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SOME RISK MARKERS IN PATIENTS WITH TRANSIENT VISUAL DISORDERS AND ARTERIAL HYPERTENSION

The objective of this study was to assess the significance of the parameters of visual evoked potentials (VERP), interhemispheric interaction and microcirculatory vessels impairment as probable risk markers of the transient visual disorders and its meaning in prognosis of cerebrovascular accidents at arterial hypertension (AH). The study involved 36 patients (mean age 59.7 years) with AH, who had transient ischemic attacks (TIA) with visual disorders. Clinical methods, neuroimaging techniques, ultrasound Doppler, assessment of the microvasculature, perimetry (Zeiss Humphrey 720 sphero-perimeter) were used. Visual evoked potentials (stimulated by flash of red light) included the assessment of ultra-early, early and long-latency response components. Interhemispheric and cognitive functions were investigated using praxis tests and the MMSE scale. It was established that AH preceded all episodes of TIA. Vessels of the fundus of eye had polymorphic signs of structural and functional changes in all patients. A function of an optic nerve, according to parameters of VERP, was found to be impaired after the TIA had ended and manifested by the asymmetry of the latent periods of healthy and compromised eyes. We also found polymorphic CNS disturbances, impairment of interhemispheric interaction and a cognitive score reduction. We can suggest that described patterns of the disturbances can be explained by chronic changes in certain cerebral blood pools that are consistent with the concept of increasing and accumulation of microfocal changes in the brain. Acute or chronic ischemia itself is a predictable or regular consequence of reduced compensatory capabilities of the cerebral circulation and worsening of the state of neuronal activity in acute ischemic event.