Why do REG of cerebral vessels?

1 What does the survey provide?

Rheoencephalography is a study that allows you to assess the elasticity of the vessel wall, reactivity, peripheral resistance of blood vessels supplying the brain. It allows you to judge the magnitude of pulse blood filling. These data allow to determine whether all the vessels are passable and how far this patency meets the standards, that is, how well the brain structures are provided with blood, oxygen and nutrients. REG brain vessels will allow in the early stages to identify foci with abnormal blood supply and begin treatment, without waiting until the pathology becomes irreversible.

The main advantages of the method:

• is quite simple in execution;
• can be performed in any conditions( it does not require much space and bulky expensive equipment for both CT and MRI);
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• allows to evaluate the picture separately in veins and arteries, as well as small diameter vessels;
• may be performed for those patients who have contraindications to CT or MRI.

REG many consider the method obsolete, ceded the primacy in the study of brain pathology to magnetic resonance and computed tomography. Nevertheless, it is still used to confirm the presence of some pathology. A number of specialists believe multichannel rheography is a promising method in assessing the adaptive and compensatory abilities of the cerebral vascular bed to different acute conditions. This study allows assessing the collateral circulation that has arisen after severe vascular lesions of the brain structures.

Rheoencephalography is just one of the survey methods that patients are often confused with other survey methods that sound similar to them. First of all it concerns EEG( electroencephalography) and ECG( electrocardioglaphy).The difference between REG and EEG is the subject of the study. EEG studies the activity of neurons, and reveals convulsive paroxysms of epileptic, traumatic, neuroinfectious nature. It is indispensable for obtaining data on epilepsy. ECG is a method of studying the myocardium.

2 Purpose of the procedure

From the blood supply of the brain depends largely on the quality of human life, its intellectual abilities and even the emotional state. A poorly "fed" brain plunges its master into depressive states. It does not allow him to work fruitfully, so memory, attention, and thinking suffers. Not to mention the monstrous headaches, literally "exploding" or "squeezing" the head. All these states push a person to visit a doctor, and then to diagnose the diagnosis with the help of various methods and the appointment of treatment. Rheoencephalography is one such method.

Allocate only three main goals, which are usually pursued by a doctor, appointing REG of the brain, or rather rheography of cerebral vessels. These include:

• diagnostic purposes( verification of the diagnosis or the establishment of the cause of the pathology);
• prophylactic goals( can be prescribed to patients aged or children to monitor their condition, including as a primary diagnosis of the state of brain vessels in newborns and infants);
• objectification of the results of treatment( for example, the effects of vasotropes).

Most often, rheoencephalography is used to confirm or recognize atherosclerotic changes in the cerebral vessels and to assess the severity of the pathprocess. Informative this type of examination is considered:

• with migraine;
• of meteorological dependence;
• for CWT( for diagnosing subdural hemorrhages);
• dystonia;
• for establishing a predisposition to ischemia;
• at states after the transferred ONMK;
• adenoma of the pituitary gland;
• for the search for the root causes of unexpressed vascular symptoms;
• for setting speed characteristics of blood flow.

If the survey is conducted as part of a comprehensive diagnosis, along with the USDG, the amount of information obtained is comparable to the data that can be obtained with MRI, but these methods are safer, more operative and less expensive( in terms of financial accessibility).Young specialists prefer MRI, but for this procedure there are a number of limitations. For example, some MRI devices are not designed for patients heavier than 120 kg and with a waist circumference of more than 70 cm. In closed devices, people with claustrophobia can not be examined. MRI is contraindicated for persons with pacemakers( except the most recent) and hemostatic clamps in the vessels of the brain. With the Ilizarov apparatus, magnetic resonance can not be made either. But REG can be carried out without problems. The method is applicable in pregnancy.

3 Indications and contraindications

There is a whole list of patient complaints, each of which can prompt the physician to prescribe a similar examination. The main ones are:

• vestibulopathy( dizziness);
• ectefalopathy( headaches);
• tinnitus;
• hypertensive crises;
• loss of consciousness:
• sleep disturbances.

Rheoencephalography can be included in the list of diagnostic procedures for examination after injuries to the cervical spine and head, if there is a suspected presence of atherosclerotic deposits on the walls of the vessels. When responding to changes in weather conditions, with a decrease in cognitive functions, as well as hearing and vision for unexplained reasons. Such a survey is often prescribed in old age and in the presence of individuals suffering from serious diseases of vascular genesis as a preventive measure. Assign it to control the condition in the post-operation period and to assess the post-stroke state of the vascular bed. It is effective in persistent hypertension to determine the severity of the syndrome of hypertension, with VSD and vertebrobasilar insufficiency, with damage to the pituitary( adenoma).

There are no absolute contraindications to the use of this method. Relative damage to the scalp( burns, abrasions, wounds) and children's age are considered to be relative. Not the children themselves, as such, REG do not make small children, which parents could not convince to put on electrodes and sit quietly. If there are large metal implants in the area of ​​the skull and electronic implants, you should inform the doctor about it.

4 Implementation of the

method No significant preliminary preparation is required for a rheographic survey from the patient. The only thing, 3 hours before the procedure, the patient is recommended not to smoke, and for a day to refuse to take funds that affect the blood supply system, necessarily in consultation with the doctor. Before the procedure, the patient is recommended to rest for 15-20 minutes, relax and rest.

The examination is carried out in a semi-sitting or lying position on the back. After the patient has taken a comfortable position, the doctor degreases the areas of the skin at the places of attachment of electrodes to improve conductivity and fixes the electrodes on the patient's head. Electrodes are lubricated with special pastes. This improves the contact of the electrode with the skin of the patient. The location of their fixation depends on which vessels are of interest to the physician:

• , when examining the condition of the external CA( carotid artery), the contacts are located in the region of the nose bridge and mastoid process;
• in the study of the condition of the PA( vertebral arteries) - occipital mounds and the same process, plus in this case the ECG is simultaneously removed;
• in the case of analysis of the state of the ICA( internal carotid artery), contacts are placed in the eyebrow area( outside) and in front of the auditory canal.

The patient is recommended to close his eyes, then begin the procedure. These studies are recorded by a special apparatus - a rheograph. The survey takes into account the age-related changes that occur with the vessels and the patient's condition. For example, sharp jumps of blood pressure on the rheoencephalogram are reflected in the form of tonus changes and oscillations of figures reflecting pulse blood filling.

To clarify the nature of the pathology: organic or functional changes, special samples can be performed. The most common are changes in the position of the body and head. Various drugs can be used, most often used nitroglycerin under the tongue, less often caffeine, antispasmodics( papaverine, noh-na), euphyllin.

5 Description of the results

Decoding the rheogram requires additional knowledge and skills.

When analyzing the graphs obtained during the survey, the doctor pays attention to various characteristics of the received waves: regularity, vertex type( rounded, sharp, smoothened), in which state are the component waves( descending or ascending), the presence and nature of the dicrot and the presence andthe location of the incision( dredging).The description of the graphs is full of incomprehensible to the philistine and frightening words, such as incisors, dicrots( dicrotic teeth), ana and cataracts. In fact, this is not a diagnosis or pathological changes in the vascular system, but only descriptions of individual elements of the wave. Inzisura is a recess, the dicrocus is an additional prong that has a smaller amplitude than the main one, an anacrotic ascending element of the wave, a cataract is a descending one.

Evaluating curves in general, the specialist also has to evaluate the relationship and location of their individual elements, so the recess should be in the middle third of the downward wave before the dikroto. It forms between systolic and diastolic waves. Evaluation of curves occurs by comparing the actual material with the normative. The decoding includes, first of all, the determination of the type of wave, which characterizes the state and behavior of the vessels. Type REG is not an independent disease, but only describes some manifestations of the existing pathology and helps to identify it.

There are 3 main types of rheoencephalographic waves( hypertonic, dystonic and angiodystonic).The first one describes a persistent increase in the tension of the walls of the vessels, delivering blood and obstructing the outflow through the veins. The second is characterized by constant jumps in the stress of the vascular wall, with this type most often dominated by a hypotonic, accompanied by a violation of the outflow of venous blood. And the latter type is associated with a constant change in vascular tone due to a violation in the structure of the vessel wall. This causes a decrease in the elasticity of the vessels and a difficulty in the outflow and blood flow along these vessels.