Chronic cerebral ischemia: from pathogenesis to therapy (guidelines for an outpatient neurologist)
O.V. Vorobyeva
Sechenov University, Moscow
Currently, there is an increase in the prevalence of cerebrovascular diseases, which significantly decreases the quality of life and often leads to disability of patients. The disease of small cerebral vessels accounts for about 40% of dementias and one fifth of the strokes that occur throughout the year all over the world. Structural brain damage associated with cerebral microangiopathy (diffuse white matter lesion, multiple lacunar infarctions, microcirculation, secondary cerebral atrophy) can remain clinically invisible for a long time, but it significantly increases the risk of dementia and disabling strokes. The main etiopathogenetic factor of cerebral microangiopathy is arterial hypertension, which causes arteriosclerosis of small penetrating arteries and arterioles. The most important trigger of this process is endothelial dysfunction. The available data indicate an increase in the circulating markers of endothelial damage in patients with cerebral microangiopathy. Timely complex therapy is a decisive factor in the reverse development of endothelial dysfunction and reliable prevention of cerebrovascular disease. The preparation Divaza with a pleiotropic effect is a pathogenetically relevant adjuvant medication for the treatment of anxiety-depressive symptoms associated with cerebral microangiopathy.
For citation: Vorobyeva O.V. Chronic cerebral ischemia: from pathogenesis to therapy (guidelines for an outpatient neurologist) //
RMJ. Medical Review. 2018. № 5. P. 26–31.
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