Method for the diagnosis of chronic vertebrobasilar insufficiency in adolescents undergoing natal injury of the cervical spine

 

The invention relates to medicine, namely to neurology. Conduct a comparative assessment of eographical index patients and healthy. Registration is carried out in occipito-mastoidal lead right and left hemispheres during the day. If no maximum value eographical index 11 and (or) 14 hours and right(or left hemisphere diagnose chronic vertebrobasilar insufficiency. The method reduces the time of the survey. 2 Il.

The invention relates to medicine, specifically to the field of neurology, and relates to methods for diagnosing chronic vertebrobasilar insufficiency (chronic VBN), developed on the background of the transferred Natal injuries of the cervical spine (sh.about.p.).

A known method for the diagnosis of various diseases by the method of rheoencephalography (REG). In particular, rheoencephalography studies were conducted in people with cerebral atherosclerosis [4, 2], hypertension [1] . Rheoencephalography studies are used to confirm the diagnosis of chronic vertebrobasilar insufficiency [6], however, the existing age limit indicator is on circulation during the day, adolescents, that is not possible in some cases to give a definite conclusion about the presence or absence of pathology vertebrobasilar basin brain. In the literature there are no data about the study of the information content of the daily changes of indices REG for the diagnosis of chronic VBN amid transferred Natal trauma sh.about.p.

The authors studied the dynamics of pulse blood filling the vertebrobasilar basin brain with the help of recanalization "REAN-131" (, Taganrog) by the standard method [3]. Investigated the performance of pulse blood supply to the brain: eographically index (RI) in occipito-mastodonia (Ω) lead, the most informative for this pathology [5], symmetrically in both hemispheres: in the course of the day every hour from 9 to 16 o'clock

The task of the invention is to provide a method of diagnosis, with simple, accessible, low cost.

This object is achieved by comparative evaluation of RI in patients and healthy, and the specified evaluation is carried out on both hemispheres in occipito-mastoidal lead, and in the absence of the maximum value of RI at 11 and (or) 14 hours and right (or left hemisphere diagnose chronic vertebrobasilar values RI OM in healthy children as right, and on the left are 11 and 14 hours, min values for 12 and 15 hours (Fig.1).

For clarity, the proposed diagnostic method we present specific examples of its implementation.

Example 1. Patient P. , aged 13 turned in 13.11.001, complaining of headaches, pain in the cervical-thoracic spine, fatigue, memory loss. During the inspection upon receipt of notice a decrease in muscle tone with pererazgibanie elbows and knees with a click. Tendon reflexes live "S">"d" with hands and feet, Pussep "S" and "d" (+). FMN - without features. Sluggish posture, round back, Cleopatra chest, smoothed waist, wing-shaped blades. The dramatic tension of the neck muscles, their pain on palpation. Pain in the spinous processes of the cervical and thoracic spine. On the radiograph revealed the presence of additional vertebrae in the cervical spine. On a routine REG marked asymmetry of pulse blood on fronto-mastoidectomy, occipito-mastoidectomy leads to the left within the boundaries of normal values, form REG curve without features, signs of difficulty of venous outflow is not revealed. Samples with turning and bowing the head - negative.

To assess the change of day from 9 to 16 hours every hour was measured indicators REG in occipito-mastoidal lead, which was used for the curves.

Changes of indices REG day wore asynchronous hemispheric in nature. Max value of RI OM had left for 15 hours, the right for 13 hours, min - 12 hours left and at 11 o'clock on the right, none of the peaks do not coincide with those of the healthy (Fig. 2.1).

Thus, the pathological form of the curves in figures RI Ω, reflecting the amplitude of the pulse of blood in vertebrobasilar basin, hidden confirmed the cerebral circulation with the appropriate clinical picture, i.e. the presence of chronic VBN amid transferred natality injury of the cervical spine.

Example. 2. Patient C., 10 years have seen a neurologist about moved perinatal lesions of the Central nervous system. Upon receipt 17.02.2001, complained of recurrent pain in the neck, headaches, morning and evening, weakness in the limbs. Muscle tone is reduced to reservatio in the elbow joint into place. Tendon reflexes "d"="S". FMN: flattened "S" nasolabial fold, installation horizontal nystagmus more pronounced right. The left shoulder is bigger than the right. Curvature of the spine of the first degree, a moderate voltage SANY plitude RI within age norms; not detected asymmetry of the pulse of blood, and signs of difficulty of venous outflow. In TH abstraction slightly increased rate of peripheral vascular resistance, the sample with the tilt of the head - positive.

To assess changes in pulse blood vertebrobasilar basin brain of the patient during the day from 9 to 16 hours every hour was measured indicators REG in occipito-mastoidal lead, which was used for the curves.

The curves of diurnal fluctuations RI Ω mostly had no hemispheric asymmetry, but differed in shape from the curves of healthy adolescents. So, max values accounted for 13 hours both right and left, min values to the left by 10 and 15 min values were right at 10, 11 o'clock displaced with respect to the performance curve of healthy children 8 and 10 hours (Fig.2.2).

Based on the results of studies in a patient found hidden vertebrobasilar failure, and analyzing the history and clinical picture, diagnosis: chronic vertebrobasilar insufficiency in the face forward Natal injuries of the cervical spine.

Example 3. The patient Was 12 years. Upon receipt 23.01.2002, complained golovyashkina: gait - normal muscle tone is moderately reduced. Tendon reflexes live "d"="S", abdominal reduced, Pussep (+) "d" and "S". FMN: horizontal nystagmus, more to the left, weak convergence, easy, deviation of the tongue to the right. The detected tension of the neck muscles, their tenderness, left lower right shoulder, smoothed waist to the right, the curvature of the spine to the right in the thoracic Department of the I degree. On the radiograph sh.about.p.: cervical lordosis is straightened, but is restored when the extension. When max flexion - abnormal mobility With3-4. The height of the intervertebral disc is not reduced. On a routine REG: the shape of the curve without features, amplitude RI is reduced, without asymmetry, signs of difficulty of venous outflow is not revealed. Samples with turning and bowing the head - negative.

For further diagnosis studied the changes of pulse blood filling the vertebrobasilar basin (RI Ω) during the day from 9 to 16 hours every hour.

Curves built on the amplitudes RI Ω, had no hemispheric asymmetry, but differed in shape from the curves of healthy adolescents. The average value of RI per day was lower than that in healthy adolescents from both sides. The maximum and minimum values was not significantly different from the environments to the absence of extreme values. On the basis of the conducted studies and comparison with the clinical picture diagnosis: chronic vertebrobasilar insufficiency in the face forward Natal injuries of the cervical spine.

Example 4. The patient Was 10 years. Upon receipt 24.12.2001, complained of pain and "crunch" in the neck when turning head, reduced vision, incontinence, weakness in the legs, instability of mood. Examination: normal gait, muscle tone is moderately reduced. Tendon reflexes live "d"="S". FMN: flattened "S" nasolabial fold, easy installation nystagmus in both directions. The head tends to the right. When turning the head, crunching into the sh.about.p., power in the hands reduced. The detected tension of the neck muscles more to the left, their tenderness to palpation. Curvature of the spine in the thoracic spine to the right of the I degree. On the radiograph: instability With3-4. On REG: the shape of the curve with signs of increased peripheral vascular resistance, the signal amplitude is within the age norm, minor hemispheric asymmetry. Samples with head turns positive.

To assess changes in pulse blood vertebrobasilar basin brain patient is which was used for the curves (Fig.2.4).

Revealed that the average value of RI for the day either on the right or on the left was higher than the value in healthy adolescents. Maximum values were left at 10 and 14 hours, the minimum value is 13 hours. To the right of the maximum value detected in 10 and 13 hours, and the minimum is 14 hours. Thus, the patient, at 10 o'clock occurred simultaneous increase in RI that does not coincide with the first maximum value in healthy adolescents. The second maximum peak on the left was 14 hours and coincided with those of the healthy, and the right one was out of phase with them.

Clinical data, the results of radiographic studies and routine REG confirm that the identified differences in dynamics of RI during the day patients, and healthy children due to the presence of hidden vertebrobasilar insufficiency in the face forward Natal trauma sh.about.p.

The proposed diagnostic method is applied at 23 and 35 healthy adolescent patients 10 to 15 years, of which 20 people were already confirmed diagnosis of chronic vertebrobasilar insufficiency in the face forward Natal injuries of the cervical spine, and 15 children, the diagnosis was detected for the first time.

When examining the proposed method villablino a mismatch max and min values of RI in occipito-mastoidal lead on the right and (or) the left side with the same indicators in the group of healthy adolescents.

Thus, the results obtained indicate the possibility of using the proposed method, namely about the study eographical index in occipito-mastoidal lead REG symmetrically in both hemispheres during the day every hour from 9 to 16 hours to diagnose in children hidden VBN amid transferred Natal injuries of the cervical spine references 1. L. D. Ugulava. Bioritmologicheskikh the formation of compensatory-adaptive reactions in the clinical model of stress. Abstract of thesis. Dr. Biol. of Sciences, Tomsk, TMI, 1999, 28 S.

2. F. I. Komarov, Y. A. Romanov, N. And.The mosaic. The bases of bioenergetics - a new trend in biomedical science and practice. //Chronobiology and the bases of bioenergetics. /Ed. by F. I. Komarova. - M.: Medicine, 1989. - S. 5-17.

3. L. P. Zenkov, M. A. Ronkin. Functional diagnosis of nervous diseases. - M.: Medicine, 1991. - 640 S.

4. I. E. Orange. Natural curative factors and biological rhythms. Moscow: Medicine, 1988, 286 S.

5. A. J. Ratner. Generic spinal cord injury in children. Ed. Kazan University, 1978, 216 S.

6. A. J. Ratner. Violations of cerebral circulation in children. Ed. Kazan University, 1983, 144 S.

 

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FIELD: medicine.

SUBSTANCE: method involves recording rheogram from feet and legs lifted and fixed at an angle of 45є. Then, rheogram is recorded on inhaling from legs directed vertically downward. Functional blood circulation reserve index is calculated as product of results of dividing and subtracting rheographic indices recorded under conditions of lifted and lowered extremities that means under conditions of functional venous system relief and venous hypertension, respectively.

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1 ex, 1 tbl

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FIELD: medicine.

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EFFECT: wide range of functional applications.

2 tbl

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