nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2019-3S-61-67nnp-1135Research ArticleREVIEWSОБЗОРЫVascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy)Сосудистые когнитивные нарушения и хроническая ишемия головного мозга (дисциркуляторная энцефалопатия)ПарфеновВ. А.ParfenovV. A.

кафедра нервных болезней и нейрохирургии лечебного факультета,

119021, Москва, ул. Россолимо, 11, стр. 1

Department of Nervous System Diseases and Neurosurgery, Faculty of General Medicine, 

11, Rossolimo St., Build. 1, Moscow 119021

vladimirparfenov@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation201923062019113SСпецвыпуск: когнитивные нарушения, цереброваскулярные заболевания6167Copyright © Parfenov V.A., 20192019Парфенов В.А.Parfenov V.A.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/1135

The paper reviews the literature on vascular cognitive impairment (VCI), the diagnosis widely used in foreign neurological practice, as well as chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP), the common diagnoses in Russian neurological practice. According to the etiology, risk factors, and manifestations, Stages I and II DEP largely corresponds to moderate VCI; Stage III DEP does to severe VCI. The results of the author’s studies show that a considerable proportion of patients followed up with a diagnosis of CCI, DEP, have no signs of chronic cerebrovascular disease (CVD), but suffer from primary or secondary headache, vertigo of various origins, emotional disorders, and other diseases. The diagnosis of CCI, DEP should be based on the presence of CCI, the reliable neuroimaging signs of chronic CVD, and the ruling out of other diseases. When treating and preventing VCI, CCI, and DEP, a premium is placed upon both non-drug (regular physical activity, smoking cessation, rational nutrition) and drug therapy aimed at normalizing blood pressure and blood lipid spectrum, preventing blood clots, and improving cognitive functions.

Представлен обзор литературы, посвященной сосудистым когнитивным нарушениям (СКН) – диагнозу, широко используемому в зарубежной неврологической практике, а также хронической ишемии головного мозга (ХИГМ) и дисциркуляторной энцефалопатии (ДЭП) – распространенным в отечественной неврологической практике диагнозам. По этиологии, факторам риска и проявлениям ДЭП I и II стадий во многом соответствует умеренным СКН, ДЭП III стадии – выраженным СКН. Результаты собственных исследований показывают, что значительная часть пациентов, наблюдаемых с диагнозом ХИГМ, ДЭП, не имеют признаков хронического цереброваскулярного заболевания (ЦВЗ), а страдают первичной или вторичной головной болью, головокружениями различного генеза, эмоциональными расстройствами и другими заболеваниями. Диагностика ХИГМ, ДЭП должна основываться на наличии СКН, достоверных нейровизуализационных признаков хронического ЦВЗ и исключении других заболеваний. В лечении и профилактике СКН, ХИГМ, ДЭП ведущее значение отводится как нелекарственным методам (регулярная физическая активность, отказ от курения, рациональное питание), так и лекарственной терапии, направленной на нормализацию артериального давления и липидного спектра крови, предупреждение образования тромбов и улучшение когнитивных функций.

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