238092313 acute-radiation-cerebrovascular-syndrome

Advanced Medical Technology & Systems

Inc.

Dmitri Popov, PhD Radiobiology.

Acute Radiation CerebroVascular

Syndrome. Part 1.

Acute Radiation Cerebrovascular

Syndrome.

Key words:

Cerebrovascular Acute Radiation Syndrome (Cv

ARS), Radiation Neurotoxins (RNT),

Neurotransmitters, Radiation Countermeasures,

Antiradiation Vaccine (ArV), Antiradiation Blocking

Antibodies, Antiradiation Antidote.

Psychoneuroimmunology, Neurotoxicity,

Autoimmunity.


Syndrome.

Functional areas of human brain.


Syndrome.

Cerebrovascular circulation


Syndrome.

To review the role of Radiation Neurotoxins in

triggering, developing of radiation induced central

nervous system injury.

Radiation Neurotoxins – rapidly acting blood toxic

lethal agent, which activated after irradiation and

concentrated, circulated in interstitial fluid, lymph,

blood with interactions with cell membranes,

receptors and cell compartments.


Syndrome.

Radiation Neurotoxins – biological

moleculesproteins with high enzymatic activity

and specific lipids, activated after irradiation.

The Radiation Neurotoxins induce increased

permeability of blood vessels, disruption of the

blood-brain barrier, blood-cerebrospinal fluid

(CSF) barrier and developing severe disorder of

blood macro- and micro-circulation.


Syndrome

Principles of Radiation Psychoneuro-immunology

and Psychoneuro-allergology were applied for

determination of pathological processes

developed after irradiation or selective

administration of Radiation Neurotoxins to

radiation naïve mammals.

Effects of radiation and exposure to radiation can

develop severe irreversible abnormalities of

Central Nervous System, brain structures and

functions


Syndrome. Antiradiation Vaccine.

Antiradiation Vaccine – most effective, advanced

methods of protection, prevention, mitigation and

treatment and was used for of Acute Radiation

Syndromes and elaboration of new technology

for immune-prophylaxis and immune-protection

against ϒ, Heavy Ion, Neutron irradiation and UV

Radiation.


Syndrome. Antiradiation Vaccine.

Results of experiments suggested that blocking,

antitoxic,specific antiradiation antibodies can

significantly reduce toxicity of Radiation Toxins.

New, advanced technology include active

immune-prophylaxis with Antiradiation Vaccine

and effective specific Antiradiation therapy that

included specific blocking antibodies to Radiation

Neurotoxins.


Syndrome.

Antiradiation Vaccine and Antiradiation IgG

preparations – prospective effective

antidote/countermeasure for ϒ-irradiation, heavy

ions irradiation, neutron irradiation and UV

Radiation.

Recommendations for treatment and immune-

prophylaxis of CNS injury, induced by radiation,

were proposed. Specific immune therapy and

specific immune prophylaxis reduce symptoms of

ARCvS.


Syndrome.

Cerebrovascular Acute Radiation Syndrome (ARCv S) is an extremely severe, specific, dynamic injury of Central Nervous System (CNS) and Peripheral Nervous System (PNS).

Toxic stimulation and inhibition of Autonomic

Nervous System – Parasympathetic and

Sympathetic Nervous System occur after

irradiation. Even small doses of radiation could induce injury or disturbance of CNS, PNS and

gastrointestinal nervous system.

Acute Cerebrovascular Radiation

Syndrome.

Grading System for Acute Cerebro-vascular

Radiation Syndrome based on general clinical

signs.

Degree 1 – Mild form of ACvRS.

Radiation Neurotoxins – SRD 4.1;

Nausea, Vomiting - Occasional (once per day).

Anorexia - Able to eat , appetite decreased.

Fatigue syndrome – Able to work.

Hypotension - Blood pressure>100/170 mm Hg.


Syndrome.

Neurologic deficit – Detectable.

Cognitive deficit – Detectable, minor.

--------------------------------------------------------

Degree 2 - Moderate Form.

Radiation Neurotoxins : SRD – 4.2.

Nausea, Vomiting - Intermitted (2-5 times per day).

Anorexia - Intake decreased.

Fatigue syndrome - Impaired work ability.


Syndrome.

Hypotension - Blood pressure <100/70 mmHg

Neurologic deficit - Easy detectable.

Cognitive deficit - Moderate loss.

-------------------------------------

Degree 3 – Severe form.

Radiation Toxins type Group - SRD – 4.3.

Nausea, Vomiting - Persistent (6-10 times per

day).

Anorexia – Intake minimal


Syndrome.

Fatigue syndrome - Need assistance in activity of

daily .

Hypotension - Blood pressure <90/60 mm Hg

Neurologic deficit - Prominent, severe form.

Cognitive deficit - Major loss, severe cognitive

deficit.

-----------------------------------------------------

Degree 4 – Extremely Severe form.

Radiation Neurotoxins form Group - SRD – 4.1.


Syndrome.

Nausea, Vomiting - Extremely severe

Refractory (>10 times per day).

Anorexia - Parenteral nutrition.

Fatigue syndrome - Severe fatique, need full

assistance for daily activity.

Hypotension - Blood pressure <80/? Mm Hg;

Neurological deficit ; Heart beat cessation - Life

threatening, unconsciousness, Possible breathing

and heart beat cessation. Need life support.

Cognitive deficit - Complete impairment


Syndrome.

Grading System of Acute CerebrovascularRadiation Syndrome based on psycho-neurological signs and symptoms .

Mild Grade of Cv ARS.

Mild Psycho-neuroimmunological, psycho-neuro-immunotoxic symptoms. Single subjective symptoms: possible anxiety, fatigue, weakness or headache. The principal effectors of radiation induced activation of Sympathetic Nervous System and Hypothalamic-Pituitary-Adrenal axis. Disrupting balance between inhibitory and excitatory neurotransmitters.


Syndrome.

Moderate Grade of Cv ARS.

Moderate Psycho-neuroimmunological, psycho-

neuro-immunotoxic symptoms.

Multiple subjective symptoms: anxiety,

fatigue, weakness and/or headache.

Edema of brain structures. Inhibitory and excitatory

neurotransmitters counteractions. Radiation

exposure change the balance and increasing

functions of excitatory neurotransmitters – glutamate

and aspartate and decrease functions of inhibitory

neurotransmitters – GABA, glycine, adenosine.


Syndrome.

Severe Grade of Cv ARS.

Severe Psycho-neuroimmunological, psycho-neuro-immunotoxic symptoms.

Multiple subjective symptoms: anxiety,

fatigue, weakness and/or headache. Hypotension.

Fever, mild confusion.

Disruption of blood-brain barrier, blood-cerebrospinal fluid (CSF) barrier, developing severe disorder of blood macro- and micro-circulation.


Syndrome.

Extremely severe Grade of Cv ARS.

Extremely severe Psycho-neuroimmunological

symptoms, psycho-neuro-immunotoxic

symptoms. Intracortical, intra-parenchemal

bleeding. Severe disruption of blood-brain barrier,

blood-cerebrospinal fluid (CSF) barrier and

developing severe disorder of blood macro- and

micro-circulation. Shock.


Syndrome.

Stages of Cerebrovascular Acute Radiation

Syndrome.

Prodromal stage of CV ARS.

Nausea, Vomiting, Watery diarrhea,

Disorientation, Confusion, prostration, Seizures.

Papilledema, ataxia, absent tendon and corneal

reflexes. Nervousness, Symptoms developing

dynamically and may last episodically.


Syndrome.

Latent stage of CV ARS.

This stage the patients developing partial

functionality

Stage continuing for minutes , hours depend on

Grades of ARS. In some cases Latent stage of

CV ARS could be absent.


Syndrome. Manifest stage of CV ARS.

Return of watery diarrhea,

convulsions, coma

The Glasgow Coma Scale allows a standard assessment that include: 1. Eye opening - to loud voice ; 2. Reactions to pain; yes, none. 3. Verbal response - oriented; confused, disoriented; speech.; None verbal response. 4. Motor Response - reaction to command ; pain reactions; abnormal flexion posturing; extensor posturing; movements – tremor, active movements, absence.


Syndrome.

Outcome stage of CV ARS.

Patterns of abnormal breathing - Cheyne-Stokes

respiration or Kussmaul breathing.

The circulatory complications of hypotension,

cerebral edema, increased intracranial pressure,

and cerebral anoxia.

Cessation of breathing, cessation of heart

beating.

238092313 acute-radiation-cerebrovascular-syndrome

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