Analysis of the MDCT-angiography data shows that the patients with the diagnosis of hypertension have got topographic and anatomic changes of cerebral vessels.
Due to the MDCT-angiography of the cerebral vessels the diminution of the VA was visualized among the 11 (52,38%) patients with hypertension of the low level of total cardiovascular risk.
1 (4.76%) patient of this group had hemodynamically significant stenosis of the V4 segment of right VA with narrowing of the lumen of the artery by 54%.
The second change of intracranial vessels was hemodynamically not significant stenotic lesion of the PcA : right – in 4 (19,05%) patients,
the left – in 3 (14,29%) patients.
The structural changes of ICA were frequent in the patients with hypertension of the low level of total cardiovascular risk.
Sulcated course of the internal carotid arteries was registered in 3 patients.
S-shaped deviation of the left ICA was visualized in one patient (4,76%) of the group.
During the examination of the images of the patients of the second group with the hypertension of the medium level of total cardiovascular risk we found that intra-cerebral arteries and neck arteries underwent changes under the influence of high blood pressure.
The most common were:
- stenotic changes of the vertebral arteries,
which were found in 10 (31.25%) patients of the group.
Hemodynamically significant stenosis was found in 3 (9,38%) patients of the group.
- hemodynamically not significant stenosis of the PcA,
which was found in 10 (31.25%) patients.
1 (3.13%) patients had hemodynamically significant stenosis of left PcA,
so its lumen was narrowed by 54%;
- hemodynamically not significant stenosis of ACA was visualized in 12 (37.5%) patients.
1 (3.13%) patients had hemodynamically significant stenosis of left ACA,
so lumen was narrowed by 60%;
In comparison with the patients of the other groups the greatest changes of the cerebral vessels were found in the patients with the hypertension of the high and very high level of total cardiovascular risk,
who created the third group of the research.
The most common changes of the cerebral vessels and the vessels of the neck were:
- stenotic diminution of the vertebral arteries,
which was found in 18 (29.03%) patients of the group.
Moreover,
10 (16.13%) patients had the hemodynamically not significant stenosis of the VA and 8 (12.9%) patients – hemodynamically significant stenosis,
so 3 (4.84%) patients had right VA lumen reduction at V1 segment by 59 ± 1,24%.
In 2 (3.23%) patients lumen of V4 segment was narrowed by 60%.
On MDCT-images of 3 (4.84%) patients of this group hemodynamically significant stenosis was located on the level of V4 segment of the left VA.
- lesion of the internal carotid artery, in the form of stenoses or deviation was found in 17 (27.42%) patients.
Hemodynamically significant stenosis of the right ICA (fig.1-2.) because of fibrous-calcified atherosclerotic plaques [7] was noticed in the MDCT-angiograms of 3 (4.84%) patients ,
the left one – 1 patient (1.61%).
- aneurysmal dilation of the intracranial vessels was visualized in 6 patients (12%).
Saccular aneurysm of the anterior communicating artery was found in 2 (4%) patients (fig.
3-5.).
Saccular aneurysm of the left internal carotid artery was verified in the pictures of 2 patients (4%),
in one patient (2%) – of the right ICA,
and one patient (2%) had aneurysm of the basilar artery.
Besides acquired changed of the cerebral vessels of the patients of the group we verified innate characteristics of intracranial vessels.
The innate changes of the vertebral arteries such as dominance of the left one was noticed in 27 (43.55%) patients and the right one – in у 6 (9,68%) patients with the hypertension of the high and very high level of total cardiovascular risk and were the most frequent.
There wasn’t the right PcA in 2 patients (4%),
the left one – 1 (2%),
and in the pictures of 2 patients (4%) neither right nor left posterior communicating artery was visualized.
Aplasia of the P1 segment of posterior cerebral artery was visualized in the MDCT-images of 5 ( 8.06%) patients,
which correlates with the literature data [6].
The data of our research showed that the most common changes of the cerebral vessels of the patients with the hypertension according to the MDCT- angiography were varying degrees of stenosis of the vertebral arteries.
The changes of the anterior,
posterior and posterior communicating arteries were frequent which usually resulted in the varying degrees of their diminution and sometimes sulcated course.
The changes of the internal carotid arteries were common which resulted in stenosis and structural changes (deviation and often the pathological angular formation).