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CEREBROVASCULAR DISORDERS AND SECONDARY HEADACHES
Akhmedov Jahongir Akmalovich
Asian International University
Tel: +998934500601
neurosurgeryjahongir @ gmail . com
ABSTRACT:
Cerebrovascular diseases are one of the pressing medical and social problems
of our time [Vereshchagin N.V., Piradov M.A. 2002; Vilensky B.S. 1995,1999; Gusev E.I.,
Skvortsova V.I. 2001; Skvortsova V.I. et al. 2001; Murray C.J.L., Lopez A.D. 1997J. In the
last decade, there has been a clear tendency towards an increase in the incidence of stroke at
a young age [Begidova N.M. et al., 2003, Burtsev E.I. 1986; Deev A.S., Zakharushkina I.V.
2000; Deev A.S. et al., 2003; Elchaninov A.P. et al., 2002]. In our country, as in most
countries of the world, the problem of cerebral circulatory disorders, the basis of which are
vascular lesions of the nervous system, continues to be one of the most important in modern
medicine [Vereshchagin N.V., Varakin Yu.L. 2001; Gusev E.I. et al., 2001; Zakharushkina
I.V. et al., 2003; Kalashnikova L.A. et al., 2003]. In most cases, vascular damage to the
brain is multifactorial - caused by a combination of several risk factors, including genetic
ones [Vereshchagin N.V., 2003; Skvortsova V.I. et al., 2001; Suslina Z.A. et al., 2004; Heiss
W.-D., 2003; Shlonkowska A., 2003]. One of the important risk factors for cerebrovascular
accidents in young people is rheumatic diseases [Ivanova M.M., 2001; Kazanchyan P.O. et
al., 1991; Kalashnikova L.A., 1997; Nasonov E.L. et al., 1999]. Rheumatic diseases (RD)
belong to a group of diseases that are characterized by the development of autoimmune
processes against antigens of almost all organs and tissues of the div, which is often
combined with the formation of autoantibodies with organ-nonspecific properties [Nasonov
E.L., 1998; Nasonov E.L. et al., 1999]. Over the past decade, Russia has seen an increase in
the total number of patients with rheumatic diseases by more than 3,230 thousand or 35%
[Folomeeva O.M. et al., 2001, 2002].
Objectives of the scientific research 1. To study the clinical features of cerebrovascular
pathology in the dynamics of the immunopathological process in patients with rheumatic
diseases (systemic lupus erythematosus, systemic scleroderma and some forms of systemic
vasculitis). 2. To study the structural features of brain damage in the studied rheumatic
diseases. 3. To assess the state of cerebral vessels of various calibers in systemic lupus
erythematosus, systemic scleroderma and systemic vasculitis. 4 4. To study the
immunological parameters of blood and cerebrospinal fluid to clarify the main
immunological mechanisms of cerebrovascular pathology development. 5. To study
hemodynamic and hemostasiological parameters and their role in the formation of the main
cerebrovascular syndromes and the state of cerebral blood flow. 6. To determine the clinical
and instrumental features of cerebrovascular disorders in various rheumatic diseases and to
evaluate the proportion of individual distinctive differential diagnostic features. 7. To
evaluate the effect of intensive care (pulse therapy) of rheumatic diseases on the condition of
cerebral vessels. 8. To highlight the main pathogenetic mechanisms of vascular damage in
various forms of rheumatic diseases. 9. To suggest diagnostic and therapeutic algorithms for
cerebrovascular pathology in patients with rheumatic diseases. Scientific novelty The article
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describes neurological syndromology in cerebrovascular disorders against the background of
systemic rheumatic diseases and shows for the first time its dynamics during long-term
follow-up observation. A high frequency of acute (cerebrovascular accidents, strokes) and
chronic cerebrovascular disorders in the study group was revealed and their frequency was
determined in various nosological forms of rheumatic diseases. For the first time, the
dynamics of cerebrovascular disorders has been traced, two critical periods for the
development of acute cerebrovascular disorders have been identified (2-5 years and after 10
years from the clinical manifestation of rheumatic disease). It has been shown that the first
period is associated mainly with autoimmune inflammation, and the second - with the
severity of somatic pathology, hemostasiological disorders and increasing atherogenesis.
Clinical features of strokes in the studied RDs are presented, an increase in their frequency
with an increase in the activity of the process in SV is shown.
CONCLUSIONS
The importance of a set of non-invasive methods for studying cerebral vessels (magnetic
resonance angiography, ultrasound Doppler, duplex scanning, ophthalmoscopy), methods
for assessing the hemostasis system (fibrinogen, PTI, APTT, RFMC, spontaneous
fibrinolysis, thrombin time), as well as immunological methods (a-n-DNA, aCL, RF, VA,
etc.) in the diagnosis of vascular lesions of the brain in RD, allowing to clarify their
pathogenesis, individualize therapy and increase its effectiveness, was assessed.
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