Cerebrovascular circulatory disorders: new aspects of pathophysiology and therapy

After reviewing new aspects in the pathophysiology of the poststenotic cerebral ischemia as the cause of the various syndromes of cerebrovascular disorders, therapeutic approaches are discussed. The fatal vicious cycle of the disturbances of the nutritive blood flow within the cerebral microcirculation can be interrupted by means of pentoxifylline. By amelioration of the disturbed flow properties of blood in the microcirculation due to improvement of red cell deformability and inhibition of platelet aggregation, oxygen supply is enhanced and more glucose offered. Membrane permeability and functions of the cells are normalized by the inhibitory action on edematous changes in the brain tissue and by removal of the mechanical obstacles of microcirculation. The disturbed cerebral metabolism is stimulated by enhancement of the energy-rich phosphates in the brain cells. The combined rheological, antiedematous and metabolic effects of pentoxifylline offer a complex therapy of cerebrovascular insufficiency.