Diagnosis and treatment of chronic cerebral ischemia (clinical discussion)

Abstract

The article presents a clinical case of diagnosis and treatment of the initial presentations of chronic cerebral ischemia (CCI) in the form of cognitive impairments in a middle-aged patient. The authors describe such features of cognitive impairments (CI) as the predominance of «subcortical» symptoms (bradyfrenia, fluctuation), which is typical for CCI. The article presents modern approaches to the diagnosis of CCI, according to which it is necessary to focus on the assessment of higher brain functions, while the significance of «focal microsymptoms» is not large.  The article discusses the treatment issues of CCI, which should first include the achievement of the maximum possible control over the underlying vascular disease. It also provides the results of recent studies of the effectiveness of pathogenetic neurometabolic therapy for vascular CIs.