Rare non-heritable causes of acute cerebrovascular disorders

О.О. Kopchak, T. Odintsova
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Abstract

Acute cerebrovascular disorder remains one of the main causes of disability and death of the population in developed countries. Among acute cerebrovascular disorders, the ischemic type (approximately 80 % of all cases) is more common than the hemorrhagic type (including intracerebral and subarachnoid hemorrhage). Traditionally, among the risk factors for the development of acute cerebrovascular disorders, we distinguish non-modified factors (age, sex, hereditary predisposition to acute cerebrovascular disorders, congenital heart defects) and modified factors (arterial hypertension, diabetes, hematocrit level, low-density lipoprotein, and cholesterol levels in the blood). However, there is a separate category of risk factors, namely, non-heritable pathology that leads to the development of acute cerebrovascular disorders. This category includes diseases such as primary angiitis of the central nervous system, Sneddon’s syndrome, reversible cerebral vasoconstriction syndrome, Susac’s syndrome, Takotsubo syndrome, and Moyamoya angiopathy. These pathological conditions are characterized by damage to cerebral vessels of different calibers, accompanied by a variety of clinical manifestations (ranging from skin rash and abnormalities in cardiac chambers to mental disorders). These pathological conditions can mimic other diseases, making it challenging to establish a correct diagnosis and provide appropriate treatment to such patients. The diagnosis of these disorders is quite complex and requires the use of neuroimaging methods and, in some cases, a multidisciplinary approach. It is believed that by understanding and recognizing the non-heritable risk factors, we will be able to prevent a significant percentage of acute cerebrovascular disorders in the population and provide timely assistance in case of their occurrence.
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急性脑血管疾病的罕见非遗传性病因
急性脑血管疾病仍然是发达国家人口致残和致死的主要原因之一。在急性脑血管疾病中,缺血性(约占所有病例的 80%)比出血性(包括脑内出血和蛛网膜下腔出血)更为常见。传统上,我们将急性脑血管病发病的危险因素分为非改变因素(年龄、性别、急性脑血管病遗传倾向、先天性心脏缺陷)和改变因素(动脉高血压、糖尿病、血细胞比容水平、血液中低密度脂蛋白和胆固醇水平)。然而,还有一类风险因素,即导致急性脑血管疾病发生的非遗传性病理因素。这类疾病包括中枢神经系统原发性血管炎、斯内登综合征、可逆性脑血管收缩综合征、苏萨克综合征、塔克洼综合征和莫亚莫亚血管病等。这些病症的特点是不同口径的脑血管受损,并伴有各种临床表现(从皮疹、心腔异常到精神失常)。这些病理情况可能会与其他疾病相似,因此要对这类患者做出正确诊断并提供适当治疗具有挑战性。这些疾病的诊断相当复杂,需要使用神经影像学方法,在某些情况下还需要采用多学科方法。我们相信,通过了解和认识非遗传性风险因素,我们将能够在人群中预防相当大比例的急性脑血管疾病,并在疾病发生时提供及时的帮助。
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