CEREBRAL VENOUS HEMODYNAMICS PECULIARITIES IN PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA OF VERTEBROGENIC ORIGIN

Authors:

Abstract:

The purpose of the study was to evaluate both venous hemodynamics and cerebrovascular reactivity in patients with chronic cerebral ischemia of vertebrogenic nature. 66 patients with vertebrogenically caused chronic cerebral ischemia were randomized into clinical group I with compensated chronic cerebral ischemia and group 2 with subcompensated chronic cerebral ischemia. Relatively healthy people composed the control group. Cerebral veins were examined using ultrasound with vertebral vein maximum blood flow velocity, Rosenthal basal veins, and direct sinus blood flow determination. Cerebral venous reactivity together with pain intensity were also established. Cephalalgia, mainly combined with cervicalgia, was the most significant clinical symptom in patients with chronic cerebral ischemia. Patients with subcompensated chronic cerebral ischemia demonstrated a significant increase in venous blood flow through vertebral veins and direct sinus. The investigated patients also revealed significant hyporeactivity. Significant hyperreactivity to antiorthostatic load in the direct sinus was registered in both groups of patients. The data obtained revealed that cervicogenic headache is one of the most common clinical syndromes in patients with chronic cerebral ischemia of vertebrogenic origin. The clinical manifestation of chronic cerebral ischemia is accompanied by venous blood flow in the vertebral veins and a significant increase in direct sinus, with an emphasis in subcompensated patients. The authors conclude that hyperreactivity to antiorthostatic loading in the direct sinus is the main pattern of cerebral venous reactivity in patients with chronic cerebral ischemia, being clinically coupled with a slight presence of intracranial hypertension. They showed that cerebral venous reactivity indices are important for early and effective diagnosis of the studied pathology, as well as for assessing the success and efficacy of the provided complex treatment.

Keywords:

chronic cerebral ischemia cervicogenic headache venous hemodynamics triplex scanning pathophysiological mechanisms cerebral venous reactivity

References:

1. Adamovych OO. Porivniannia liniinykh rozmiriv ta shchilnosti struktur shyinoho viddilu khrebta u osib riznoi stati. Herald of Problems of Biology and Medicine. 2016; 2(128): 302-305 [in Ukrainian].
2. Yemecz OT, Maxlynecz VYu, Vansovych OS, Sapiga II, Oros MM. Cervikalgiya: suchasni pidxody do likuvannya. Int Neurol J (Ukraine). 2020; 16(4): 50-54. [in Ukrainian].
3. Kononets OM. Problema khronichnoi tserebralnoi venoznoi konhestii v strukturi somatonevrolohii: diahnostychni ta likuvalni aspekty. Int Neurol J (Ukraine). 2021; 7 (109), 31-36. doi: 10.22141/2224-0713.7.109.2019.183010 [in Ukrainian].
4. Kopchak OO. Holovnyi bil napruzhennia y tservikohennyi holovnyi bil: osoblyvosti klinichnoi kartyny, diahnostyky y likuvalnoi taktyky Int Neurol J (Ukraine). 2021; 3(105): 52-57. doi:10.22141/2224-0713.3.105.2019.169919 [in Ukrainian].
5. Oros MM, Oros MM (Jr). Bil holovy ta venozna dystsyrkuliatsiia: de pravda? Practitioner. 2020; 9 (1): 54-57. [in Ukrainian].
6. Andreyeva TO, Stoyanov OM, Chebotaryova GM, Kalashnikov VI, Vastyanov RS, Mashchenko SS. Densitometric correlates of degenerative-dystrophic processes in cervical vertebrae of humans and domestic animals. Regulatory Mechanisms in Biosystems. 2023; 14(3): 386–392. doi:10.15421/022357
7. Böhmer C, Amson E, Arnold P, van Heteren AH, Nyakatura JA. Homeotic transformations reflect departure from the mammalian 'rule of seven' cervical vertebrae in sloths: inferences on the Hox code and morphological modularity of the mammalian neck. BMC Evol Biol. 2018; 18(1): 84. doi: 10.1186/s12862-018-1202-5.
8. Bukhari MK, Alghamdi SA. Ischemic stroke secondary to dynamic vertebral artery stenosis: a case report and literature review. Cureus. 2021; 13(12): 20167. doi: 10.7759/cureus.20167
9. Hurley RW, Adams MCB, Barad M, Bhaskar A, Bhatia A, Chadwick A. et al. Consensus practice guidelines on interventions for cervical spine (facet) joint pain from a multispecialty international working group. Reg Anesth Pain Med. 2022; 47(1): 3-59. doi: 10.1136/rapm-2021-103031.
10. Jiang X, Chen D, Lou Y, Li Z. Kinematic analysis of cervical spine canal diameter and its association with grade of degeneration. Eur Spine J. 2016; 25(7): 2166-2172. doi: 10.1007/s00586-016-4624-z.
11. Lima Neto AC, Bittar R, Ghattas GS, Bor-Seng-Shu E, Oliveira ML, Monsanto RDK. et al. Pathophysiology and diagnosis of vertebrobasilar insufficiency: a literature review. Int Arca Otorhinolaryngol. 2017; 21(3): 302–307. doi: 10.1055/s-0036-1593448.
12. Liu A, Qiu NH, Zhong XR, Fang X, Liao JJ, Zhang ZP. et al. Dynamic evaluation of the cervical spine by kinematic MRI in patients with cervical spinal cord injury without fracture and dislocation. J Orthop Surg Res. 2023; 18(1): 249. doi: 10.1186/s13018-023-03745-1.
13. Moors C, Stapleton C. Signs and symptoms of vertebrobasilar insufficiency secondary to atherosclerosis: a systematic review. J Osteopath Med. 2025; 125(11): 519-532. doi: 10.1515/jom-2024-0203.
14. Morinaga Y, Nii K, Sakamoto K, Inoue R, Mitsutake T, Hanada H. Focus on diagnosis, treatment, and problems of Barré-Lièou syndrome: Two case reports. Drug Discov Ther. 2019; 13(4): 239-243. doi: 10.5582/ddt.2019.01046.
15. Verma S, Tripathi M, Chandra PS. Cervicogenic Headache: Current Perspectives. Neurol India. 2021; 69(Suppl): 194-198. doi: 10.4103/0028-3886.315992.

Publication:

«World of Medicine and Biology» Vol. 22 No. 97 (2026), pp. 86-90
UDC 616.12-008.331.1+616.899-053.9

DOI:

https://doi.org/10.26724/2079-8334-2026-3-97-86-90