CEREBROVASCULAR DISORDERS: TYPICAL AND UNUSUAL CLINICAL PROBLEMS

Abstract

There is a big number of patients with chronic brain ischemia both among in-patients and out-patients seen by neurologists. This is a typical clinical situation. Retino-cochleo-cerebral vasculopathy (also called Susac syndrome) is a rare autoimmune disorder affecting brain vessels, the 8th cranial nerve and retina. Chronic brain ischemia usually manifests as cognitive decline, affective (emotional) disorders and focal neurological signs. We studied a “portrait” of patients with chronic brain ischemia, admitted to the hospital As in-patient of rehabilitation unit. Here we present the typical case using as an example cerebral ischemic conditions and unusual ones describing retino-cochleo-cerebral vasculopathy as one of the conditions from the group of primary angiitis of central nervous system in adults. All the case were observed by us in neurological and neurorehabilitation wards. It is a pilot project with 43 patients as the total number of patients included into this study. Their mean age was 62.8 years. The mean duration of in-patient observation was 14 days at the hospital. In this paper we discuss the clinical characteristics of our cohort of patients. The least affected here was the short-term memory for numbers. The most affected domain included emotions, anxiety, and depression. We followed this situation in most of our cases. The unusual clinical case of Susac syndrome in a male patient of 59 years is described. The diagnosis was confirmed using modern instrumental tests such as magnetic-resonance tomography and fluorescent angiography of eye retina.