As a continuation of the topic of the article in the previous issue of the International Neurological Journal, which presents an analytical review of domestic and foreign studies on the syndrome of chronic cerebral venous dysfunction (SСCVD), this section discusses the classification of pathology, key issues of diagnosis and treatment. It is noted that in Ukraine and in most countries of the post-Soviet space, clinical classifications of M.Ya. Berdychevsky and A.V. Shemagonov are still used, where clinical forms, etiological factors, stages and types of the pathology were identified. In the ICD-10, venous cerebral insufficiency may correspond to the following chapters: G46, I87.8, I98, I99. Diagnosis of SCСVD, first of all, is based on a clinical assessment. Having quite characteristic general clinical symptoms, the pathology nevertheless differs in certain features of the course. Most often patients with SCСVD complain of chronic stabbing, monotonous headache, a feeling of heaviness in the head and so on. In addition, most patients have constant or intermittent noise in the head, ears, dizziness and vertigo. Additional verification methods are ultrasound examination of the vessels of the head and neck, plethysmography, magnetic resonance angiography. Since SCСVD is not an independent unit, the treatment of this pathology primarily requires the elimination of the underlying disease that provoked cerebral venous discirculation. As important preventive and curative measures, non-drug methods that reduce congestion in the body should be considered: regular physical activity, dosed exercises for the spine, various types of massage and physiotherapy, reflexology. It is important to adhere to a certain diet and quality of food. Among venotonic drugs, there are those of plant origin (flavonoids and saponins), synthetic agents, combined drugs.

The article presents an analytical review of the results of domestic and foreign studies on chronic disorders of cerebral venous circulation, which is given less attention against the arterial system due to blurred manifestations, especially early, anatomical variability of the venous system, even in healthy, difficulty in diagnosis. When the balance of arterial and venous inflow is disturbed and this state exa­cerbates, irreversible changes evolve other structures of the cranial ca­vity — primarily in the brain (consistent with the concept of Monroe-Kelly). Chronic disorders of cerebral venous circulation may have different causes and varying degrees of severity. The equivalent of chronic cerebral venous insufficiency (SCVD), terminologically accepted in our country, in some countries is considered as chronic venous cerebrospinal insufficiency, which emphasizes the pathogenetic link of disorders of cerebral venous blood flow and extracranial veins, which is, in our opinion, is logical and reasonable. Recognition of chronic cerebrospinal venous insufficiency has aroused intense interest for a better understanding of the role of extracranial venous pathology and developmental options. Although the diagnosis was originally based on Doppler sonography, there are currently no diagnostic imaging methods, non-invasive or invasive, that can serve as the gold standard for detecting venous abnormalities indicative of chronic cerebrospinal venous insufficiency. The results of some studies are discussed, in particular, the hypothesis that chronic cerebrospinal venous insufficiency plays a role in the pathoge-nesis of multiple sclerosis or in many concomitant clinical manifestations. The affinity of the pathogenesis of idiopathic intracranial hypertension, Ménière’s disease, spondylotic vertebrobasilar insufficiency syndrome is analyzed. Attention is also focused on the other opinion of scientists when the increase in venous blood supply to the brain and other formations in the head cavity under certain conditions is considered as a compensatory reaction. The anatomical and physiological features of the venous system of the cranial cavity are considered, which substantiate the clinical manifestations of venous dysfunction, methods of diagnosis and treatment of pathology. Summarizing the above, chronic venous blood circulation in the cranial cavity, which is largely associated with problems of extracranial venous blood flow, not only in itself is a very characteristic syndrome complex t that adversely affects neurological functions due to cerebral hypoxia and metabolic changes, deteriorates the quality of life, but also has a negative impact on the course of the disease or has a pathogenetic link with other diseases, in particular, may be accompanied by different levels of blood pressure.

Introduction. The syndrome of chronic venous cerebral dysfunction (SCVCD) - widely studied at present nosology. In the presence of anxiety-depressed disorders, this disease is complicated. Specific clinical manifestations of SCVCD, as pronounced practical experience, are found in people of different age and social groups, usually in conditions of comorbidity, in particular, with different arterial pressure (AP) and accompanying anxiety-depressive disorders, which is reflected in the general intellectual potential of society. In our opinion, it is an interesting and relevant issue that contributes to changes in the emotional-volitional sphere of a person carries out a SCVCD in combination with different indicators of arterial pressure (AP). The aim of the study. To conduct a comparative analysis of the interconnections of the indicators of the emotional-volitional sphere (anxiety and depression), estimated using the scales of the anxiety Ch. D. Spieberger - Yu. L. Hanin and depressions A. T. Beck, in patients with chronic cerebral venous dysfunction syndrome and without it and various indicators of arterial pressure. Materials and methods. 153 patients tested on a series of reactive and personal anxiety and depression. The main group amounted to 125 people who were elected by clinical signs of the existence of the SCVCD and various indicators of AP, and they were distributed to three clinical groups: 33 people - people with increased indicators of AP (157.20 ± 12.20 / 98.30 ± 4.20 mm Hg - hypertonics; 21 person with reduced blood pressure (100.32 ± 7.23 / 65.45 ± 6.40 mm Hg) - hypotonic; 24 people with labile AP with predominantly normal average digits of AP (125.23 ± 12.20 / 82.22 ± 4.14 mm Hg) - "conditional" normotonics. For comparison of indicators, 28 patients of the control group were involved - people without clinical signs of SCVCD and various indices of AP, distributed on the same principle: hypertension - eight people, hypotonics - five people, "conditional" normotonics - 15 people. The statistical elaboration of the results was carried out using the Medstat application package. Since the law of distribution of indicators differed from normal, for the presentation of data calculated median value and the inter-quatering interval (QI-QIII), for comparison used nonparametric criteria for U. Kruskala A. Wallis, criteria for J. Dannah and Chi-square. Results. The level of personal and reactive anxiety (among persons with chronic cerebral venous dysfunction) in hypertonics was statistically significantly higher than hypotonics. The level of depression (among persons with chronic cerebral venous dysfunction) in hypotonics was statistically significant than in hypertension and "conditional" normotonics. In patients in the control group, there is no statistically significant connection between the numbers of personal and reactive anxiety and the level of depression with the digits of arterial pressure. Anxiety is most often an essential part of depression. Transformation of hypotension in hypertension (and vice versa) in persons with chronic cerebral venous dysfunction syndrome may be accompanied by a transition of anxiety in depression or depression in anxiety. Conclusions. The assessment of personal and reactive anxiety on the scale of anxiety and depression revealed statistically significant bonds with arterial pressure in persons with chronic cerebral venous dysfunction syndrome. The figures of personal and reactive anxiety were statistically significant in hypertension compared to normotonics (p less than 0.001) an hypotonic (p less than 0.001). The figures of depression were statistically significant in hypotonics compared with hypertonics and normotonics (p less than 0.001). In persons from the control group, the level of reactive anxiety and blood pressure in hypertonics (p = 0.003) in comparison with hypotonic and normotonics is statistically significant. In hypеrtonics with chronic venous dysfunction syndrome, it was statistically significantly higher (p less than 0.001) level of personal anxiety compared with hypertonic control group, and among the hypotonics of the main group noted statistically significant (p less than 0.001) higher level of depression. Key words: Syndrome of chronic cerebral venous dysfunction, reactive anxiety, personal anxiety, arterial pressure, depression.