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Headache in elderly patients with chronic cerebral ischemia: outpatient diagnosis and treatment

https://doi.org/10.14412/2074-2711-2018-1-102-106

Abstract

Chronic cerebral ischemia (CCI) is one of the most common diagnoses in middle-aged and elderly patients in the practice of an outpatient neurologist. Unfortunately, the diagnosis of CCI in these patients is often established only on the basis of complaints of headache, dizziness, instability during walking, and lower mood. At the same time, other diseases that cause these symptoms are not diagnosed, patients do not receive treatment, which considerably worsens quality of life and leads to anxiety and depression.

A variety of diseases, such as headache, peripheral vestibular vertigo, depression, Alzheimer's disease, and Parkinson's syndrome, are frequently hidden under the diagnosis of CCI. The leading neurological syndrome in CCI is cognitive impairment that can be both moderate and reach the level of dementia. Approximately 40% of patients with chronic cerebrovascular disease complain of headache that is usually caused by mixed primary headache. The management tactics for a CCI patient suffering from headache is aimed at treating primary headache, modifying vascular risk factors, and managing cognitive impairment. The paper discusses the use of choline alphoscerate in patients diagnosed with CCI. 

About the Authors

M. P. Platov
City Polyclinic Forty-Six, Moscow Healthcare Department
Russian Federation
17A, Kazakov St., Build. 1, Moscow 105064


O. V. Kosivtsova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery, 

11, Rossolimo St., Moscow 119021



References

1. Парфенов ВА, Неверовский ДВ. Ведение пациентов с дисциркуляторной энцефалопатией в амбулаторной практике. Неврология, нейропсихиатрия, психосоматика. 2015;7(1):37-42. [Parfenov VA, Neverovskii DV. Outpatient management of patients with dyscirculatory encephalopathy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(1): 37-42. (In Russ.)]. doi: 10.14412/2074-2711-2015-1-37-42

2. Самородская ИВ, Андреев ЕМ, Заратьянц ОВ и др. Показатели смертности населения старше 50 лет от цереброваскулярных болезней за 15-летний период в России и США. Неврология, нейропсихиатрия, психосоматика. 2017;9(2):15-24. [Samorodskaya IV, Andreev EM, Zarat'yants OV, et al. Cerebrovascular disease mortality rates in the population over 50 years of age in Russia and the USA over a 15-year period. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(2):15-24. (In Russ.)]. doi: 10.14412/2074-2711-2017-2-15-24

3. Яхно НН, Левин ОС, Дамулин ИВ. Сопоставление клинических и МРТ-данных при дисциркуляторной энцефалопатии. Сообщение 1: двигательные нарушения. Неврологический журнал. 2001;6(2):10-6. [Yakhno NN, Levin OS, Damulin IV. Comparison of clinical and MRI data in dyscirculatory encephalopathy. Message 1: motor disorders. Nevrologicheskii zhurnal. 2001;6(2): 10-6. (In Russ.)].

4. Яхно НН, Захаров ВВ, Локшина АБ и др. Деменции. Москва: Медпресс-информ; 2011. [Yakhno NN, Zakharov VV, Lokshina AB, et al. Dementsii [Dementias]. Moscow: Medpress-inform; 2011].

5. Парфенов ВА. Дисциркуляторная энцефалопатия и сосудистые когнитивные расстройства. Москва: ИМА-ПРЕСС; 2017. [Parfenov VA. Distsirkulyatornaya entsefalopatiya i sosudistye kognitivnye rasstroistva [Dyscirculatory encephalopathy and vascular cognitive disorders]. Moscow: IMA-PRESS; 2017].

6. Головачева ВА, Парфенов ВА, Табеева ГР, и др. Оптимизация ведения пациентов с хронической ежедневной головной болью. Журнал неврологии и психиатрии им. С.С. Корсакова. 2017;117(2):4-9. [Golovacheva VA, Parfenov VA, Tabeeva GR, et al. Optimization of management of patients with chronic daily headache. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2017;117(2):4-9. (In Russ.)].

7. Hagen K, Stovner LJ, Vatten L, et al. Blood pressure and risk of headache: a prospective study of 22 685 adults in Norway. J Neurol Neurosurg Psychiatry. 2002 Apr;72(4):463-6.

8. Осипова ВВ, Табеева ГР. Первичные головные боли. Практическое руководство. Москва: МИА; 2014. [Osipova VV, Tabeeva GR. Pervichnye golovnye boli. Prakticheskoe rukovodstvo [Primary headache. Practical guide]. Moscow: MIA; 2014.]

9. Bigal ME, Bordini CA, Speciali JG. Etiology and distribution of headaches in two Brazilian primary care units. Headache. 2000 Mar;40(3):241-7.

10. Maizels M, Burchette R. Rapid and sensitive paradigm for screening patients with headache in primary care settings. Headache. 2003 May;43(5):441-50.

11. Shea AM, Reed SD, Curtis LH, et al. Characteristics of nontraumatic subarachnoid hemorrhage in the United States in 2003. Neurosurgery. 2007 Dec;61(6):1131-7; discussion 1137-8.

12. Linn J, Fesl G, Ottomeyer C, et al. Intraarterial application of nimodipine in reversible cerebral vasoconstriction syndrome: a diagnostic tool in select cases? Cephalalgia. 2011 Jul; 31(10):1074-81. doi: 10.1177/0333102410394673. Epub 2011 Jan 10.

13. Hoving JW, Marquering HA, Majoie CBLM. Endovascular treatment in patients with carotid artery dissection and intracranial occlusion: a systematic review. Endovascular treatment in patients with carotid artery dissection and intracranial occlusion: a systematic review. Neuroradiology 2017;59:641.

14. Barbagallo SG, Barbagalio M, Giordano M, el al. Glycerophosphocholine in the mental recovery of cerebral ischemic attacks. An Italian multicenter clinical trial. Ann N Y Acad Sci. 1994 Jun 30;717:253-69.

15. Scapicchio PL. Revisiting choline alphoscerate profile: a new, perspective, role in dementia? Int J Neurosci. 2013 Jul;123(7): 444-9. doi: 10.3109/00207454.2013.765870. Epub 2013 Feb 19.


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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)