Возрастные И Гендерные Аспекты Цереброваскулярной Патологии И Когнитивных Расстройств

Мякотных, В.С.; Остапчук, Е.С.; Сиденкова, А.П.

doi:10.32986/978-5-93673-307-9-12-2020

Cited by 2 publications

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“…Некоторые авторы по морфологической картине разделяют ЛИ на «атеросклеротический» и «гипертонический». По мнению В. С. Мякотных и Т. А. Боровковой (2006), механизм образования лакун у лиц пожилого и старческого возраста сочетанныйатеросклеротический и гипертонический [8][9][10][11][12].…”

Section: Introductionunclassified

Lacunary stroke. Clinical cases

Захарычева

Shirokova

Polyakov

et al. 2022

Regional blood circulation and microcirculation

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Introduction. Cerebral microangiopathy is the leading cause of vascular cognitive disorders accompined by dementia in the final stages of the disease. Purpose – to study the spectrum of lacunar syndromes in patients with acute cerebrovascular accidents based on our own observations and provide a description of rare clinical variants of the didorders. Materials and methods. We examined 18 patients (10 men and 8 women) aged 33 to 66 years (mean age 52.33 years) in the acute period of lacunar strokes (LS). We studied the neurological status, the data of laboratory-instrumental, speech therapy and neuropsychological testing. The diagnosis of LS was verified using magnetic resonance imaging. Results. Lacunar strokes were more common in patients of mature age (72.22 %) suffering from arterial hypertension (88.89 %) in combination with obesity (44.44 %); patients with atherosclerosis of the coronary and cerebral arteries (27.78 %), type 2 diabetes mellitus (22.22 %) found to have lacunar stroke less often. The sensorimotor hemisyndrome was found to be prevailed (44.44 %). Other classical lacunar syndromes were detected less frequently: with the same frequency (16.67 %) – isolated hemihypesthesia and «hemiballism / hemichorea», as well as «dysarthria – clumsy hand» (11.11 %). The predominant localization of the lesion is the right hemisphere (88.89 %), the internal capsule (66.67 %), rarely the thalamus (27.78 %). Multiple LS were registered in 27.78 % of cases, including the patients with tandem atherostenosis of the cerebral arteries. Descriptions of two clinical cases of LS are presented. Conclusion. Sensorimotor hemisyndrome dominated in clinical scenario. We also observed more rare disorders – bulbar syndrome with anarthria with bilateral damage to the knee of the internal capsule and hyperkinetic syndrome with myoclonus of the respiratory, vocal and articular apparatus. The right-hemispheric lesion predominated with the localization of foci in the internal capsule, the thalamus suffered rarely. Multiple LS were registered in 27.78 % of cases. LSs have unfavorable prognosis for patients with uncontrolled arterial hypertension combined with tandem stenoses of extra- and intracerebral arteries with cognitive disorders that made it difficult to manage patients. The relevance of LS neuroimaging in overweight patients was noted.

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Section: Introductionunclassified

Lacunary stroke. Clinical cases

Захарычева

Shirokova

Polyakov

et al. 2022

Regional blood circulation and microcirculation

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Somatic Pathology in Elderly and Senile Persons Suffering From Alzheimer’s Disease and Alzheimer’s Type Dementia

Мякотных¹,

Сиденкова²,

Kravchenko³

et al. 2023

Успехи Геронтологии

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Для изучения распространенности и коморбидных связей хронической соматической патологии у лиц пожилого и старческого возраста, страдающих болезнью Альцгеймера (БА) и деменцией альцгеймеровского типа (ДАТ) с представлением гипотезы соматопсихической патогенетической коморбидности, наблюдали 217 пациентов, условно разделенных на две подгруппы: 1-я — с деменцией вследствие БА (n=73), 2-я — с ДАТ (n=144). Определены различия в вариантах коморбидной соматической патологии БА и ДАТ, которые оказывали негативное влияние на возникновение когнитивных расстройств и формирование наиболее тяжелых вариантов деменции. В случаях БА ведущими оказались патологические процессы в толстой кишке, коморбидными с ДАТ — болезни системы кровообращения и сахарный диабет 2-го типа. Высокая коморбидность соматической патологии с деменцией и трудности в прижизненной верификации этиологических факторов, обусловливающих нозоспецифичность клинического варианта деменции, детерминирует необходимость применения стандартизированного диагностического алгоритма соматического обследования с учетом принципов комплексной гериатрической оценки и фокусной направленности терапии не только на психическую, но и на соматическую сферу для устранения факторов риска соматогенно-обусловленного ухудшения психического функционирования у лиц с деменцией. In order to study the prevalence of chronic somatic age-associated pathology in elderly and senile people suffering from Alzheimer’s type dementia with the presentation of the hypothesis of somatopsychic pathogenetic comorbidity observation and treatment, 217 patients were observed, conditionally divided into 2 comparable groups: with a defi nitive diagnosis of Alzheimer’s disease (n=73) and with so-called Alzheimer’s type dementia (n=144). Distinct differences in the variants of comorbid to the selected types of dementia of somatic pathology were determined, which had a negative impact not only in terms of the occurrence of cognitive disorders, but also in the future, during the formation of the most severe variants of dementia. In cases of Alzheimer’s disease, pathological processes in the large intestine turned out to be leading, with Alzheimer’s type dementia — diseases of the circulatory system and type 2 diabetes mellitus. Nevertheless, the diagnostic algorithm of patients with dementia should include the most comprehensive somatic examination, and treatment should affect not only the mental, but also the somatic sphere, taking into account the principles of a comprehensive geriatric assessment. With such approaches and under the condition of social wellbeing in the family, it is possible to achieve not only stabilization, but also some improvement in terms of psychopathological disorders, in particular with Alzheimer’s type dementia.

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Возрастные И Гендерные Аспекты Цереброваскулярной Патологии И Когнитивных Расстройств

Cited by 2 publications

References 0 publications

Lacunary stroke. Clinical cases

Lacunary stroke. Clinical cases

Somatic Pathology in Elderly and Senile Persons Suffering From Alzheimer’s Disease and Alzheimer’s Type Dementia

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