Cerebral vasomotor reactivity in patients with discirculatory hypertensiveencephalopathy and cerebral hypoperfusion risk

Aim. To study cerebral vasomotor reactivity (CVR) in patients with chronic cerebrovascular disturbances caused by arterial hypertension (AII) and to d etermine Criteria of cerebral hypoperfusion risk during antihypertensive th erapy. Material and methods. 80 patients with chronic cerebrovascular disturbances because of AH and 15 normotensive subjects without any neurological pathol ogy (control group) were examined using CT of the brain, duplex scanning of extra- and intracranial arteries, echocardiography. CVR was assessed with transcranial dollperography of the blood flow velocity in both middle cereb ral arteries before and after nitroglycerine provoked test. Results. CVR in the patients significantly differed from that of the contro ls. Main factors responsible for changes in CVR ara the age, form and durat ion of arterial hypertension, circadian rhythm of blood pressure, occlusive extra- or intracranial arteries disease. CT signs of focal (lacunes) or di ffuse (leukoaraiosis) ischemic brain damage, deformations of the neck vesse ls, left ventricular hypertrophy tray be leading markers of severe disturba nces in CVR. Conclusion. In patients with chronic cerebrovascular disease disturbances o f CVR arise due to arterio/ arteriolopathy as a result of AN. Limitation of the vasodilatation potential demonstrates cerebral autoregulation dysfunct ion. Thus, factors and markers of CVR impairment can be considered as risk criteria of cerebral hypoperfusion during inadequate antihypertensive treat ment.