S100 proteins and NSE, mitigates inflammatory reactions, and ameliorates cerebral hemodynamics in patients. The combined therapy also has a good safety profile.

A magnetic resonance imaging-based computational analysis of cerebral hemodynamics in patients with carotid artery stenosis.

Management of asymptomatic carotid artery stenosis (CAS) relies on measuring the percentage of stenosis. The aim of this study was to investigate the impact of CAS on cerebral hemodynamics using magnetic resonance imaging (MRI)-informed computational fluid dynamics (CFD) and to provide novel hemodynamic metrics that may improve the understanding of stroke risk. CFD analysis was performed in two patients with similar degrees of asymptomatic high-grade CAS. Three-dimensional anatomical-based computational models of cervical and cerebral blood flow were constructed and calibrated patient-specifically using phase-contrast MRI flow and arterial spin labeling perfusion data. Differences in cerebral hemodynamics were assessed in preoperative and postoperative models. Preoperatively, patient 1 demonstrated large flow and pressure reductions in the stenosed internal carotid artery, while patient 2 demonstrated only minor reductions. Patient 1 exhibited a large amount of flow compensation between hemispheres (80.31%), whereas patient 2 exhibited only a small amount of collateral flow (20.05%). There were significant differences in the mean pressure gradient over the stenosis between patients preoperatively (26.3 vs. 1.8 mmHg). Carotid endarterectomy resulted in only minor hemodynamic changes in patient 2. MRI-informed CFD analysis of two patients with similar clinical classifications of stenosis revealed significant differences in hemodynamics which were not apparent from anatomical assessment alone. Moreover, revascularization of CAS might not always result in hemodynamic improvements. Further studies are needed to investigate the clinical impact of hemodynamic differences and how they pertain to stroke risk and clinical management.

The peculiarities of hemodynamic violations for patients with combat acoustic trauma and violations in the central departments of auditory analyzer in the dynamics of treatment

The active combat actions in our country resulted in the increasing the risk of occurrence of the acoustics trauma, acubarotrauma. There is an increase of number of cases of combat acoustic trauma in servicemen and now this problem acquires a large value. The objective estimation of cerebral hemodynamics in patients with acoustics trauma, got in battle conditions, is a necessary condition for the effective complex treatment of sensorineural violations of hearing in such patients. Aim: the examination of quantitative and qualitative indexes of rheoencephalography before and after the treatment of the sensorineural hearing loss (SNL) that is accompanied by violations in the central departments of auditory analyzer, in servicemen that got acoustic trauma in the real combat terms. Materials and methods: The 52 servicemen with acoustic trauma and 15 healthy persons were inspected. There were analyzed 67 rheoencephalograms. Examinations were conducted by means of computer rheography firm "DX systems". Results and their discussions: During the quality estimation of rheograms of the inspected patient’s violation of circulation of blood of cerebrum was educed both in the carotid (FM) and in vertebral-basilar (OM) systems. Before the beginning of treatment, the normal indexes of the state of cerebral circulation of blood by data of REG did not register in any patient with acoustic trauma. The difficulty of venous outflow took place in 69,0% cases in the carotid system and in 87,0% in vertebral-basilar system. Among the investigated patients we also registered the decline of tone of cerebral vessels (15,0%) and cases of atony curve (23,0%). Only in 14,0% examined fighters we found the increase of tone of cerebral vessels with the phenomena of angiospasm. There was the considerable part of patients with unsteady vascular tone with inclination to the increase (41,0%) or decline (18,0%) in both systems of cerebral circulation of blood. In relation to the pulse blood filling, in patients with acoustic trauma there was more than half (51,0%) cases with its decline in the carotid system and (77,0%) in a vertebral-basilar pool. In the vertebral-basilar system in patients with acoustic trauma there was also marked asymmetry of REG-curves (13,0%). After the treatment the improvement of quality indexes of REG took place. In the carotid system the percent of registration of unsteady vascular tone went down with inclination to the decline and cases of atony curve. The patients with acoustic trauma after treatment had less of cases (33,0%) of declines of the pulse blood filling in the carotid system. The percent of asymmetry of REG-curves diminished also (3,0%) in both systems of cerebral circulation of blood. In the inspected patients the changes of tone of cerebral vessels and difficulty of venous outflow, and also the declines of the pulse blood filling, took place both in carotid and in vertebral-basilar systems. This got the reflection in the quantitative indexes of REG: the changes of indexes α, dicrotic (DCi), diastolic (DSi) and rheographic (Rі) indexes of REG-curve in both systems of cerebral blood supply. Conclusions: The treatments of servicemen, that got acoustic trauma in the zone of battle actions must be as possible quicker and complex taking into account the data of audiometry and instrumental inspections, the cerebral circulation of blood. Patients with acoustic trauma have unsteady or decreased tone of cerebral vessels, atony curve, fall-off of the pulse blood filling, difficulty of venous outflow. The most informing quantitative indexes of REG are DCi, DSi and Rі, that represent the presence of such changes of cerebral hemodynamics. Conducted studies showed considerable violations of cerebral circulation of blood both in carotid and, especially, in the vertebral-basilar system in patients with acoustic trauma, got in the real battle terms. The servicemen with battle acoustic trauma should be treated straightaway with the presence of initial sensorineural violations, it is necessary in time to begin a complex treatment taking into account the state of the auditory system and extra aural changes, first of all the cerebral circulation of blood. It will allow to warn the progression of auditory violations and forming the heavy sensorineural hearing loss. The results of the objective state of cerebral circulation of blood for fighters with acoustic trauma can be useful in expertise questions.

Features of the bioelectrical activity of the brain and cerebral hemodynamics in patients with hypertensive dyscirculatory encephalopathy and hypothyroidism

Encephalopathy is common in people of working age. In the last decade there was an important question the relationship of thyroid and cerebrovascular disease. The aim of the study was to investigate the characteristics of the brain’s elektorogenezis and cerebral hemodynamics in patients with hypertensive encephalopathy and related dyscirculatory hypothyroidism.
 We examined 97 patients, including 60 people with the HDE and the associated hypothyroidism and 37 - with the HDE without hypothyroidism.
 The fact, that bioelectrical activity of the brain in patients with hypothyroidism and related HDE was mostly characterized by desynchronization and disorganization of the cortical rhythm, was revealed during the study. Changes revealed by the EEG reflected the presence of metabolic and hemodynamic disturbances of the brain. Also, in patients with GDE and accompanying hypothyroidism, according to the duplex scanning of cerebral vessels, there is a significant decrease in cerebral blood supply and structural changes in vessels with a decrease in the elasticity of the common carotid artery and vertebral arteries and a decrease in cerebral reactivity accordingly. Thus, the comorbidity of HDE and hypothyroidism appears credible changes in the functional activity of the brain and decrease in cerebral reactivity.

Retinal microvasculature and cerebral hemodynamics in patients with internal carotid artery stenosis

PurposeTo investigate the relationship between retinal microvasculature and cerebral hemodynamics in patients with internal carotid artery (ICA) stenosis.MethodsPatients with unilateral moderate or severe ICA stenosis(≥50%) from West China hospital, Sichuan university were consecutively and prospectively recruited enrolled in the current study. En face angiograms of the superficial vascular complex (SVC), deep vascular complex (DVC), superficial vascular plexus (SVP), intermediate capillary plexus (ICP), and deep capillary plexus (DCP) were generated by automatic segmentation using swept-source optical coherence tomography angiography (SS-OCTA) to assess the retinal microvascular perfusion. The cerebral blood flow perfusion on bilateral middle cerebral artery territories measured at the basal ganglia level was assessed by brain computed tomography perfusion (CTP). CTP data were postprocessed to generate maps of different perfusion parameters including cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT) and permeability surface(PS). Relative perfusion parameters (rPS, rCBF, etc.) were calculated as the ratio of the value on the contralateral side to that on the ipsilateral side.ResultsIn the final analysis, 31 patients were included, of whom 11 patients had a moderate ICA stenosis (50–69%) and 20 with a severe ICA stenosis(≥70%). A total of 55 eyes were analyzed in the study, 27 eyes from the ipsilateral side (ie, side with stenosis) and 28 eyes from the contralateral side. In the patients with ICA stenosis, there was a strong correlation between the retinal microvascular perfusion of SVC with rCBV(B = 0.45, p = 0.03), rCBF(B = 0.26, p = 0.02) and rPS(B = 0.45, p < 0.001) after adjustment for age, sex and vascular risk factors. Similar correlations were also found between microvasculature in SVP and cerebral perfusion changes. There were no any significant associations of microvascular perfusion in both DVC and DCP with CTP parameters(all p > 0.05).ConclusionsRetinal perfusion changes in superficial vascular layer (SVC and SVP) were correlated with brain hemodynamic compromise in patients with unilateral moderate or severe ICA stenosis(≥50%). Given the limited size of our study, future studies with larger sample size are needed to confirm our findings.

State of cerebral hemodynamics in patients with deviation of the nasal septum

Violation of the ecological state of the environment has led to the fact that the center of gravity in otorhinolaryngology has shifted towards rhinology. The curvature of the nasal septum is the most common cause of persistent and severe obstruction of nasal breathing, as well as violations of all the numerous functions of the nose, the development of inflammatory and degenerative processes in the upper respiratory tract. In the case of trouble-free functioning of the nasal cavity of a person, first of all, he is worried (or not worried) by the existing cosmetic function, its preservation or correction. However, the situation changes dramatically when there are disorders of the respiratory, olfactory, protective functions of the nasal cavity. Violation of these functions can cause a person to have complaints and symptoms that are understandable to him, such as difficulty in nasal breathing, one or two sides, excessive secretion of nasal secretions, postnasal rhinorrhea, frequent acute sinusitis or exacerbation of chronic sinusitis, and it is not clear how headache pain, otitis media, dysfunction of the auditory tube, manifestations of rhinocardinal, rhinocerebral and rhinopulmonary reflexes. And not the last place in the occurrence of these complaints and conditions belongs to the nasal septum.

Effects of intravascular hypothermia on intracranial pressure and cerebral hemodynamics in patients with severe traumatic brain injury after standard decompression craniectomy

Effects of intravascular hypothermia on intracranial pressure and cerebral hemodynamics in patients with severe traumatic brain injury after standard decompression craniectomy

"Characteristics of cerebral hemodynamics in patients with type 2 diabetes on program hemodialysis"

"Characteristics of cerebral hemodynamics in patients with type 2 diabetes on program hemodialysis"

Patient-Specific Cerebral Blood Flow Simulation Based on Commonly Available Clinical Datasets.

Cerebral hemodynamics play an important role in the development of cerebrovascular diseases. In this work, we propose a numerical framework for modeling patient-specific cerebral blood flow, using commonly available clinical datasets. Our hemodynamic model was developed using Simscape Fluids library in Simulink, based on a block diagram language. Medical imaging data obtained from computerized tomography angiography (CTA) in 59 patients with aneurysmal subarachnoid hemorrhage was used to extract arterial geometry parameters. Flow information obtained from transcranial Doppler (TCD) measurement was employed to calibrate input parameters of the hemodynamic model. The results show that the proposed numerical model can reproduce blood flow in the circle of Willis (CoW) per patient per measurement set. The resistance at the distal end of each terminal branch was the predominant parameter for the flow distribution in the CoW. The proposed model may be a promising tool for assessing cerebral hemodynamics in patients with cerebrovascular disease.