Transient cerebrovascular accident

PNMK make up about 20-30% among patients with stroke in hospitals and 46% in polyclinics. According to the data of Yu. A. Varakin (1990), among men aged 20-54, the proportion of PNMK is 25%. At the same time, in more than a quarter of cases of PNMC are the debut of various latently occurring cerebrovascular diseases.

The main reasons include:

• Hypertonic disease
• Symptomatic hypertension
• Atherosclerosis

Much less often, the cause of PNMK can be:

• Vasculitis in diffuse connective tissue diseases
• Heart diseases (malformations, mitral valve prolapse, myocardial infarction )
• Osteochondrosis of the cervical spine (vertebral artery syndrome, usually in combination with its atherosclerotic lesion)

• Acute violation of autoregulation of cerebral circulation, spasm of cerebral vessels with blood stasis in the capillaries and venous stasis (the main mechanism of hypertensive crisis).
• Microthrombi , microemboli with perifocal edema (against the background of atheromatous plaques, cell accumulations in the face of changes in the aggregation properties of blood).
• Transient vascular cerebral insufficiency - local ischemia with thrombosis or obliteration of the cerebral vessel in case of continued possibility of replacement blood supply in the vilizium circle . One of the mechanisms is the phenomenon of "robbery" due to retrograde outflow of blood from the collateral vessels of the brain to the distal parts of the occluded vessel, most often with subclavian syndrome .
• Stenosis of the main vessels of the head and their branches in the face of a drop in blood pressure ( myocardial infarction , heart rhythm disturbance , blood loss ),
• Cerebral microhemorrhage with transient symptoms.

PNMCs include transient ischemic attacks, hypertensive cerebral crises, as well as some more rare forms of cerebral vascular disorders with unstable symptoms ^[1] . In particular, the WHO classification also includes short-term paroxysms such as fainting called “general cerebral dysfunction”. They occur in less than 5% of cases due to severe compression of the vertebral artery during sharp turns of the head.

Transient Ischemic Attack

An acute violation of cerebral circulation, manifested primarily by focal neurological symptoms, depending on the location of the lesion in a particular vascular pool. Duration - from several minutes to several hours. A more common household name is a microstroke.

Hypertensive cerebral crisis

A sudden and individual for each patient a significant increase in blood pressure, accompanied by the appearance or aggravation of previously existing cerebral, and often cardiac symptoms.

Transient cerebrovascular accident may accompany the following diseases:

• Cerebrovascular disease ( discirculatory encephalopathy )
• Head injury

Repeated PNMK are the basis for determining the II group of disability .

• Gusev E.I., Konovalov A.N., Burd G.S. Neurology and neurosurgery. M .: Medicine, 2000.
• Clinical neurology with the basics of medical and social expertise. SPb .: Medline-Media LLC, 2006.
• Skoromets A.A. , Skoromets A.P., Skoromets T.A. Nervous diseases. M .: MEDpress-inform, 2007.

• Encephalopathy
• Hypertensive cerebral crisis
• Transient ischemic attack
• Stroke