Chronic cerebral ischemia: a view from the ХХI century

V.V. Zakharov, K.B. Sleptsova, O.O. Martynova

First Moscow State Medical University named after I.M. Sechenov (Sechenov University), Moscow

The article is devoted to one of the most common forms of chronic cerebral circulatory disorders — chronic cerebral ischemia (CCI), the risk factors of which are various diseases with small-caliber vascular lesions (microangiopathy): arterial hypertension, diabetes mellitus, cerebral amyloid angiopathy, less common — genetic vasculopathy, vasculitis, etc. The article also considers the main pathogenetic mechanisms of chronic progressive vascular cerebral damage: recurrent brain infarctions without stroke, microhemorrhages, focal and diffuse changes in the white matter (leukoareosis). The questions concerning the earliest and most common clinical manifestations of CCI — cognitive disorders, the peculiarity of which is the inability to concentrate, problems with control and visuospatial functions with relative memory preservation, are covered in detail. In addition to controlling the risk factors, treatment of patients with CII involves the prescription of pathogenetically based treatment aimed at the main mechanisms of brain damage and/or activation of the neurorestoration processes. The article presents the experience of using the neuroprotective and neurotrophic drug, Cellex^®, in cerebral vascular diseases, and considers its effect on the severity of cognitive disorders.

Keywords: chronic cerebral ischemia, silent strokes, leukoareosis, microhemorrhages, vascular cognitive disorders, neuroprotection.

For citation: Zakharov V.V., Sleptsova K.B., Martynova O.O. Chronic cerebral ischemia: a view from the ХХI century. RMJ.
2021;5:45–49.