Rosytska O. Chronic brain ischemia due to multifocal atherosclerosis (clinical and catamnestic studies)

The work is devoted to improving the diagnosis and treatment of patients with chronic brain ischemia (CBI) which is caused by multifocal atherosclerosis (MFA). Results based on the study of etiopathogenetic factors and pathological processes that determined the structural and functional CNS changes, which affect course and outcome of the disease. A dynamic observation of patients with CBI caused by MFA was carried out. It was found that atherosclerotic lesions of blood vessels of the brain, heart and lower extremities are primary. Leading and additional risk factors affecting both either debut or progression of CBI were clarified. The polysymptomatic nature of CBI was established. Different types of cognitive impairment and predictors of pathological processes in the brain structures were identified. Predictors of structural brain lessions and structural changes of arterial system of the brain, which determine the formation and course of CBI caused by MFA, have been specified. A direct correlation between the health-related components of the integral indicator "quality of life" and the nature of the course of CBI, age over 60 years and the severity of comorbid diseases has been established. The catamnestic analysis of 10 years of mortality in patients with CBI showed that comorbid pathology prevailed among its causes and that mortality rates were higher in severely comorbid patients. Prognostic factors have been identified that significantly increase the risk of mortality in patients with CBI and a gradation of the risk of mortality has been determined using the created mathematical model. Algorithms for early diagnosis and treatment of CBI patients caused by MFA have been developed.