Clinical and diagnostic criteria of brain ischemic disease in atherosclerotic stenosis disorder of both carotid arteries

Complex angiologic and neurologic examination, ultrasonic extracranial and intracranial dopplerography were performed in 64 patients with isolated (unilateral) middle atherosclerotic stenosis of the inner carotid artery. Neuropsychological syndrome and steal syndrome of the vertebro-basilar region were homogeneous in the patients with early, acute and chronic forms of ischemic brain disease. Hemisphere neurological symptoms depended on the localization of ishemic brain lesion. Ishemic stroke developed in the region of the inner carotid artery stenosis in 50 % of the patients, in the vertebro-basilar region in 42,8 % of the patients, in the contralateral carotid artery stenosis region in 7,2 % of the patients. 3 types of hemodynamic disorders and those of cerebro-vascular reactivity were determined in the ipsilateral and contralateral middle and posterior cerebral arteries. Carotid endarterectomy was performed in 52 patients and middle stenosis level of inner carotid artery was confirmed. We reveled that the cerebral blood flow decrease and cerebro-vascular reactivity disorders correlated with the frequency of neurological symptoms. Linear blood flow speed reduction and that of cerebro-vascular reactivity on hypoxia (CVR) were unilateral - ipsilateral in the carotid artery region in the patients with the early forms of ischemic brain disease 55,3 ± 11,6 sm/s and 1,10 ± 0,04 respectively. Hemodynamic disorders had systemic character in the patients with acute and chronic forms of ischemic brain disease. We can make the conclusion about hemodynamic significance of the middle stenosis of the inner carotid artery and expedience of the carotid endarterectomy for the prevention of ischemic lesion progression.