Cerebral small vessel disease — new ideas about chronic cerebral ischemia
https://doi.org/10.30629/0023-2149-2024-102-3-205-211
Abstract
Cerebral small vessel disease (CSVD) is a heterogeneous disease of the microcirculatory vessel bed, leading to the development of cognitive impairments, lacunar strokes, and intracerebral hemorrhages. The pathogenesis of CSVD is characterized by disturbances in the structure of the intercellular matrix of the vessel wall, resulting in the accumulation of pathological proteins, hyalinosis, necrosis, and increased permeability of the blood-brain barrier. Disease progression is associated with a decrease in the area of the microvascular bed, inflammatory processes, atrophy, and demyelination. The article presents a pathogenetic classification of CSVD, discusses principles of diagnosis and treatment. Special attention is given to promising approaches for managing patients with chronic small artery pathology. Principles for the use of vasodilators from various pharmaceutical groups are proposed and justified, along with discussions on the prospects of using systemic proteolytic enzymes and platelet anti-aggregants.
About the Authors
E. A. Shirokov
Russian New University, Center for Innovative Medicine;
Military Medical Academy named after S.M. Kirov (Moscow branch) of the Ministry of Defense of Russia
Russian Federation
Russian Federation
Evgeny A. Shirokov — Dr of Sci. (Med.), Professor, Consultant of the Center for Innovative Medicine of the Russian New University, Associate Professor of the Department of Emergency Treatment, Military Medical Academy named after S.M. Kirov (Moscow branch)
Moscow
О. A. Sapronenkova
Military Medical Academy named after S.M. Kirov (Moscow branch) of the Ministry of Defense of Russia
Russian Federation
Russian Federation
Olga A. Sapronenkova — Cand. of. Sci. (Med.), Associate Professor of the Department of Emergency Treatment
Moscow
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For citations:
Shirokov E.A., Sapronenkova О.A. Cerebral small vessel disease — new ideas about chronic cerebral ischemia. Clinical Medicine (Russian Journal). 2024;102(3):205-211. (In Russ.) https://doi.org/10.30629/0023-2149-2024-102-3-205-211
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