What is brain reg in children. Technique and contraindications for performing cerebral vascular registration

Rheoencephalography of the brain is a non-invasive method for diagnosing blood vessels, which is based on rheography. The study provides information mainly about the functional state of blood vessels: tone, peripheral resistance, blood filling. Also, REG of cerebral vessels shows anatomical features, for example, the elasticity and integrity of vascular walls.

Blood is a liquid system filled with shaped elements and electrolytes. These components affect the electrical charge of the tissues of the arteries and veins. When blood flows through a vessel, the charge changes, followed by a change in the electrical resistance of the tissue. The change in this indicator is recorded by a device - a rheoencephalograph. The output data indicates the condition of the blood vessels.

The method is safe and does not affect the patient's health. It can be carried out an infinite number of times.

The effectiveness of the study is now disputed in medical communities. Some neurologists doubt the diagnostic value of the method due to the fact that electrical resistance is also present in the bones of the skull, so the results obtained do not reflect all pathological processes. Opponents' research proves that bones are not an obstacle to current flow, so the results are not distorted.

A rheoencephalogram is rarely prescribed as an independent study. Usually the method is combined with other methods: magnetic and computed tomography, contrast radiography and electroencephalography. This increases the diagnostic value of each method and reduces the likelihood of an erroneous diagnosis.

Indications and contraindications

A rheoencephalogram is prescribed in the following cases:

• General cerebral disorders:
  • headache, dizziness, impaired consciousness;
  • tinnitus;
  • nausea and vomiting;
  • decreased visual acuity and loss of lateral fields, darkening of the eyes;
  • hypersensitivity to climate change.
• Mental disorders:
  • decreased memory capacity, decreased concentration, slowed thinking;
  • irritability, frequent mood swings (more than 2-3 times a day), short temper, sleep disturbance;
  • reduced ability to learn and receptive to new information.
• Mechanical head injuries: skull fractures, bruises and concussions.
• Suspicion of an intracranial tumor.
• Somatic diseases in which blood circulation is impaired:
  • diabetes mellitus;
  • arterial hypertension;
  • coronary heart disease, heart failure;
• Post-stroke condition.
• Acute circulatory disorders, subarachnoid hemorrhage, accumulation of blood and brain spaces.
• Encephalopathy.
• Assessing the effectiveness of prescribed medications.

REG safe method, however, it is not recommended for newborns and people whose skin areas being examined are damaged: wounds, hematomas, boils. The study should not be carried out on children if they are overly excited and agitated. First, the child needs to be reassured, and only after that the diagnosis begins.

Vascular rheoencephalography is prescribed when there are several of the above symptoms at once. The manifestation of single symptoms is often considered a temporary functional impairment. For example, when concentration of attention decreases, REG is not prescribed.

Diagnosis in adults is no different from the pediatric version.

You should not smoke half an hour before the start. Nicotine constricts blood vessels, which distorts the results. It is also recommended to remain calm before and during the procedure: anxiety affects vascular tone, so the results may be distorted.

Conducting a survey

How to do RZHG of cerebral vessels, step-by-step algorithm:

• The subject is asked to sit down.
• Gel is applied to some areas of the scalp - this prevents irritation and blocks additional resistance.
• A cap equipped with electrodes is placed on the patient's head. They measure and record changes in electrical resistance.
• At the doctor's request, the subject closes his eyes. This is necessary in order to remove excess load on sensory system brain

Separate electrodes are applied to different places on the head - it depends on the indicators:

1. Sensors are attached to the bridge of the nose and mastoid process if it is necessary to examine the blood flow in the internal carotid artery and its basin.
2. In front of the ear and above the eyebrows is the pool of the external carotid artery.
3. Occipital protuberances, mastoid process - basin of the basilar artery.

Examination of the rag's head can be carried out using functional tests. The latter are drugs that are administered before the study to record sudden changes in vascular tone. Functional tests are prescribed to differentiate and find the difference between organic vascular damage, such as atherosclerosis, and dysfunction, such as arterial hypertension.

Results

The interpretation of the results depends on the age of the patient. So, the older the person under study, the lower his vascular tone and their functional state.

The result of the study is depicted on a graphic curve, the lines of which are located in a certain way and have parameters. This graphical curve is located on the tape. The result looks like an electrocardiogram. Each pulsating impulse of blood in a vessel is reflected by a wave - a repeating complex, which must consist of stable and regular elements.

What the wave shows: normally it has a peak - anacrotic. It is followed by an incissura - a depression, after which a new wave begins - a dicrotic rise. At various diseases these three components change. For example, with atherosclerosis the complex becomes flattened.

Decoding the indicators takes into account the following parameters:

1. Wave frequency.
2. Degree of anactor rounding.
3. The state of a descending and ascending line.
4. The nature of the depression and dicrotic rise.
5. The presence of additional waves on the tape.

When deciphering, the difference in electrical resistance of the vessels of the left and right hemispheres is taken into account. Ideally, these results are combined with an electroencephalogram, so that the electrical activity of the brain is studied as a whole.

What does REG of the head show in diseases:

• Atherosclerosis of cerebral vessels:
  • sharp peaks;
  • all complexes on the REG are smoothed.
    With massive atherosclerosis, the waves have the appearance of an arch.
• Decreased vascular tone:
  • waves have increased amplitude;
  • sharp apex and rise;
  • between the complexes there is an additional tooth that moves upward;
  • the rising line is short.
• Increased tone of vascular walls:
  • waves have low amplitude;
  • the rise is smooth;
  • the top is displaced;
  • there is an additional tooth, but it is weakly expressed;
  • the rising line is distorted.
• :
  • the descending line is convex and elongated;
• Severe vascular spasm:
  • the tops are rounded.
• Arterial hypertension:
  • the amplitude and shape of the complex changes.

One of diagnostic methods detection of pathology cerebral circulation is rheoencephalography (REG). It is based on the fact that pulse fluctuations in the blood supply of blood vessels affect electrical resistance. This difference in values ​​is recorded by the device and displayed in the form of a graph. REG provides indirect information about the state of cerebral vessels and venous outflow, therefore rheoencephalography is prescribed for certain indications.

What is rheoencephalography

A significant portion of the total blood volume (15%) flows through the human brain. In addition, the speed of blood flow in it is much more intense than in all other organs. This is due to the fact that it needs a colossal amount of oxygen to function properly. Pathology of cerebral circulation leads to severe consequences(disability, death of the patient), therefore it is very important to identify developing deviations in a timely manner. And rheoencephalography helps with this.

Blood has the highest electrical conductivity compared to other tissues. That is why, with systolic filling of tissues with blood, the electrical resistance decreases, and with a diastolic decrease in blood filling, it increases. On a rheoencephalogram, all these changes are presented in the form of a curve synchronous with the pulse. When analyzing it, pay attention to:

• waveform;
• the maximum amplitude of the wave, reflecting the blood supply to the tissues;
• the severity and location of various segments and points on the curve;
• presence of additional waves.

The study of such parameters helps to identify the presence of vascular pathology. It is prescribed when a patient comes to the doctor with complaints about headache, dizziness, changes in blood pressure. To identify the causes of such symptoms, the specialist refers the patient to rheoencephalography.

When is REG necessary?

REG helps to detect the fact of cerebral circulation disorders, and in some cases, to establish the cause of this condition.

Rheoencephalography is a bloodless and reliable method for studying changes in the hemodynamics of the brain. With its help they study:

• tone and elasticity of vascular walls;
• venous outflow;
• intensity of blood supply;
• blood flow speed in cerebral vessels.

REG is often prescribed with functional tests and pharmacological tests. This makes it possible to establish the cause of cerebrovascular accident (pathology cordially- vascular system, organic changes in brain tissue). Accordingly, rheoencephalography is performed to establish an accurate diagnosis if:

• blockage or stenosis of the internal carotid artery;
• pathology in the system and main arteries;
• hypertensive crisis;
• epilepsy;
• migraine;
• hemorrhages in the brain.

Reveal certain changes on REG and for brain tumors, but in this case a more specific diagnosis should be carried out using.

In order for rheoencephalography to give the most accurate result, it must be carried out correctly.

Methodology for conducting REG

Before the study, the patient should refrain from consuming substances that affect blood circulation. If the doctor has prescribed medications that affect vascular tone (nitroglycerin, antihypertensives, etc.), it is imperative to find out whether they need to be taken before the examination, since they can have a significant impact on the result.

Before entering the office functional diagnostics, it is recommended to calm down and relax. It is advisable to sit for 15 minutes.

Rheoencephalography is done using a special device. Electrodes are attached to the patient's head:

1. To begin with, the skin where the sensor will be located is wiped with alcohol. The electrode is lubricated with electrically conductive paste or gauze soaked in saline or hypertonic saline is applied. This is necessary to reduce the electrical resistance of the skin and ensure better contact.
2. The electrodes are fixed using a rubber band with holes. It is necessary to exclude the possibility of their displacement in order to obtain the most accurate result.

REG can be performed in different positions:

• lying down;
• sitting;
• with a functional test (you will need to stand up or tilt your head).

Changes in body position significantly affect the study parameters. That is why a functional test is prescribed to clarify the diagnosis if there is a suspicion of impaired cerebral blood flow due to cervical osteochondrosis or orthostatic hypotension. For example, when the head is lowered to 30 0 (Trendelenburg position), a venous wave appears on the REG, which allows us to judge the state of reactivity of the venous bed. In patients with orthostatic hypotension, the REG amplitude decreases when standing up.

The influence of heart function on the state of cerebral vessels is studied by conducting a pharmacological test. Before the procedure, the patient must be administered medications that dilate blood vessels:

• papaverine;
• aminophylline;
• amyl nitrite;
• nitroglycerine;
• nicotinic acid.

With the help of vasodilators, the nature of the changes that have occurred is determined, whether they are functional or organic. This is necessary to determine further treatment tactics. If, after taking vasodilator drugs, the graphic image shows normalization of the shape of the curve, then the vascular pathology is functional in nature.

During the study, all changes in vascular resistance are recorded in the form of a graphic image. Then the functional diagnostics doctor processes and deciphers the obtained values. Many offices are equipped with modern devices, so data processing is carried out using special programs. However, the doctor must take into account the presence of artifacts that can significantly affect the result of the study:

• electrode interference
• incorrect settings of the rheograph;
• voluntary or violent movements of the patient.

On a rheoencephalogram, the doctor sees by changes in wave amplitude and curvature exactly what changes in cerebral circulation are occurring, whether they are associated with organic lesions or are functional.

Conclusion

Fundus examination and REG are complementary methods that allow diagnosing cerebral vascular pathology.

REG is a fairly accurate method for studying cerebral circulation, but it alone is not enough to establish an accurate diagnosis. Vascular pathology is detected by studying reflexes and the presence of visual nystagmus. Complements clinical picture study of the fundus. That is why, in addition to REG, the neurologist refers you to an ophthalmologist for consultation. An ophthalmologist, examining the fundus of the eye, if there is a circulatory pathology, will notice angiopathy, a violation venous outflow. To clarify the diagnosis, the doctor may recommend a CT or MRI.

Constant headaches not only worsen a person’s mood, but also reduce their performance. To eliminate such an unpleasant symptom, many take various medicines However, this does not always bring the patient a feeling of relief.

For staging correct diagnosis and to determine the cause of headaches, a study such as rheoencephalography of cerebral vessels is used. What is an REG examination, what may be the indications for its implementation and what pathologies can be identified with its help?

Rheoencephalography is one of the methods for assessing blood circulation in the brain. With the help of such a study it is possible to identify various pathologies brain and assess the state of the circulatory system. Many specialists resort to this research method, since it is highly informative and makes it possible to obtain accurate results, and its cost is low.

Carrying out REG makes it possible to obtain data on the state of the blood vessels of the brain and diagnose abnormalities in the circulatory system at an early stage. This is considered quite important factor, because on initial stage it is possible to prevent the development of many dangerous pathologies and consequences.Thanks to REG of cerebral vessels, it is possible to determine blood viscosity, blood flow speed, flow and distribution time pulse wave. This procedure is carried out using a recording device such as a rheograph.

Rheoencephalography is prescribed to patients both in the presence of certain indications and in for preventive purposes.

The fact is that for many people in old age, the elasticity of blood vessels significantly decreases, and the consequence of this is the development of many concomitant pathologies.

Experts identify the following indications for prescribing a study such as REG:

• patient complaints of temporary and permanent dizziness, as well as when positioned vertically
• injuries of varying complexity to the cervical region and head
• the appearance of problems with hearing, vision and memory
• recurrent headaches or noise in the hearing organs
• family history
• diagnosis of damage to the vascular system of the brain
• grade functionality collateral circulation
• control of cerebral circulation after surgery
• patient's dependence on weather conditions
• cerebral atherosclerosis
• migraines of various origins and complexity
• vascular crises
• the appearance of attacks of osteochondrosis or epilepsy

In addition to the listed indications, REG of cerebral vessels is used to determine the speed of the trigger wave and blood flow, as well as its viscosity.

Despite the fact that REG is considered a fairly simple study, it can help identify an extensive list of diseases:

1. hematomas and various formations after injuries
2. pathologies of cerebral circulation in acute form
3. disorders of the vegetative-vascular system
4. cerebral vessels
5. migraines of varying severity
6. pre-stroke conditions and strokes

If a specialist has doubts about making the correct diagnosis, then REG provides him with great help in this. Thanks to such a study, it is possible not only to identify a pre-stroke condition, but also to select effective treatment. To clarify the results obtained during REG, computer and magnetic resonance imaging, as well as Doppler ultrasound, may be prescribed.

Rheoencephalography is considered a non-invasive research method, when performed on skin there is no impact from various surgical instruments.

Research methodology

When an REG is prescribed, patients often begin to worry and completely in vain. This method is considered completely painless, since there is no effect on the skin. REG does not cause any harm to the human body, so it can be performed even on infants.

The REG study is performed using a 2-6 channel device - a rheograph. In fact, the more channels the device has, the larger the survey area will be covered. The REC procedure includes the following steps:

1. The patient is asked to sit on a soft couch.
2. Metal plates – electrodes – are placed on a person’s head, which are pre-treated with a special gel in order to avoid irritation of the skin.
3. Using a rubber band, the electrodes are attached to the areas where the condition of the blood vessels is to be assessed.
4. Electrodes are applied depending on which part of the brain will be examined.
5. If it is necessary to study the territory of the internal carotid artery, electrodes are placed in the area of ​​the bridge of the nose and mastoid process.
6. When examining the external carotid artery, metal plates are attached above the eyebrow, outside and in front of the ear canal.
7. If it is necessary to assess the functioning of the vessels of the vertebral artery basin, electrodes are applied to the mastoid process and occipital protuberances while simultaneously performing an ECG.

If a specialist needs to conduct an examination of the head, it is recommended to close your eyes. This is due to the fact that the impact external stimuli on the body may cause the final results to be distorted.

All data recorded by the device is reflected on paper tape.

The difficulty of carrying out the procedure lies in the fact that under the influence of a stressful environment a person begins to become very nervous, which leads to a narrowing of blood vessels and this can result in unreliable results.

Decoding the results

Before starting to decipher the results of the REG, the specialist asks the patient about his age. The fact is that such a factor must be taken into account to obtain adequate information. In fact, for a young and an elderly person, the standard indicators of tone and elasticity will be completely different. When conducting an REG, exactly those waves are recorded that characterize the areas of the brain filled with blood and the reaction of blood vessels to this process.

After the study and recording of the REG, the specialist notes deviations from the required norm and makes certain conclusions. Typically, a doctor determines the following types of damage to the vascular system:

• dystonic type
• angiodystonic type
• hypertensive type

Each type of REG should not be interpreted as a separate pathology, since they accompany another disease. In addition, such indicators serve as a kind of diagnostic guideline for identifying the disease.

Carrying out the procedure in childhood

A research method such as REG is used to examine young children. Typically, the duration of such a procedure is approximately 10 minutes, but can stretch up to half an hour. During such a study, the child has to lie or sit motionless with his eyes closed so as not to be distracted by external stimuli.

In fact, not all small patients can withstand such a long time, so experts recommend abandoning REG if the child is too restless. The main task of parents is to influence the child educationally and tell him about why such an examination is needed.

In fact, REG is considered a more preferable research method compared to tomography.

REG is a completely safe procedure, the implementation of which does not affect the patient’s health in any way. It is for this reason that absolutely no one can be sent for such an examination. healthy people for preventive purposes. REG has been carried out by specialists for quite some time now long time, and some scientists consider it already obsolete, however, its effectiveness is beyond doubt.

To conduct such a study, it is not necessary to provide additional laboratory space or purchase expensive equipment. During the procedure, the device reflects data on the functioning of arteries and veins separately from each other, which greatly simplifies the diagnosis of pathologies at various stages of their development. The main advantage of REG over other methods is its painlessness and simple conditions carrying out.

More information about what electroencephalography is can be found in the video:

Today, REG of cerebral vessels is considered one of the most important and informative research, which is characterized by high diagnostic value. Thanks to this technique, it is possible not only to assess the condition of the brain vessels, but also to diagnose many dangerous diseases.

REG is one of the functional methods of brain research. The method is based on recording the difference in tissue resistance of the central nervous system when a low current at high frequency passes through it. Based on the results obtained, which look like a graph, a conclusion is made about the degree of pathology and the optimal treatment is selected.

Rheoencephalography of cerebral vessels

What is REG of head vessels

Rheoencephalography is less informative than modern methods diagnostics - computer and magnetic resonance imaging, but in combination with Dopplerography and neurosonography (ultrasound) helps to establish the cause of brain disorders and avoid serious consequences.

REG of cerebral vessels is prescribed by neonatologists, neurologists, neurosurgeons and traumatologists not only for indications, but also for the prevention of vascular diseases. This is important for identifying pathology on its early stages. A patient who has received a referral for examination wonders what it is and how harmless it is.

The internal liquid environment of the human body has high electrical conductivity and different resistance to alternating current at the time of systole and diastole. Using this method, determine:

• blood viscosity;
• firmness and elasticity of brain vessels;
• volume of incoming blood;
• venous outflow;
• blood circulation in the main vessels and collateral blood supply pathways.

Compared to MRI and CT scans, which are performed using special equipment, this type of diagnostics stands out for its low cost and accessibility. The REG procedure, despite the use of electric current, is painless and does not cause discomfort.

The diagnostic capabilities of this method are growing with the development of technology: specially created computer programs simplify the procedure for deciphering the results, thereby reducing their processing time. This is important if you need an answer immediately.

What is cerebral vascular reg

Indications and contraindications for the study

REG of the brain is prescribed to people of different age categories (including newborns) for a number of reasons. To establish the exact cause of a cerebrovascular accident, for example as a result of a bruise or concussion, the doctor will need an examination to rule out the presence of hemorrhage and hematoma formation.

Organic brain damage and malfunctions of the cardiovascular system can cause blockage or stenosis of the carotid arteries, and abnormalities in the vertebral arteries. Elderly patients are especially at risk of developing vascular pathology, so head examination may be routine.

Indications for examination may be:

• unstable pressure;
• constant headaches, tinnitus;
• head injuries;
• dizziness and fainting;
• decreased performance and fatigue;
• impaired coordination;
• a sharp decrease in hearing and vision.

Rheoencephalography is necessary for monitoring cerebral circulation in patients after a stroke or surgical intervention. It provides information about the well-being of the vascular bed, allows you to monitor the effectiveness of the chosen treatment method and the effectiveness of medications. The tumor can also affect the REG of the brain, but MRI and CT remain more informative for this disease.

Contraindications for the study are any acute and chronic dermatoses, infectious, fungal diseases scalp:

• seborrhea;
• psoriasis;
• purulent eczema;
• lichen;
• pediculosis.

An examination is also not prescribed if there are rashes, wounds, scratches and cuts, since alcohol treatment is required for closer contact between the electrodes and the skin.

Indications for cerebral vascular registration

Preparation and performance of rheoencephalography

REG does not require special training. In order for a rheoencephalogram to show a reliable result, the minimum requirements must be met.

You should approach the room where the procedure is being carried out in advance to have time to rest and normalize your breathing. On the eve of REG it is recommended to avoid stressful situations, do not abuse tonic drinks (tea, coffee), alcoholic drinks eliminate completely, quit smoking. All of the above affects the state of the vascular system, blood flow speed, blood pressure and entails distortion of the results.

In addition, some medicines affect vascular tone. The doctor who refers you for examination should decide to temporarily discontinue the drug, as this will help make the correct diagnosis.

The procedure is carried out in a special chair. The subject must relax, close his eyes, and remain calm. The readings are affected by changes in body position, so the functional diagnostics physician may ask the patient to lie on the couch in a face-down or lateral position.

The skin is treated with alcohol at the places where the sensors are attached, the location of which depends on the area of ​​study. A gel is applied to the surface of the electrodes to increase signal conductivity. The computer records the resistance of brain tissue, and the condition of the blood vessels is displayed graphically. The head REG procedure takes 15-20 minutes.

After this, the results are deciphered. Based on the curvature of the waves, their regularity, and changes in amplitude, a conclusion is drawn about the state of the vascular system. To obtain a complete clinical picture and record a deviation from the norm, the doctor must take into account the patient’s well-being, age (the elasticity of the walls of blood vessels decreases with age), and the presence of chronic diseases.

How is cerebral vascular regra performed?

Where to do and how much does a head examination cost?

No contraindications and side effects makes the procedure a popular diagnostic method. Rheoencephalography is carried out in public medical institutions or private clinics. The cost of equipment for this research method makes it affordable.

The price for this service depends on the level of equipment of the clinic, the newness of the equipment, the number of specialists making the conclusion, and ranges from 1,500 to 3,500 rubles. Add to list paid services Many centers include an at-home brain examination. In this case, you must be prepared to pay more.

In modern medical science, there are many diagnostic methods and blood vessels. One of them is rheoencephalography (REG). Most likely, every reader has ever heard this word, but does not know what it is and why it is carried out. We'll tell you.

Rheoencephalography (REG) is a functional diagnostic method that can be used to assess the condition of the blood vessels of the brain. With the help of REG, it is possible to characterize the blood supply to the blood vessels of the brain, their elasticity, tone (wall tension), the state of venous outflow, as well as the symmetry of the blood supply to both hemispheres.

These indicators change with vascular damage due to diabetes mellitus, . REG can help in diagnosis cervical osteochondrosis and vertebral artery syndrome. This study is often prescribed for vascular dystonia.

The essence of the method is to measure tissue resistance electric current. When the vessels are filled with blood (electrolyte), the electrical resistance of the tissues decreases, which is recorded by the rheograph. The rate of change of this resistance is used to judge the speed of blood flow in the vessel and the speed of “straightening” of its walls under the influence of blood flow.

Currently, the diagnostic value of the method is questioned. However, REG is widely used for the initial assessment of the state of vascular tone and blood filling in neurological and vascular diseases. The data obtained from REG are nonspecific; they cannot indicate any specific disease. The results of the REG describe only the functional state of the cerebral vessels. Therefore, more often than not, other, more advanced research methods are required to clarify the diagnosis.

How to prepare for research?

Before the examination, it is recommended to get a good night's sleep and not drink tonic drinks.

The results of the REG will be more reliable if you get enough sleep before performing it.
In the morning before the REG, it is not recommended to drink coffee, strong tea or smoke. As prescribed by a doctor, some medications that affect vascular tone can be discontinued. However, most often the study is carried out against the background of the patient’s usual therapy.

Before the examination, you need to rest while sitting for 10 to 15 minutes, and avoid stuffy rooms.

Holders long hair You need to have hairpins or elastic bands with you so that you can secure them. A handkerchief or napkin will be useful so that you can wipe your face and neck after the examination.

How is the research conducted?

REG is performed with the patient sitting. . An elastic band is placed on the subject's head, passing over the eyebrows, over the ears and along the back of the head. In this case, it is better if the hair is removed, because it will get under the tape and interfere with the diagnosis. In addition, it is quite painful.

Then small round electrodes are attached using tape: two above the eyebrows, two behind the ears and two in the occipital region. Sometimes small damp gauze pads are placed under the electrodes. After this, registration of the rheoencephalogram begins. This usually takes a few minutes.

After the main entry, various functional tests. Most often, the patient is asked to take half or a whole tablet of nitroglycerin under the tongue. However, at low blood pressure, glaucoma, nitroglycerin intolerance, this test is not performed. The subject may refuse to undergo it. After taking nitroglycerin, a rheoencephalogram is recorded again.
In some cases, tests are carried out with changes in the position of the body and head (bending, turning), with holding the breath or hyperventilation, temperature, with physical activity and others.
The examination itself takes up to 10 minutes. The results of the study are processed by a functional diagnostics doctor, and this procedure is performed nurse. This is associated with a possible delay in the readiness of the medical report.