Angelov, T.

Minchev, D.

Zlateva, G.

English

Varna Medical University Press: Journals

C L I N I C A L , E L E C T R O E N C E P H A L O G R A P H I C AND R H E O E N C E P H A L O G R A P H I C CORRELATIONS IN R E L A T I V E S OF S T R O K E PATIENTS D. Minchev, G. Zlateva, T. Angelov Key-words: stroke —heredity —clinics—electroencephalography — rheoencephalography Heredity has a determining importance for the appearance of the vascular diseases of the nervous system. It is established that cerebral atherosclerosis and its neurological complications occur two-three times more frequently in relatives of stroke patients (2, 3, 5). Besides, changes bf B E A and brain hemodynamics are observed in members of families with stroke patients (2, 6, 7). Pathological abnormalities of lipid metabolism (8) followed by viscosity and hemocoagula-tion disturbances play an important role in tliis complex of investigation pur-poses (10, 11). The aim of the present work was to carry out clinico-laboratory studies with relatives of stroke patients and to look for correlations between the subjective complaints, bioelectrical and hemodynamic cerebral changes and elevated bio-chemical parameters. Material and methods A total of 40 relatives of stroke patients, of different age and sex were cl ini-cally and by E E G and R E G studied. Their lipid profile was specified, too. The results obtained were compared with those from 30 healthy control individuals without any hereditary predisposition concerning vascular diseases of the nerv-ous system. Results and discussion In all the patients studied subjective complaints cculd be revealed. Ther analysis showed the greatest relative part of headache (in 32 cases) followed by that of vertigo (24 ones), buzzing (10 ones), easy fatigueness (18 ones), memory disorders (16 ones). Both characteristic and intensity of complaints varied in relation with the age distribution. Variations were noted by +up to + + + ac-cording to intensity (table 1). In the opinion of some authors (3—5) these symp-toms were associated with initial subjective manifestations of an insufficiency of the cerebral circulation. We established an increased systolic blood pressure (150—160 mm Hg) in 16 patients which was combined with a diastolic pressure increase (100—110 mm Hg) in 28 ones. Other investigators (2, 10) consider simil-ar data a risk factor for the development of an acute insufficiency of the cerebral circulation. We also studied the lipid metabolism, namely cholesterol (after Liebermann-Burhard; normal value 4.62—6.46 mol/1); beta-lipoproteins (after Burstein; normal value 0—45 U) , and total fats (phosphovanilic solution; normal value 4—8 g/1). Then we compared the data obtained with those from the control per-sons (table 2). Clinical, electroencephalographic and. 67 T a b l e 1 Age distribution of the clinical manifestations Age groups Number Headache Vertigo Buzzing Memory decreasing Work capacity decreasing + ++ +++ 20—30 10 31—40 18 41—50 12 2 — 9 3 10 2 10 3 5 - 3 7 11 6 3 9 3 7 12 9 3 5 3 7 14 8 T a b l e 2 Biochemical investigations Age groups Number j Blood sugar Total fats Cholesterol ^-lipoproteins i norm. J pathol. norm. pathol. norm, j pathol. norm. pathol. 20—30 31—40 41—50 10 18 12 7 11 10 It was obvious that in patients' relatives there was a predisposition towards ypercholecterolemia, hyperbetalipoproteinemia and an increase of the total ats that was statistically significant (p<0.001) thus confirming the point of view bout their importance at young age in relation to the development of early athe-"sclerotic vascular lesions (1 , 3, 8). Dynamic E E G follow-up demonstrated a background recording of desyn-ronized B E A with not lavishly dispersed teta-waves and decreased reactivity uring functional tests. These results were obtained with patients having consi-erable subjective complaints, blood pressure changes and abnormalities of bio-T a b l e 3 R E G and E E G indexes in patients' relatives and healthy persons R E G and E E G indexes Persons examined FMA (Q) FM a (sec) FM a (%) a-f-p FMDI (%) FMHC (ml/min) E E G F I atients' latives "ealthy rsons 0.108 0.102 15.4 38.8 235.2 9.8 - 0 . 0 1 1 —0.013 - 0 . 1 1 - 1 . 1 - 1 . 1 +0.11 0.098 0.097 11.05 25.5 335 8.6 - 0 . 0 1 2 - 0 . 0 1 1 ± 0 . 1 3 - 0 . 1 - 2 . 1 - 0 . 1 2 egend: <0.001 MA — frontomastoid amplitude MD1 — frontomastoid dicrotic index MHC — frontomastoid hemispheric circulation I — frequency index 68 D. Minchev, G . Zlateva, T. Angelov chemical indexes. They, therefore, testified to dysfunction of mesodiencephalic brain structures (9), an important pathogenetic factor for development of hyper­tension and cerebral vascular complications. The rheoencephalographic examination of patients' relatives and of control individuals showed the following hemodynamic disorders (see table 3). When we compared REG-indices of patients' relatives with those of healthy controls we ascertained signs of a decreased blood supply index in the pool of the intern­al carotid artery or of the vertebro-basilar system accompanied by an increased vascular tone of spastic type and by an altered brain vessel reactivity. These data were an addition to the concepts about the state of collateral circulation (2, 6). Our data summarized from the clinical, biochemical and electrophysiolo­gical investigations performed propose criteria for the early objectivization of risk factors in stroke patients' relatives with a view to their timely prophylaxis. R E F E R E N C E S 1. А к и м о в , Г. А. Начальные проявления сосудистых заболеваний головного мозга. М., Медицина, 1983, 5 8 — 6 5 . - 2 . Б о г о л е п о в, Н. К- В. Е. Г р е ч к о , В. М. К у з м и н . В: Вопросы клинической неврогенетики. М., Медицина, 1973, 38—49.— 3. Б у р ц е в , Е. М. Нарушение мозгового кровообращения в молодом возрасте. М. , Медицина, 1978, 168—175. — 4. Д а в и д е н к о в а, Е. Ф. , Н. К о л о с о в а , 3 . М. М а -л а в и е в а . Наследственные факторы в развитии церебральных инсультов. М., Медицина, 1976.—5. М и с ю к , Н. С , А. Е. С е м а к , Е. Г. Г р и ш к о в . Мозговой инсульт — прогнозирование и профилактика. М. , Медицина, 1980, 14—72. — 6. Х у б е н о в , П. Автореф. докт. дис. Варна , 1977.—7. Т у т е н , Ю. С Ж . невропатол. и психиатр., 1975, № 8, 1170—1173. — 8 . В l o c h , R. , N . B a y e r . Clin. Orthop. Relat Res., 131, 1978, 4. — 9 . H o l m e s , G . L . Clin. ЕEG, 11, 1980, 2. — 10. R a b k i n, S. W. , et al . Ann. Intern. Med., 89, 1978, 1. — 11. T o h g y , A . , H . J a n i a no u с h i . Stroke, 9, 1978, 4. КЛИНИЧЕСКИЕ, ЭЛЕКТРОЭНЦЕФАЛОГРАФИЧЕСКИЕ | 1 | И РЕОЭНЦЕФАЛОГРАФИЧЕСКИЕ КОРРЕЛЯЦИИ У РОДСТВЕННИКОВ | 1 БОЛЬНЫХ С МОЗГОВЫМ ИНСУЛЬТОМ Д. Минчев, Г. Златева, Т. Ангелов Р Е З Ю М Е ! ' • 1 1 | | I Сорок родственников (сыновей и дочерей) больных с мозговым инсультом были исследо­ваны клинически, электроэнцефалографически, реоэнцефалографически, проведено также исследование липидного профиля, с целью обнаружить ранние клинико-лабораторные кри­терии начального этапа сосудисто-мозговой недостаточности. Полученные результаты были сопоставлены с соответствующими результатами контролной группы из 30 здоровых лиц без наследственной отягощенности заболеваниями сосудов. У всех родственников были установлены субъективные жалобы на головную боль, головокружение, быструю утомляе­мость, а также пониженные возможности памяти и повышенное диастолическсе кровяное давление. ЭЭГ-картина показывает данные о дисфункции мезодиэнцефальных мозговых структур, а на РЭГ снижен индекс кровенаполнения и спастично повышен тонус глобаль­ного ОМ и регионарного ОМ отведений. Полученные статистически значимые результаты корреспондируют с патологическими отклонениями в липидном обмене и представляют собой прогностические критерии при раннем диагностицировании мозговой сосудистой недостаточности. 

CLINICAL, ELECTROENCEPHALOGRAPHIC AND RHEOENCEPHALOGRAPHIC CORRELATIONS IN RELATIVES OF STROKE PATIENTS

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CLINICAL, ELECTROENCEPHALOGRAPHIC AND RHEOENCEPHALOGRAPHIC CORRELATIONS IN RELATIVES OF STROKE PATIENTS

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