17 research outputs found
ΠΠ»ΠΈΠ½ΠΈΠΊΠ°, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΌΠΎΠ·Π³ΠΎΠ²ΡΡ Π²Π΅Π½ ΠΈ Π²Π΅Π½ΠΎΠ·Π½ΡΡ ΡΠΈΠ½ΡΡΠΎΠ²
The problem of thrombosis of cerebral veins and venous sinuses is insufficiently studied. The real incidence of cerebral venous thrombosis remains incompletely defined. The article presents results of clinical research on cerebral vein and sinus thrombosis, which served as a ground for an analysis of causes and development of the disease. In 20β35% of patients with cerebral venous thrombosis, this disease remains idiopathic after extensive investigation. Particular attention is given to risk factors, clinical presentations, early diagnosis, treatment, prognosis of cerebral vein and sinus thrombosis.Π’ΡΠΎΠΌΠ±ΠΎΠ· ΠΌΠΎΠ·Π³ΠΎΠ²ΡΡ
Π²Π΅Π½ (ΠΠ) ΠΈ Π²Π΅Π½ΠΎΠ·Π½ΡΡ
ΡΠΈΠ½ΡΡΠΎΠ² (ΠΠ‘) ΠΎΡΠ½ΠΎΡΠΈΡΡΡ ΠΊ ΡΠΈΡΠ»Ρ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ ΠΈΠ·ΡΡΠ΅Π½Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, Π΅Π³ΠΎ ΡΠ°ΡΡΠΎΡΠ° Π½Π΅ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π°. Π ΡΡΠ°ΡΡΠ΅ ΠΈΠ·Π»ΠΎΠΆΠ΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΠ ΠΈ ΠΠ‘, ΠΏΠΎΡΠ»ΡΠΆΠΈΠ²ΡΠΈΡ
ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π»Ρ Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΡΠΈΡΠΈΠ½ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π 20β25% ΡΠ»ΡΡΠ°Π΅Π² ΠΏΡΠΈΡΠΈΠ½Ρ ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΠ ΠΈ ΠΠ‘ Π½Π΅ ΡΠ΄Π°Π΅ΡΡΡ Π²ΡΡΠ²ΠΈΡΡ Π΄Π°ΠΆΠ΅ ΠΏΠΎΡΠ»Π΅ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ½Π°Π»ΠΈΠ·ΠΈΡΡΡΡΡΡ Π²ΠΎΠΏΡΠΎΡΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ°, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½Ρ, ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΠ ΠΈ ΠΠ‘
ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΌΠ΅Π»Π°ΡΠΎΠ½ΠΈΠ½Π° Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΎΡΠ° ΠΏΡΠΈ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΠ½ΡΡΠ»ΡΡΠ΅
Statistics of the World Health Organization (WHO) show that the cerebrovascular disease is the second most frequent cause of death and the third - as the main disabling factor in the working age population. Timely treatment is the key to quickly recovering ischemic tissue. According to the different ischemic cascade stages, the variety of the treatment combinations are proposed. American Stroke Association guidelines 2018 contains no neuroprotectors. In this regard, there remains a need for a biochemical agent successfully blocking one or more stages of the ischemic cascade, preventing cell apoptosis. Melatonin is also considered as such substance due to its neuroprotective properties. The main function of melatonin is the regulation of the sleep-wake cycle. The nuclear and membrane receptors in various organs determines other biological effects of this hormone. The ability of melatonin to regulate the blood pressure, oncogenesis, ovaries cycle, retina function and differentiation of osteoblasts was found. The significant neuroprotective potential of melatonin is realized through the antioxidant, anti-excitotoxic and anti-inflammatory properties. The positive effect on the ischemic lesion size and stroke-related pathological conditions (delirium, insomnia) has been demonstrated both in animal experiments and in clinical studies.ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΠΠ, ΡΠΎΡΡΠ΄ΠΈΡΡΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π° Π·Π°Π½ΠΈΠΌΠ°ΡΡ Π²ΡΠΎΡΠΎΠ΅ ΠΌΠ΅ΡΡΠΎ ΡΡΠ΅Π΄ΠΈ ΠΎΠ±ΡΠΈΡ
ΠΏΡΠΈΡΠΈΠ½ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΈ ΡΡΠ΅ΡΡΠ΅ - ΡΡΠ΅Π΄ΠΈ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°ΡΠΈΠΈ ΡΡΡΠ΄ΠΎΡΠΏΠΎΡΠΎΠ±Π½ΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ. Π‘ΡΠΎΡΠ½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ±ΡΠ·Π°ΡΠ΅Π»ΡΠ½ΡΠΌ ΡΡΠ»ΠΎΠ²ΠΈΠ΅ΠΌ Π²ΠΎΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΡ ΠΈΡΠ΅ΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΡΠΊΠ°Π½ΠΈ. Π ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ ΠΈΠ·Π²Π΅ΡΡΠ½ΡΠΌ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠΌ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΡΠ΅Π΄Π»Π°Π³Π°ΡΡΡΡ Π»Π΅ΡΠ΅Π±Π½ΡΠ΅ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΡ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΡΠ΅ Π½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΠ΅ ΡΡΠ°ΠΏΡ ΡΡΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ°. Π Π Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠ»ΡΡΠ° Π² ΠΎΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ 2018 Π³ΠΎΠ΄Π° ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΎΠΉ Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΠ΅ΠΉ ΠΈΠ½ΡΡΠ»ΡΡΠ° Π½Π΅ Π²ΠΊΠ»ΡΡΠ΅Π½ Π½ΠΈ ΠΎΠ΄ΠΈΠ½ ΠΈΠ· Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΎΡΠΎΠ². Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ ΡΠΎΡ
ΡΠ°Π½ΡΠ΅ΡΡΡ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΡ Π² ΠΏΠΎΠΈΡΠΊΠ΅ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°Π³Π΅Π½ΡΠ°, ΠΊΠΎΡΠΎΡΡΠΉ ΠΌΠΎΠ³ Π±Ρ ΡΡΠΏΠ΅ΡΠ½ΠΎ Π±Π»ΠΎΠΊΠΈΡΠΎΠ²Π°ΡΡ ΠΎΠ΄ΠΈΠ½ ΠΈΠ»ΠΈ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ ΡΡΠ°ΠΏΠΎΠ² ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΊΠ°ΡΠΊΠ°Π΄Π°, ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ°Ρ Π·Π°ΠΏΡΡΠΊ Π°ΠΏΠΎΠΏΡΠΎΠ·Π° ΠΊΠ»Π΅ΡΠΊΠΈ. Π ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΡΠ°ΠΊΠΎΠ³ΠΎ Π²Π΅ΡΠ΅ΡΡΠ²Π° ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡ, Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ, ΠΌΠ΅Π»Π°ΡΠΎΠ½ΠΈΠ½, Π±Π»Π°Π³ΠΎΠ΄Π°ΡΡ Π½Π°Π»ΠΈΡΠΈΡ Ρ Π½Π΅Π³ΠΎ Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΡΠ²ΠΎΠΉΡΡΠ². ΠΡΠ½ΠΎΠ²Π½ΠΎΠΉ ΡΡΠ½ΠΊΡΠΈΠ΅ΠΉ ΠΌΠ΅Π»Π°ΡΠΎΠ½ΠΈΠ½Π° ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ΅Π³ΡΠ»ΡΡΠΈΡ ΡΠΈΠΊΠ»Π° ΡΠ½Π° ΠΈ Π±ΠΎΠ΄ΡΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ°Π»ΠΈΡΠΈΠ΅ ΠΊΠ°ΠΊ ΡΠ΄Π΅ΡΠ½ΡΡ
, ΡΠ°ΠΊ ΠΈ ΠΌΠ΅ΠΌΠ±ΡΠ°Π½Π½ΡΡ
ΡΠ΅ΡΠ΅ΠΏΡΠΎΡΠΎΠ² Π² ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΎΡΠ³Π°Π½Π°Ρ
ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ ΠΈ Π΄ΡΡΠ³ΠΈΠ΅ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΡ ΡΡΠΎΠ³ΠΎ Π³ΠΎΡΠΌΠΎΠ½Π°. ΠΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΡ ΠΌΠ΅Π»Π°ΡΠΎΠ½ΠΈΠ½Π° ΡΡΠ°ΡΡΠ²ΠΎΠ²Π°ΡΡ Π² ΡΠ΅Π³ΡΠ»ΡΡΠΈΠΈ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄Π°Π²Π»Π΅Π½ΠΈΡ, ΠΎΠ½ΠΊΠΎΠ³Π΅Π½Π΅Π·Π°, ΠΎΠΊΠ°Π·ΡΠ²Π°ΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π½Π° ΡΠ°Π±ΠΎΡΡ ΡΠΈΡΠ½ΠΈΠΊΠΎΠ², ΡΠ΅ΡΡΠ°ΡΠΊΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²ΠΊΡ ΠΎΡΡΠ΅ΠΎΠ±Π»Π°ΡΡΠΎΠ². ΠΠ»Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅Ρ ΠΈΠ½ΡΠ΅ΡΠ΅Ρ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π» ΠΌΠ΅Π»Π°ΡΠΎΠ½ΠΈΠ½Π°, ΡΠ΅Π°Π»ΠΈΠ·ΡΠ΅ΠΌΡΠΉ Π·Π° ΡΡΠ΅Ρ Π°Π½ΡΠΈΠΎΠΊΡΠΈΠ΄Π°Π½ΡΠ½ΡΡ
, Π°Π½ΡΠΈΡΠΊΡΠ°ΠΉΡΠΎΡΠΎΠΊΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ²ΠΎΠΉΡΡΠ² Π³ΠΎΡΠΌΠΎΠ½Π°. ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π° ΡΠ°Π·ΠΌΠ΅Ρ ΠΎΡΠ°Π³Π° ΠΈΡΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΈ ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠΈΠ΅ ΠΈΠ½ΡΡΠ»ΡΡΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ (Π΄Π΅Π»ΠΈΡΠΈΠΉ, ΠΈΠ½ΡΠΎΠΌΠ½ΠΈΡ) Π±ΡΠ»Π° ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π½Π° ΠΊΠ°ΠΊ Π² ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Ρ
Π½Π° ΠΆΠΈΠ²ΠΎΡΠ½ΡΡ
, ΡΠ°ΠΊ ΠΈ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΠΠ»ΠΈΠ½ΠΈΠΊΠ°, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΌΠΎΠ·Π³ΠΎΠ²ΡΡ Π²Π΅Π½ ΠΈ Π²Π΅Π½ΠΎΠ·Π½ΡΡ ΡΠΈΠ½ΡΡΠΎΠ²
The problem of thrombosis of cerebral veins and venous sinuses is insufficiently studied. The real incidence of cerebral venous thrombosis remains incompletely defined. The article presents results of clinical research on cerebral vein and sinus thrombosis, which served as a ground for an analysis of causes and development of the disease. In 20β35% of patients with cerebral venous thrombosis, this disease remains idiopathic after extensive investigation. Particular attention is given to risk factors, clinical presentations, early diagnosis, treatment, prognosis of cerebral vein and sinus thrombosis.Π’ΡΠΎΠΌΠ±ΠΎΠ· ΠΌΠΎΠ·Π³ΠΎΠ²ΡΡ
Π²Π΅Π½ (ΠΠ) ΠΈ Π²Π΅Π½ΠΎΠ·Π½ΡΡ
ΡΠΈΠ½ΡΡΠΎΠ² (ΠΠ‘) ΠΎΡΠ½ΠΎΡΠΈΡΡΡ ΠΊ ΡΠΈΡΠ»Ρ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎ ΠΈΠ·ΡΡΠ΅Π½Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, Π΅Π³ΠΎ ΡΠ°ΡΡΠΎΡΠ° Π½Π΅ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π°. Π ΡΡΠ°ΡΡΠ΅ ΠΈΠ·Π»ΠΎΠΆΠ΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΠ ΠΈ ΠΠ‘, ΠΏΠΎΡΠ»ΡΠΆΠΈΠ²ΡΠΈΡ
ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π»Ρ Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΡΠΈΡΠΈΠ½ Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π 20β25% ΡΠ»ΡΡΠ°Π΅Π² ΠΏΡΠΈΡΠΈΠ½Ρ ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΠ ΠΈ ΠΠ‘ Π½Π΅ ΡΠ΄Π°Π΅ΡΡΡ Π²ΡΡΠ²ΠΈΡΡ Π΄Π°ΠΆΠ΅ ΠΏΠΎΡΠ»Π΅ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ½Π°Π»ΠΈΠ·ΠΈΡΡΡΡΡΡ Π²ΠΎΠΏΡΠΎΡΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ°, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½Ρ, ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΡΡΠΎΠΌΠ±ΠΎΠ·Π° ΠΠ ΠΈ ΠΠ‘
ΠΠ·Π°ΠΈΠΌΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΠΈ ΠΈ ΡΠ½Π° Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅
Sleep is a natural analgesic condition, due to both the processes of relative deafferentation and the influence of neurotransmitters and hormones. An important role in the pain reduction during sleep is a conduct impairment at the thalamus level and orexin activity suppression (neuropeptide involved in the regulation processes of excitation, Β«sleep-wakeΒ» cycle), and melatonin secretion increase. Night sleep disorder is accompanied by an increase in the frequency of various pain syndromes occurrence, both due to a reduction in the overall duration and because of the sleep continuity deterioration. Correction of the common sleep disorder - chronic insomnia - is accompanied by both an improvement in sleep itself and a decrease in concomitant pain. This is shown concerning cognitive behavioral therapy (CBT) - the choice method in chronic insomnia treatment. Some psychological mechanisms commonality of chronic pain syndromes and sleep disorders allows the use of a combined technique that affects both conditions. The pharmacological possibilities of improving sleep in chronic pain syndromes and combining CBT with pharmacotherapy are discussed. Combined techniques application both concerning the intervention direction and pharmacological and non-pharmacological approach combination is promising for improving sleep in pain syndromes and, as a result, for better pain management.Π‘ΠΎΠ½ ΡΠ²Π»ΡΠ΅ΡΡΡ Π΅ΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ±ΠΎΠ»Π΅Π²ΡΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ΠΌ, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΡΠΌ ΠΊΠ°ΠΊ ΠΏΡΠΎΡΠ΅ΡΡΠ°ΠΌΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ Π΄Π΅Π°ΡΡΠ΅ΡΠ΅Π½ΡΠ°ΡΠΈΠΈ, ΡΠ°ΠΊ ΠΈ Π²Π»ΠΈΡΠ½ΠΈΠ΅ΠΌ Π½Π΅ΠΉΡΠΎΠΌΠ΅Π΄ΠΈΠ°ΡΠΎΡΠΎΠ² ΠΈ Π³ΠΎΡΠΌΠΎΠ½ΠΎΠ². ΠΠ°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ Π² ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠΈ ΠΎΡΡΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΠΈ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΡΠ½Π° ΠΈΠ³ΡΠ°Π΅Ρ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π½Π° ΡΡΠΎΠ²Π½Π΅ ΡΠ°Π»Π°ΠΌΡΡΠ°, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎΠ΄Π°Π²Π»Π΅Π½ΠΈΠ΅ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΎΡΠ΅ΠΊΡΠΈΠ½Π° (Π½Π΅ΠΉΡΠΎΠΏΠ΅ΠΏΡΠΈΠ΄Π°, ΡΡΠ°ΡΡΠ²ΡΡΡΠ΅Π³ΠΎ Π² ΠΏΡΠΎΡΠ΅ΡΡΠ°Ρ
ΡΠ΅Π³ΡΠ»ΡΡΠΈΠΈ Π²ΠΎΠ·Π±ΡΠΆΠ΄Π΅Π½ΠΈΡ, ΡΠΈΠΊΠ»Π° Β«ΡΠΎΠ½ - Π±ΠΎΠ΄ΡΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠ΅Β») ΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠ΅ΠΊΡΠ΅ΡΠΈΠΈ ΠΌΠ΅Π»Π°ΡΠΎΠ½ΠΈΠ½Π°. ΠΠ°ΡΡΡΠ΅Π½ΠΈΠ΅ Π½ΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ½Π° ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ°ΡΡΠΎΡΡ Π²ΡΡΡΠ΅ΡΠ°Π΅ΠΌΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π²ΡΡ
ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠ² ΠΊΠ°ΠΊ ΠΈΠ·-Π·Π° ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΡ ΠΎΠ±ΡΠ΅ΠΉ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ, ΡΠ°ΠΊ ΠΈ ΠΈΠ·-Π·Π° ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΡ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΡΡΠΈ ΡΠ½Π°. ΠΠΎΡΡΠ΅ΠΊΡΠΈΡ ΡΠ°ΠΌΠΎΠ³ΠΎ ΡΠ°ΡΡΠΎΠ³ΠΎ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π° ΡΠ½Π° - Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠ½ΡΠΎΠΌΠ½ΠΈΠΈ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΈ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠ΅ΠΉ Π±ΠΎΠ»ΠΈ. ΠΡΠΎ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎ-ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠΠ’) - ΠΌΠ΅ΡΠΎΠ΄Π° Π²ΡΠ±ΠΎΡΠ° Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠ½ΡΠΎΠΌΠ½ΠΈΠΈ. ΠΠ±ΡΠ½ΠΎΡΡΡ Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² Ρ
ΡΠΎΠ½ΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ Π±ΠΎΠ»Π΅Π²ΡΡ
ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠ² ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΡΠ½Π° ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΡ, Π²Π»ΠΈΡΡΡΡΡ Π½Π° ΠΎΠ±Π° ΡΠΎΡΡΠΎΡΠ½ΠΈΡ. ΠΠ±ΡΡΠΆΠ΄Π°ΡΡΡΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΠ½Π° ΠΏΡΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Π±ΠΎΠ»Π΅Π²ΡΡ
ΡΠΈΠ½Π΄ΡΠΎΠΌΠ°Ρ
ΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ ΠΠΠ’ Ρ ΡΠ°ΡΠΌΠ°ΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΠΊΠ°ΠΊ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΡΡΠΈ ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΈ, ΡΠ°ΠΊ ΠΈ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ Π½Π΅ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ Π΄Π»Ρ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΠ½Π° ΠΏΡΠΈ Π±ΠΎΠ»Π΅Π²ΡΡ
ΡΠΈΠ½Π΄ΡΠΎΠΌΠ°Ρ
ΠΈ, Π² ΠΈΡΠΎΠ³Π΅, Π΄Π»Ρ Π»ΡΡΡΠ΅Π³ΠΎ ΡΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ ΡΠ°ΠΌΠΎΠΉ Π±ΠΎΠ»ΡΡ
Neurological alterations in insulinoma
[No abstract available
Neurophysiological assessment of persistent idiopathic facial pain
Objective. To study neurophysiological characteristics of persistent idiopathic facial pain (PIFP) in comparison to trigeminal neuralgia. Material and methods. Forty-five patients with PIFP at the age from 25 to 74 years (42 women and 3 men), 25 patients with trigeminal neuralgia at the age from 25 to 84 (15 women and 10 men) and 20 healthy volunteers were examined. Multimodal evoked potentials (EP): brainstem auditory (BAEPs), trigeminal (TEPs) and sympathetic skin responses (SSRs) evoked potentials were recorded. EEG with functional tests (hyperventilation, rhythmical photic stimulation and test with eye opening) was recorded as well. Results. The neurophysiological pattern of PIFP includes: 1) shortening of the latent period (LP) and an increase in peak amplitudes of short-latent components of the BAEPs on both sides in combination with signs of brainstem structure dysfunction (fusion of IIβIII or IIIβIV peaks, bifurcation of peaks and lengthening of inter-peaks intervals); 2) normal parameters of the TEPs; 3) an increase in the amplitude of autonomic components (sympathetic and parasympathetic without signs of predominance of the tone of this or that system), intensification of the autonomic reaction; 4) disorganization and acuity of the alpha rhythm, smoothing of zonal differences, presence of bilateral tapering alpha-, theta-or alpha-theta waves on the EEG. Conclusion. Patients with PIFP have significant changes in EP and EEG connected with brainstem structure dysfunction and irritation of subcortical structures and autonomic disorders. Β© 2018, Media Sphera Publishing Group. All rights reserved
Follow-up study of the patients operated for traumatic subdural hematomas
In 56 patients operated for traumatic subdural hematomas clinical manifestations were analysed (8 main syndromes of the remote period) as well as the degree of neurologic rehabilitation and the level of social-occupational adaptation. Such adaptation appeared to be rather high: 66,1% of the patients were able to resume work. The highest lethality was in the acute period; the worst rehabilitation and follow-up adaptation were observed in elderly and old patients who were in comatose state before the operation and had severe accompanying contusion of the brain. Policy of drug treatment was determined in patients with traumatic subdural hematomas regarding peculiarities and manifestations of the syndromes (urgent operation, if necessary - cranioplasty, psychologic support in the remote period, resorption therapy and symptomatic drugs)
To the 100th anniversary of the birth of professor yu.S. martynov
The article is dedicated to the 100th anniversary of the birth of a prominent Soviet and Russian neurologist, professor, doctor of medical sciences Yuri Stepanovich Martynov. The article reflects the life of Yu.S. Martynov: his participation in the Great Pa-triotic War, subsequent scientific, medical and pedagogical activities. The authors highlight the contribution of Yu.S. Martynov and his school in the creation and development of new directions in neurology and clinical medicine. Β© 2021, Media Sphera Publishing Group. All rights reserved