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Clinical manifestations and issues of diagnosis of chronic cerebrovascular disease (chronic cerebral ischemia) at an early (pre-dementia) stage

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The paper presents experts' opinion on the clinical manifestations and diagnosis of chronic cerebrovascular disease (CVD) (chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP)) at the pre-dementia stage. It is noted that DEP/CCI is a common diagnosis in Russian neurological practice, the criteria for which have not been updated for a long time. DEP/CCI most often develops in the presence of cerebral small artery (CSA) disease (cerebral microangiopathy (CMA)), the severity of which can be quantified by magnetic resonance imaging. The main clinical manifestation of DEP/CCI is cognitive impairment that may be subjective or moderate at the pre-dementia stage. Emotional disorders (apathy, depression, anxiety) and instability are considered as possible manifestations of CSA disease. It is noted that headache and vestibular vertigo are not caused by chronic CVD; while in patients with CMA, they are usually associated with other diseases (primary headache, peripheral vestibular vertigo, and vestibular migraine). The diagnosis of DEP/CCI should be based on the presence of cognitive impairment, reliable neuroimaging signs of CVD, and the exclusion of another cause of cognitive impairment.

About the Authors

A. A. Kulesh
Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation

Aleksey Aleksandrovich Kulesh

26, Petropavlovskaya St., Perm 614590

A. Yu. Emelin
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Russian Federation
6, Academician Lebedev St., Saint Petersburg 194044

A. N. Bogolepova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
1, Ostrovityanov St., Moscow 117997

O. B. Doronina
Novosibirsk State Medical University, Ministry of Health of Russia
Russian Federation
52, Krasnyi Prospect, Novosibirsk 630091

V. V. Zakharov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021

O. V. Kolokolov
V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia
Russian Federation
137, Bolshaya Sadovaya St., Saratov 410000

S. V. Kotov
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
61/2, Shchepkin St., Moscow 129110

L. L. Korsunskaya
S.I. Georgievsky Medical Academy, V.I. Vernadsky Crimean Federal University
Russian Federation
5/7, Lenin Boulevard, Simferopol 295051, Republic of Crimea

M. A. Kutlubaev
Bashkir State Medical University, Ministry of Health of Russia
Russian Federation
3, Lenin St., Ufa 450000

V. B. Laskov
Kursk State Medical University, Ministry of Health of Russia
Russian Federation
3, K. Marx St., Kursk 305000

O. S. Levin
Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia
Russian Federation
2/1, Barrikadnaya St., Build. 1, Moscow 125993

V. A. Parfenov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021


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For citation:

Kulesh A.A., Emelin A.Yu., Bogolepova A.N., Doronina O.B., Zakharov V.V., Kolokolov O.V., Kotov S.V., Korsunskaya L.L., Kutlubaev M.A., Laskov V.B., Levin O.S., Parfenov V.A. Clinical manifestations and issues of diagnosis of chronic cerebrovascular disease (chronic cerebral ischemia) at an early (pre-dementia) stage. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):4-12.

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