Zozulya K. Diagnostics and surgical treatment of cerebral circulation disorders at vertebral arteries vertebral lesions

The thesis is devoted to study of treatment outcomes at brain circulatory disorders due to vertebral arteries (VA) extracranial sections, caused by their vertebral lesions in 103 patients. One of the main causes of onset and progression of brain circulatory disorders in vertebrobasilar basin was vertebral lesions of VA main segments (V1-2 and V2). Vertebral stenosis of the left VA was detected three times more often than of the right VA. Almost in 25% cases stenosis of both VA was revealed at widespread stenosis of the cervical spine of varying severity. Typical clinical manifestations were chronic and progressive flow of brain circulatory disorders, ineffectiveness of conservative treatment, steady decline in quality of life of most patients. In 54 (52.43%) patients reconstructive surgery was performed for blood flow optimization in VA. Indications for surgery at VA stenosis were set on base of diagnostic scheme that defined hemodynamic decompensation and functional parameters of blood circulation of the brain. Significant improvement was achieved in 95% operated patients. Operations on VA main segments have a small number of contraindications, mainly general surgical, they can be performed even at somatically severe patients.