Microstructural disturbances develop in the wall of vessels in patients with mild traumatic brain injuries (TBI).The purpose of our research was to detect the regularities of changes of hemodynamics and reactivity of cerebral circulation in patients with consequences of mild traumatic brain injuries by using the method of Doppler ultrasonography with hyper-and hypocapnic tests. Materials and methodsWe examined 62 patients with consequences of mild TBI. The control group consisted of 20 healthy people. Doppler ultrasonography with hyper-and hypocapnic tests were carried out according to the standard method. ResultsConducting Doppler ultrasonography with hyper-and hypocapnic tests in the patients with consequences of TBI we detected that coefficient of reactivity was 1.11±0.07. The insignificant asymmetry of bloodflow which increased after hyper-and hypocapnia was observed in the patients (82%). An early development of atherosclerotic lesion of cerebral vessels in the form of hemodynamic insignificant atherosclerotic plaques of the walls of cerebral vessels was observed (73%). We detected paradoxical reaction of cerebral vessels in 40 patients when hyper-and hypocapnic tests were being held. ConclusionsThe data obtained confirm the changes of reactivity of cerebral vessels towards the decrease of linear velocity of bloodflow in the patients with consequences of mild TBA. The detected paradoxical reaction of vessels which was observed when we used hyper-and hypocapnic tests, is the consequence of the decrease of elasticity of vessels walls as a result of microstructural disturbances of vessels, an early development of atherosclerotic changes in vessels and the manifestation of a long-term angiospasm.No conflict of interest.

Regional Clinical special clinic for radiation protection of the population * The aim of the study was to investigate the characteristics of cerebrovascular disorders in the remote period in liquidators of the Chernobyl accident on the basis of a complex examination and dynamic observation of patients from 1996 to 2015. 68 patients were examined -men aged from 50 to 65 years. We studied the clinical and instrumental performance (clinical neurological examination, EEG, REG, Doppler ultrasound of the neck vessels and brain vessels, brain MRI, etc.). Dynamic observation averaged 10-15 years. It is confirmed on the basis of clinical and paraclinical examinations that leading pathology in liquidators is encephalopathy, with a specific set of neurological symptoms, which is characterized by progressive course, the early development of cognitive, psycho-emotional disorders, the development of cortical atrophy. This shows the rapid progression of cerebrovascular disease, the early development of atherosclerosis manifestations of premature aging of the brain at the liquidators of the Chernobyl nuclear power plant.Key Words: cerebrovascular disorders, the liquidators of the Chernobyl accident, the clinical and neurophysiological examination, premature aging of the brain.Стаття надійшла до редакції 03.01.2017 р.

Background and Aims: To study and describe cephalgic syndromes depending on the pathogenetic mechanisms of their development in participants of Chornobyl accident clean-up. Methods: The study involved 162 male patients aged 39-55 exposed to ionizing radiation in the zone of the Chornobyl accident in 1986-1987, who underwent a complex clinical-instrumental study including computed electroencephalography and visual evoked potential, ultrasound Doppler study, magnetic resonance imaging, electromyography, etc. Results: Depending on the character of the headache, which occurred in 100% of cases, the patients were divided into 5 main groups. Group 1, 52 patients with vasomotor cephalgias (32.1%). Group 2, 29 subjects (17.9%), was characterized by tension headache. Group 3, 32 persons (19.7%) with cephalgia of vasomor-muscular origin. Prevalence of venous and liquor components was noted in 38 patients, which comprised group 4 (23.5%). Group 5, 11 persons (6.8%), consisted of the patients with so-called psychalgias, provoked by emotional factors. The peculiarities of forming cerebral dyscirculations, the changes in the velocity of cerebral hemorrhage and vascular tone were noted. The signs of venous-liquor dyscirculation, limited impairments of the brain, subcortical and trunk structures were revealed in cephalgic syndromes of various origin. The character of changes in the muscular tone in the muscles of the scalp and neck was investigated in tension cephalgias and psychalgias. Conclusion:The findings of the research allowed to expand our knowledge about the pathogenesis of various main cephalgic syndromes developing in the participants of Chornobyl accident clean-up and correctly plan the pathogenetic treatment in this population of patients.

Myofascial pain syndrome in railway workersAbstract. Effect of proprioceptive neuromuscular facilitation and injection of anesthetic (0.5% novocaine or 2% lidocaine solutions) into the trigger points in combination with standard therapy was studied in 64 railway workers suffering from myofascial pain syndrome manifested by pain, muscle tension, decrease of amplitude of muscle movements, active trigger points in affected muscles, sensory and autonomic disorders in the area of referred pain. Ap-plication of this combination was accompanied by fast decrease of pain syndrome, increase in the amplitude of muscle movements and disappearance of active trigger point in them, normalized indicators of electromyography.

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