Idiopathic arterial hypotension: neurological abnormalities and cerebral and central hemodynamics

Abstract

To study abnormalities of central and cerebral hemodynamics inchronic cerebrovascular pathology, 65 patients were examinedwith long-term stable idiopathic arterial hypotension (IAH),mean age of 40.2 (8.1) years. According to neurologic examination,all patients were distributed into two groups. The first groupcomprised 19 (29%) patients with somatoform disturbances, andthe second group comprised 46 (71%) patients with cerebrovascularpathology: early signs of cerebral blood supply impairmentand dyscirculatory encephalopathy, stage I. Patients from thesecond group were older and had longer hypotension anamnesis.Cerebral and central hemodynamics was examined with duplexultrasonography of internal carotid arteries (ICA), vertebralarteries (VA) and medial cerebral arteries and with transthoracicechocardiography. In all patients ICA ultrasound showed moderateslowness of blood velocity and compensatory reduction ofvascular resistance. There was no compensatory vasodilatationin VA, which resulted in considerable blood flow reduction,most expressed in the second group. The cardiac index wasincreased in both groups: in the first group due to increase in theleft ventricular contractility and in the second group due toincrease in the cardiac rate. Cerebrovascular disorders inpatients with IAH are associated with age, duration of arterialhypotension, predominant deterioration of blood supply in thevertebral-basilar system and hyperkinetic state of central hemodynamics.

Keywords

• idiopathic hypotension
• neurological abnormalities
• central and cerebral hemodynamics