Evaluation of the hemorheological and neurosonographic relationship in patients with cerebrovascular diseases

During the last fifteen years some of our priority scientific topics of research were hemorheological and neurosono- graphic investigations in 229 patients with different forms of cerebrovascular diseases (CVD): 75 patients with asymptomatic CVD (ACVD), 65 patients with transient ischemic attacks (TIAs) and 89 patients with chronic unilateral cerebral infarctions (UCI). The findings were compared with 70 healthy persons. The main estimated hemorheological parameters were hemat- ocrit (Hct), apparent whole blood viscosity (WBV), plasma viscosity (PV) and fibrinogen (Fib). They were correlated with the following sonographic parameters, obtained by extracranial and transcranial Doppler sonography: blood flow velocities (BFV) and peripheral resistance index of Pourcelot (RP) of the major arteries of the head and the basal cerebral arteries and vasomotor reactivity indices (VMRI) of the middle cerebral arteries (MCA). Among the hemorheological variables the correlations of Hct with the velocity sonographic parameters predominated in all groups. Significant positive correlations between Hct, WBV and the RP of the internal carotid artery and MCA were found in patients with CVD. In UCI the increase in Hct and Fib was associated with a decrease in BFV of the collateral circulation where aging and high mean blood pressure were additional risk factors for impairment of the cerebral hemodynamics. Plasma viscosity was found to correlate with cerebral VMRI of MCA in patients with UCI. The clinical impact of these findings and their relation to the therapeutic strategy in CVD are discussed.