Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego · 2026
Features of cerebral blood flow in patients with dyscirculatory encephalopathy and concomitant hypothyroidism at long-term follow-up.
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Lytvyn Olena V, Kovalenko Olha Y, Mikhaliev Kyrylo O
Аннотация
OBJECTIVE: Aim: To evaluate cerebral blood flow characteristics in patients with dyscirculatory encephalopathy (DE) and concomitant hypothyroidism in the long-term follow-up period.
PATIENTS AND METHODS: Materials and Methods: A single-center cohort study consecutively included 60 patients with hypertensive DE and concomitant hypothyroidism (mean age 61±6 years; 95% women). In the long-term follow-up period (mean duration - 10 years), results of repeated clinical-neurological and instrumental examinations of 52 patients were analysed. Duplex scanning of extra- and intracranial vessels assessed peak systolic velocity (Vps) and end-diastolic velocity (Ved), and resistive index (RI) and pulsatility index (PI) were calculated.
RESULTS: Results: At baseline, patients with DE and concomitant hypothyroidism predominantly presented with cephalgic (67.3%), vestibular (61.5%), and cerebroasthenic (63.5%) syndromes. In the long-term follow-up period, an increase in the frequency of vestibular syndrome was observed, reaching 80.8% (p=0.034). Duplex scanning demonstrated an increase in Vps in the left common carotid artery (CCA) and bilateral internal carotid arteries (ICA), accompanied by a decrease in Ved in the middle cerebral artery (MCA) on both sides. Additionally, an increase in RI was observed in the right CCA and left MCA. At the same time, in the vertebrobasilar system, a decrease in flow velocity parameters was noted in the right vertebral artery (V4 segment) and basilar artery (BA), along with an increased RI in the right V4 segment of the vertebral artery.
CONCLUSION: Conclusions: Long-term follow-up demonstrated an increased frequency of vestibular syndrome, deterioration of cerebral blood flow predominantly in the carotid circulation due to reduced vascular elasticity, and decreased flow velocity in the vertebrobasilar system in patients with DE and concomitant hypothyroidism. These findings justify the need for timely diagnosis and correction of thyroid dysfunction in patients with chronic cerebral ischemia to optimize therapeutic, preventive, and rehabilitation strategies.
PATIENTS AND METHODS: Materials and Methods: A single-center cohort study consecutively included 60 patients with hypertensive DE and concomitant hypothyroidism (mean age 61±6 years; 95% women). In the long-term follow-up period (mean duration - 10 years), results of repeated clinical-neurological and instrumental examinations of 52 patients were analysed. Duplex scanning of extra- and intracranial vessels assessed peak systolic velocity (Vps) and end-diastolic velocity (Ved), and resistive index (RI) and pulsatility index (PI) were calculated.
RESULTS: Results: At baseline, patients with DE and concomitant hypothyroidism predominantly presented with cephalgic (67.3%), vestibular (61.5%), and cerebroasthenic (63.5%) syndromes. In the long-term follow-up period, an increase in the frequency of vestibular syndrome was observed, reaching 80.8% (p=0.034). Duplex scanning demonstrated an increase in Vps in the left common carotid artery (CCA) and bilateral internal carotid arteries (ICA), accompanied by a decrease in Ved in the middle cerebral artery (MCA) on both sides. Additionally, an increase in RI was observed in the right CCA and left MCA. At the same time, in the vertebrobasilar system, a decrease in flow velocity parameters was noted in the right vertebral artery (V4 segment) and basilar artery (BA), along with an increased RI in the right V4 segment of the vertebral artery.
CONCLUSION: Conclusions: Long-term follow-up demonstrated an increased frequency of vestibular syndrome, deterioration of cerebral blood flow predominantly in the carotid circulation due to reduced vascular elasticity, and decreased flow velocity in the vertebrobasilar system in patients with DE and concomitant hypothyroidism. These findings justify the need for timely diagnosis and correction of thyroid dysfunction in patients with chronic cerebral ischemia to optimize therapeutic, preventive, and rehabilitation strategies.