Duplyak L. Рeculiar features of clinical manifestations, running and diagnosis of multifocal cerebral lesions of vascular genesis

The thesis is devoted for studying clinico-neurovisual relationships and their pathomorphological equivalents in multifocal cerebral lesions of vascular genesis. The work was carried out on clinical material. Altogether 151 patients, 121 with multifocal and 30 patients with monofocal cerebral lesions of vascular genesis. All the patients were subject to neurovisual examinations (computer and magnetic resonance tomography) supplemented with morphometric examinations. Also used were the materials of 51 autopsies of dead patients with the above-indicated pathology. It was established that multifocal cerebral lesions of vascular genesis are characterized by polysyndrome nature. Not all the foci revealed by neurovisual methods (CT, MRT) had clinical manifestations. Pathomorphologically, there was revealed a phenomenon of bedding tortuosity not only extra- and intracerebral arteries, but also vessels of the microcirculatory bed with formation of multiple microaneurisms, zones of venous hyperemia and ischemia, which resulted in persistent edema of the brain matter, in multifocal cerebral lesions of vascular genesis. The analysis of clinical, neurovisual and pathomorphological changes in repeated acute impairments of cerebral blood flow indicated that focal neurological symptomatology and outcomes of cerebral infarctions, capability of restoring lost functions depend not only on size and localization of the foci, but also on degree of previous diffuse and focal changes in the brain.