Haemodynamic Changes in the Extracranial Carotid Vessels in Acute Ischemic Strokes of Various Etiologies

Abstract

The complexity and multifactorial nature of the development of ischemic strokes necessitate a comprehensive study of some aspects of their pathogeneses. The purpose of the study was to examine the patterns of extracranial cerebral blood vessel hemodynamics in acute ischemic strokes: - cardioembolic, atherosclerotic, and lacunar infarctions. Material and methods: we examined 90 patients with ischemic strokes of cerebral hemispheric localization, of which 25 (27.5%) had a cardioembolic stroke, 35 (38.9%) had a stroke of atherosclerotic origin, and 30 (33%) had a lacunar stroke. Thirty (30) examined people made up the control group. Results: the main neurological manifestations of hemispheric ischemic stroke were characterized by the predominance of focal symptoms: central paresis of the 7th and 12th nerves, the presence of mono-, hemiparesis or hemiplegia, the appearance of pathological reflexes, reflexes of oral automatism, combined with sensory disorders in the form of superficial or total mono and hemianesthesia. In patients with lacunar stroke, signs of diffuse vasospasm of the BCV (brachiocephalic vessels) predominated (83.29%), ipsilateral to the affected hemisphere with an increase in the level of blood flow velocity (BFV) and intima media complex (IMC), as well as the level of peripheral resistance and vascular tone. Hemodynamically significant signs of stenosis were detected in 6.58% of this group. Conclusion: the results of the studies indicate that strokes of cardioembolic and atherosclerotic origins are associated with significant haemodynamic changes and in lacunar stroke, thechanges are surprisingly significant. Therefore, there is a  need to put this into consideration while treating acute ischaemic strokes.