nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2019-3S-4-17nnp-1128Research ArticleLECTURESЛЕКЦИЯCerebral small vessel disease: classification, clinical manifestations, diagnosis, and features of treatmentЦеребральная болезнь мелких сосудов: классификация, клинические проявления, диагностика и особенности леченияКулешА. А.KuleshA. A.

614990, Пермь, ул. Петропавловская, 26

26, Petropavlovskaya St., Perm 614990

aleksey.kulesh@gmail.comДробахаВ. Е.DrobakhaV. E.

614990, Пермь, ул. Петропавловская, 26

26, Petropavlovskaya St., Perm 614990

ШестаковВ. В.ShestakovV. V.

614990, Пермь, ул. Петропавловская, 26

26, Petropavlovskaya St., Perm 614990

ФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера» Минздрава РоссииРоссияAcad. E.A. Vagner Perm State Medical University, Ministry of Health of RussiaRussian Federation201922062019113SСпецвыпуск: когнитивные нарушения, цереброваскулярные заболевания417Copyright © Kulesh A.A., Drobakha V.E., Shestakov V.V., 20192019Кулеш А.А., Дробаха В.Е., Шестаков В.В.Kulesh A.A., Drobakha V.E., Shestakov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1128

The paper considers the relevance of the problem of cerebral small vessel disease (CSVD) that is an important cause of ischemic and hemorrhagic stroke, associated with the development of cognitive impairment and complications of antithrombotic therapy. It presents briefly the current issues of etiology and pathogenesis of the disease. Sporadic non-amyloid microangiopathy, cerebral amyloid angiopathy, and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are discussed in detail from the point of view of their clinical presentation, neuroimaging, and features of therapeutic tactics. An algorithm for diagnosing CSVD in patients admitted to hospital for stroke and a differentiated approach to their treatment are proposed. Consideration of the neuroimaging manifestations of CSVD is noted to be necessary for the safe and more effective treatment of patients with cerebrovascular diseases.

В статье рассматривается актуальность проблемы церебральной болезни мелких сосудов (ЦБМС), которая служит важной причиной ишемического и геморрагического инсульта, сопряжена с развитием когнитивных нарушений и осложнений антитромботической терапии. Кратко представлены актуальные вопросы этиологии и патогенеза заболевания. С точки зрения клинической картины, нейровизуализации и особенностей терапевтической тактики подробно обсуждены спорадическая неамилоидная микроангиопатия, церебральная амилоидная ангиопатия и церебральная аутосомно-доминантная артериопатия с субкортикальными инфарктами и лейкоэнцефалопатией (CADASIL). Предложены алгоритм диагностики ЦБМС у пациентов, поступивших в стационар с инсультом, и дифференцированный подход к их лечению. Отмечается, что учет нейровизуализационных проявлений ЦБМС необходим для безопасного и более эффективного лечения пациентов с цереброваскулярными заболеваниями.

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The authors declare that there are no conflicts of interest present.