Changes in cerebral hemodynamic parameters for patients with encephalopathies of different genesis

Abstract

Mental function impairment is a common sign of encephalopathies, which various factors, including neurological disorders and cerebral hemodynamics, can cause.The purpose of the study was to establish changes in cerebral hemodynamic parameters in patients with encephalopathies of various origins.Material and methods. 520 patients with chronic traumatic encephalopathy (CTE, n=145), vascular encephalopathy in chronic brain ischemia (CVE, n=145), chronic alcoholic encephalopathy (CAE, n=102) and post-infectious encephalopathy (PIE, n=128) were examined. The patients were receiving inpatient treatment on the basis of the communal non-profit enterprise "Ternopil Regional Clinical Psychoneurological Hospital" during the period of 2021-2022. The cerebral blood flow was assessed using transcranial doppler scanning of intracranial and extracranial brachiocephalic vessels on a Philips HDI device.Research results. The most frequent disorders of cerebral hemodynamics in patients with CTE are the following: insufficient blood flow (44.83%), angiospasm (44.14%) and stenosis (40.69%); in patients with CVE – stenosis (67.59%), insufficient blood flow (66.21%) and venous stasis (64.83%); in patients with CAE – insufficient blood flow (32.35%), angiospasm (31.37%) and venous stasis (30.39%); in patients with PIE - angiospasm (45.31%), blood flow insufficiency (37.50%) and vertebro-basilar insufficiency (30.47%). Comparing the parameters of cerebral hemodynamics in patients with encephalopathies of various genesis, it was established that angiospasm in patients with CVE was recorded more often (by 23.11%) than in patients with CAE. A similar trend was noted in patients with CTE and PIE relative to the CAE group. The frequency of registration of blood flow insufficiency in patients with CVE probably exceeded the data of groups of CTE, CAE, and PIE (by 21.38, 33.86, and 28.71%, respectively). At the same time, the presence of changes within two distribution zones - carotid cerebral and vertebral-basilar in patients with CVE probably exceeded the data of the CAE and PIE groups. Regarding the comparison of the characteristics of stenoses, the frequency of detection of this phenomenon in patients with CTE probably exceeded the data of the CTE, CAE, and PIE groups (by 26.90, 53.86, and 64.46%, respectively). At the same time, the proportion of patients with significant stenosis in the CTE group probably exceeded the data of the CVE, CAE and PIE groups. The highest frequency of registration of venous stasis was established in patients with CTE (64.83%), which probably exceeded the data of the CTE, CAE and PIE groups. Vertebro-basilar insufficiency was not detected in patients with CAE, and in the PIE group its frequency of registration was 14.61% higher than the data of the CVE group and 18.06% higher than the data of the CTE group.Conclusions. The obtained results indicate the heterogeneity and polymorphism of the parameters of cerebral hemodynamics in patients with encephalopathies of various genesis, which requires further research to find possible relationships between them and cognitive dysfunction.