A relationship between clinical and biological disturbances in atherosclerotic lesions of the carotid arteries

: A study of the functional state of cerebral hemodynamics using transcranial dopplerography and blood excitotoxic amino acids, playing an important role in the pathogenesis of ischemic brain damage, has been carried out in 43 patients with atherosclerotic lesions of the carotid arteries. Neurological deficit that developed as a result of ischemic stroke was related to the changes of cerebral hemodynamics (a decrease of hemodynamic reserve and blood flow velocity in the middle cerebral artery) and an increase of the level of blood amino acids involved in excitotoxic mechanisms of the nerve tissue lesions in brain ischemia. These biochemical disturbances in the non-acute period of ischemic stroke may be explained by the state of chronic excitotoxicity that developed because of blood circulation insufficiency in the brain and a decrease of cerebrovascular reserve. The authors admit that genetically determined features of cerebral metabolism of excitotoxic amino acids, concomitant with their higher release to the extracellular space, along with hemodynamical disturbances, may be risk factors of ischemic brain lesion when cerebral blood flow decreased as a result of stenosis or occlusion of the carotid arteries. This should be taken into account for elaboration of complex methods of neuroprotection in atherosclerosis of the great brain arteries.