scholarly journals Electric myocardial inhomogeneity and stroke: connection and specifics

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
R Sharafutdinova ◽  
VI Ruzov ◽  
RH Gimaev ◽  
DY Skvortsov ◽  
PV Belogubov
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Right Hemisphere ◽  
Qt Dispersion ◽  
Electrical Stability ◽  
Hemispheric Stroke ◽  
Funding Sources ◽  
Electrical Instability ◽  
The Right ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background. The inconsistency of the literature data on the influence of different hemispheric localization of Cerebrovascular accident (CVA) on the development of cardiac arrhythmias suggests the expediency of further study of the so-called "zones" of the cerebral cortex associated with electrical instability of the myocardium.  It is known that dispersion of QT interval and fragmented myocardial activity belong to the markers of electrical instability of the heart and are associated with arrhythmogenesis.  The aim of the study.  To study the severity of abnormalities of the parameters of electrical instability of myocardium in right and left hemispheric stroke localization in patients with hypertension. Material and methods. 111 patients with left hemispheric localization of ischemic stroke and 75 patients with right hemispheric stroke were examined. Hemorrhagic stroke was observed in 17 patients in the left hemisphere and in 13 patients in the right hemisphere. The average age was 58,2 ± 7,48 years. For all strokes, men prevailed (64% vs. 36%). For the first day of the stroke, all patients were evaluated for QT dispersion and fragmented myocardial activity on the device "Polyspectro-8EX" (Russia).  Research results.  Evaluation of the parameters of electrical instability of myocardium in patients with stroke revealed more pronounced disorders in hemorrhagic stroke of left hemispheric localization (Table 1). In ischemic stroke, the severity of electrophysiological parameters, reflecting the instability of the myocardium depending on the hemispheric localization, indicates the absence of differences.  Conclusions.  1.The most pronounced disturbances in the parameters of electrical stability of the myocardium is observed in hemorrhagic stroke.  2.The severity of myocardial electrical instability in ischemic stroke is not associated with the localization of the focus.

scholarly journals Overview of The Head CT-Scan in Stroke Patients who was Treated at Muhammadiyah Hospital Palembang

2021 ◽  
Vol 2 (1) ◽  
pp. 24
Author(s):  
Pratrisna Yusastra ◽  
Indriyani Indriyani ◽  
Budi Utama
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Hemorrhagic Stroke ◽  
Right Hemisphere ◽  
Clinical Symptoms ◽  
Neurological Deficits ◽  
Thalamic Lesion ◽  
Stroke Patients ◽  
Head Ct ◽  
The Right

Background: Stroke is a collection of symptoms of neurological deficits due to sudden acute disturbance of brain function, both focal and global, caused by blockage or rupture of arteries and veins and proven by imaging and/or reflex pathology. Using CT-Scan, the description of acute phase stroke can be easier and can determine the appropriate treatment criteria for stroke. Purposes: To determine characteristic Head CT-Scan image of stroke patients hospitalized in Muhammadiyah Palembang Hospital. Methods: This study was conducted in a retrospective descriptive manner and obtained a sample of 41 stroke patients according to the inclusion and exclusion criteria using total sampling. Result: In this study, there were 28 patients (68.2%) with ischemic stroke and 13 patients (31.7%) with hemorrhagic stroke. Head CT-Scan image of ischemic stroke shows basal ganglia lesion (28.5%) and the right hemisphere lesions (57.1%) as the most predominant area. Head CT-Scan image of hemorrhagic stroke (58.3%) had intracerebral hemorrhage with the dominant thalamic lesion area (66.6%) and the right hemisphere (58.3%) had the most lesions with 8 patients (66, 6%) had a midline shift. Stroke patients were treated as experienced by the elderly (90.2%) and were dominated by the female sex (63.4%) and are dominated by clinical symptoms of hemiparesis (29.2%). Conclusion: Stroke patients at Muhammadiyah Palembang hospital dominated by ischemic stroke and on head CT Scan image predominantly shows lesions on the right cerebral hemisphere.

scholarly journals Unexpected Reading Dissociation in a Brazilian “nisei” with Crossed Aphasia

1994 ◽  
Vol 7 (3-4) ◽  
pp. 165-170 ◽  
Author(s):  
P. Caramelli ◽  
M. A. M. P. Parente ◽  
M. L. Hosogi ◽  
M. Bois ◽  
A. R. Lecours
Keyword(s):  
Reading Comprehension ◽  
Ischemic Stroke ◽  
Right Hemisphere ◽  
Written Language ◽  
Cerebral Hemispheres ◽  
Japanese Language ◽  
Writing System ◽  
Crossed Aphasia ◽  
The Right ◽  
Reading Impairments

There is an increased interest in reading impairments in the Japanese language, due to its particular writing system which includes two different scripts, Kanji (logograms) and Kana (phonograms). Reading dissociations between Kanji and Kana have been described, showing that each system is processed differently by the cerebral hemispheres. We describe the case of a 68 year old Brazilian “nisei” (i.e. born from Japanese parents) who had knowledge of both Japanese and Portuguese. He presented an ischemic stroke affecting the right hemisphere and subsequently developed a Broca's aphasia and an unexpected reading dissociation, with an impairment in Kana reading comprehension and a good performance in Kanji and in Portuguese. These findings suggest that the patient's right and left hemispheres have assumed opposite roles not only for oral but also for written language decodification.

scholarly journals The influence of nicergoline on cerebral, systemic and cardiac hemodynamics in patients who have had an ischemic stroke

2021 ◽  
pp. 17-26
Author(s):  
Viktor Kuznetsov
Keyword(s):  
Ischemic Stroke ◽  
Recovery Period ◽  
Peripheral Resistance ◽  
Cerebral Hemodynamics ◽  
Stroke Patients ◽  
Hemispheric Stroke ◽  
Cardiac Hemodynamics ◽  
Before And After ◽  
Blood Flow Velocities ◽  
The Right

The Aim of study was analysis of the effect of nicergoline on the cerebral, cardiac, systemic hemodynamics of patients after ischemic stroke, taking into account the hemispheric localization of the ischemic focus. Materials and methods. A comprehensive clinical and neurological examination was carried out in 38 elderly patients (mean age 64.3 ± 2.5 years) who had undergone atherothrombotic ischemic stroke in the carotid system (recovery period). There were 20 patients with left hemispheric stroke and 18 with right hemispheric stroke. All patients had arterial hypertension (AH). These were ACE inhibitors (enalapril 10-20 mg 1 tablet 2 times a day) and hydrochlorothiazide at a dose of 12.5 mg. Patients received nicergoline at a dose of 4 mg IV drip for 10 days. A comprehensive examination was carried out before and after treatment with nicergoline. The Results of the study allowed us to conclude that the course of nicergoline intake in patients after ischemic atherothrombotic stroke improves the subjective state and reduces the severity of neurological disorders, cerebral hemodynamics, increases linear systolic blood flow velocities (LBFVsys) and reduces peripheral resistance in individual extra- and intracranial vessels of the carotid and vertebro-basilar basins. In patients with right and left hemispheric localization of stroke under the influence of nicergoline, LBFVsys increases in the right and left ICA, PCA, and VA. In addition, LBFVsys increases in patients with right hemispheric stroke in the right MBA; in patients with left hemisphere - in two MBA and BA. In ischemic stroke patients, nicergoline affects systemic and cardiac hemodynamics: it reduces the systemic and cardiac hemodynamics, decreases the systemic vascular resistance and increases the ejection fraction, changes the structure of the relationship between systemic and cerebral hemodynamics, forming a positive relationship between blood pressure and hemodynamics in the vessels of the vertebro-basilar basin. Thus, the complex positive effect of nicergoline on various levels of cerebral, systemic and cardiac hemodynamics in ischemic stroke patients gives grounds to recommend the inclusion of this drug in the rehabilitation system of this category of patients.

scholarly journals Music and Stroke Rehabilitation: A Narrative Synthesis of the Music-Based Treatments used to Rehabilitate Disorders of Speech and Language following Left-Hemispheric Stroke

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Kevin Draper
Keyword(s):  
Right Hemisphere ◽  
Language Disorders ◽  
Narrative Synthesis ◽  
Speech And Language ◽  
Speech Prosody ◽  
Hemispheric Stroke ◽  
Melodic Intonation Therapy ◽  
The Right ◽  
Speech And Language Disorders

Stroke is a leading cause of long-term disability. A stroke can damage areas of the brain associated with communication, resulting in speech and language disorders. Such disorders are frequently acquired impairments from left-hemispheric stroke. Music-based treatments have been implemented, and researched in practice, for the past thirty years; however, the number of published reports reviewing these treatments is limited. This paper uses the four elements of the narrative synthesis framework to investigate, scrutinise and synthesise music-based treatments used in the rehabilitation of patients with speech and language disorders. A systematic review revealed that fifteen studies meet the inclusion criteria set out. It was found that the music-based treatments utilised included: Melodic Intonation Therapy (MIT), Modified Melodic Intonation Therapy (MMIT), adapted forms of MIT, the Singing Intonation, Prosody, breathing (German: Atmung), Rhythm and Improvisation (SIPARI) method and a variety of methods using singing and songs. From a synthesis of the data, three themes emerged which were key elements of the interventions; they were: (a) singing songs and vocal exercises, (b) stimulating the right hemisphere and (c) use of speech prosody. These themes are discussed and implications for newly-qualified practitioners are explored.

Abstract WMP16: Eloquence-Weighted Imaging Improves Clinical Outcomes Prediction in Endovascular Stroke Therapy

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Sunil A Sheth ◽  
David S Liebeskind ◽  
Conrad W Liang ◽  
Albert J Yoo ◽  
Reza Jahan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Acute Ischemic Stroke ◽  
Left Hemisphere ◽  
Right Hemisphere ◽  
Infarct Volume ◽  
Good Outcome ◽  
Relative Contribution ◽  
C Statistic ◽  
The Right

Background: Larger infarct size at presentation as determined by ASPECTS is associated with reduced likelihood of good outcome in acute ischemic stroke. However, infarct volume alone explains only a modest fraction (∼30%) of the variation in stroke outcome. Incorporating the relative eloquence of each ASPECTS region may improve the predictive power. Methods: In the combined database of the SWIFT and STAR trials, we identified patients treated with the Solitaire stent retriever. Using the 24hr CT scan, a multivariate linear regression was used to determine the relative contribution of each ASPECTS region, separately in each hemisphere, to freedom from disability (mRS 0-2) at 90 days. The coefficients from the regression were used to create an Eloquence-weighted ASPECTS score (EL-ASPECTS), which was compared against the original in predicting outcome based on the presentation CT scan. Results: Among 254 patients treated with ET, average age was 68, 64% were female, and NIHSS was mean 16 (SD +/- 5). Mean ASPECTS at presentation was 8.2 and 6.4 at 24 hrs. The most commonly involved ASPECTS regions were the lentiform nuclei (70%), insula (55%), and caudate (52%). In multivariate analysis, for the right hemisphere on 24hr CT, preservation of M1 (OR 1.6) and M4 (OR 1.2) regions were most strongly predictive of good outcome. For the left hemisphere on 24 hr CT, preservation of M3 (OR 2.6), and M5 (OR 2.5) and involvement of M2 (OR -1.9) were most predictive. Eloquence weights were assigned to all 20 R/L ASPECTS regions to create EL-ASPECTS. EL-ASPECTS, compared with original ASPECTS, demonstrated improved discrimination for independent functional outcome for right hemisphere (C-statistic 0.78 vs. 0.69), left hemisphere (0.78 vs. 0.72), and all stroke patients (0.76 vs. 0.70). On presentation CTs, multivariate analyses including age and presentation NIHSS demonstrated EL-ASPECTS but not original ASPECTS was predictive of good clinical outcome (OR 1.65, p<.01). Higher C-statistic values were seen with EL-ASPECTS in analysis of presentation CT scans. Conclusions: Incorporation of regional weighting into ASPECTS improves the ability to predict who will achieve independent functional outcomes with endovascular therapy in acute ischemic stroke.

scholarly journals Structural changes in liver under conditions of experimental hemorrhagic stroke

2019 ◽  
Vol 32 (2) ◽  
pp. 67-70
Author(s):  
Natalia Motorna
Keyword(s):  
Structural Changes ◽  
Hemorrhagic Stroke ◽  
Right Hemisphere ◽  
Total Density ◽  
Partial Regression ◽  
The Right

Abstract The article describes the results of histological and morphometric studies of liver in Balb/c mice with hemorrhagic stroke. The hemorrhagic stroke was modeled in the animals by administering autoblood in volume of 0.1 ml in the right hemisphere, and within 5, 10 and 30 days an analysis of structural changes in the liver was performed. Progressive changes were established in terms of 5-10 days of the experiment. This consisted of changes in the sinusoidal capillaries and notable changes in the central veins of the liver lobuli. Herein, acute dilatation and erythrocytal stasis were most pronounced around the lumen of the central veins, while hepatocytes with signs of necrosis (severe cytoplasmic swelling, vacuolar dystrophic changes) were detected in the sinusoid capillaries. The results of the morphometry indicated an increase in the area of the nucleus and the cells caused by intracellular swelling, domination of euchromatin and decrease of total density of chromatin in nuclei. Partial regression of the diameter of sinusoidal capillaries and the area of hepatocytes were detected on the 30th day of the experiment. The changes in the sinusoidal capillaries of the liver lobules are assessed as secondary to stroke, as well as to changes in organ microcirculation, and are associated with dystrophic changes in the hepatocytes.

scholarly journals Leadless pacemakers: where is the device?

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
M Elrefai ◽  
C Menexi ◽  
P Roberts
Keyword(s):  
Heart Diseases ◽  
Sinus Node ◽  
X Rays ◽  
Funding Sources ◽  
Safety And Reliability ◽  
Chest X Ray ◽  
Implantation Sites ◽  
The Right ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Leadless pacemakers (LPs) were designed to avoid lead-related complications associated with transvenous pacing. To minimise the risk of complications, there is preference towards implanting LPs into the septal aspect of the right ventricle rather than the apex or free wall. The Transcatheter Pacing Study (TPS) and the international post-approval registry demonstrated the safety and reliability of the LP systems in real-world settings. The registry demonstrated that more than half of the LPs were implanted into the septum and most required &lt;2 attempts at deployment. We report a radiological method of defining LP position. Methods We reviewed the first 100 LPs implanted at our centre. Two independent observers who didn’t implant LPs reviewed the patients’ post-implant fluoroscopy images and/or post-implant CXRs when available. The reviewers assessed the devices’ positions in postero-anterior (PA) and/or right anterior oblique (RAO) views based on conventional fluoroscopic criteria for lead position. We used the proposed criteria interchangeably on fluoroscopic images and post implant CXRs (Figure). Differences in classification of device position were resolved by consensus. Results Three experienced operators implanted 100 LPs at our centre. Patients (61% male) 56.6 ± 22.2 years had normal hearts (74%), ischaemic cardiomyopathies (12%), congenital heart diseases (6%), valvular pathologies (5%) and dilated cardiomyopathies (3%). Indications for pacing were symptomatic sinus node dysfunction (36%), followed by high grade atrio-ventricular block (33%), bradyarrhythmia associated with atrial tachyarrhythmias (27%) and other indications for pacing (4%). We had a 100% successful implant rate, 88% required ≤2 attempts and 70% required one attempt. There were no major complications. We were able to classify the site of the LPs implants in a total of 90 patients who had fluoroscopic projections or chest x-rays that would allow us to classify the implant sites. A total of 32 implants were in the apex (35.6%). 28 were in mid-septum (31.1 %), 15 in the apical septum (16.7%), 14 on the septal aspect of the right ventricular inflow (15.5%) and 1 implant (1.1%) in the septum of the RV outflow tract. Conclusion Our proposed method of defining LP position demonstrated that the rate of implants into the true apex at our centre was highly comparable to that of the international registry. It also showed that we had lower rates of implants into the mid-septum in favour of apical septum. There were no pericardial effusions or cardiac perforations resulting from our implant procedures regardless of the site of the implant. We utilised widely used fluoroscopic and chest x-ray criteria for categorisation of the LPs implantation sites. However, a recognised limitation to our analysis is that our findings were not validated using other imaging modalities such as echocardiogram or cardiac computerised tomography (CT). Abstract Figure. Criteria to classify device position

scholarly journals Diagnostic of psychoemotional and cognitive impairments in acute ischemic stroke

2021 ◽  
Author(s):  
Anastasya . M. Tynterova
Keyword(s):  
Ischemic Stroke ◽  
Coping Strategies ◽  
Acute Ischemic Stroke ◽  
Left Hemisphere ◽  
Right Hemisphere ◽  
Cognitive Impairments ◽  
Self Control ◽  
Cerebral Hemispheres ◽  
Adaptive Coping ◽  
The Right

Aims: to assess the severity of cognitive, psychoemotional, behavioral disorders, the level of self-control and prevalence of certain coping strategies in patients with lesions of the right and left cerebral hemispheres after acute ischemic stroke. Materials and methods: The study included 60 patients with a diagnosis of ischemic stroke. Depending on the location of the stroke, patients were divided into two groups: Group 1 - 30 patients with lesions of the right hemisphere, Group 2 - 30 patients with lesions of the left hemisphere. The study was conducted on the 7th day of treatment and included: assessment of the cognitive status according to the Montreal scale (with additional scales for assessing the functions of the right hemisphere); assessment of the level of distress, depression, anxiety and somatization using the Four DimensionalSymptomQuestionnaire; assessment of mental and physical asthenia according to the MFI-20 scale, level of self-control using the Rotter'sLocus of Control Scale and coping strategies modality using E. Heim coping questionnaire. Results: The study established the prevalence of depression, a tendency towards non-adaptive coping strategies, ideational praxis related disorders understanding of metaphors and low level of self-control in relation to health in patients with lesions of the right hemisphere. Patients with ischemic stroke localized in the left hemisphere are characterized by a high level of mental asthenia, a choice of adaptive and relatively adaptive coping strategies, and a low level of self-control in respect to interpersonal relationships. Conclusions: The results of the study show that in the acute period of stroke there are qualitative and quantitative differences in neuropsychiatric symptoms of patients with lesions of the right and left cerebral hemispheres. The predominance of depression, cognitive impairments, and non-adaptive coping strategies in patients with lesions of the right hemisphere even with minimal or moderate motor deficits justifies early examination of the patient's behavioral, neuropsychiatric, and cognitive syndromes. The results of the study indicate the need to develop individual psychological rehabilitation programs for patients with lesions of the right and left cerebral hemispheres during the acute period of stroke.

scholarly journals HUBUNGAN LETAK LESI HEMISFER SEREBRAL DAN DERAJAT KLINIS KECEMASAN PADA PENDERITA STROKE ISKEMIK

2018 ◽  
Vol 36 (1) ◽  
Author(s):  
Yelly Marliana Patu ◽  
Audry Devisanty Wuysang ◽  
Nadra Maricar
Keyword(s):  
Ischemic Stroke ◽  
Rating Scale ◽  
Right Hemisphere ◽  
P Value ◽  
Chi Square ◽  
Hemisphere Lesion ◽  
Hamilton Anxiety Rating Scale ◽  
The Right ◽  
The Relationship ◽  
Hamilton Anxiety

   RELATIONSHIP BETWEEN LOCATION OF CEREBRAL HEMISPHERE LESION AND CLINICAL DEGREES OF ANXIETY IN ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Stroke is the leading cause of disability and the third cause of death in the world. The lesion in the right hemisphere is most often associated with anxiety.Aim: Knowing the relationship between the location of the lesion and the degree of anxiety in patients with acute ischemic post-stroke.Method: Cross-sectional study of 40 ischemic post-stroke patients at Wahidin Sudirohusodo Hospital and network- ing hospitals in January-April 2018.  The degree of anxiety was measured by the Hamilton Anxiety Rating Scale (HARS). Chi-square and Mann-Whitney tests were used to analyze the relationship between variables with a p value <0.05 consid- ered significant.Result: There was a significant relationship between the location of the lesion in the hemisphere and the HARS score (p=0.01); and between the location of infarction lesions (cortical and subcortical) with the degree of anxiety in patients with ischemic stroke (p=0.012).Discussion: Moderate-severe anxiety levels occur higher in the lesions in the right hemisphere. The clinical instru- ments used cannot eliminate the element of subjectivity.Keywords: Anxiety in stroke, ischemic stroke, left hemisphere, lesion location, right hemisphereABSTRAKPendahuluan: Stroke merupakan penyebab utama kecacatan dan kematian ketiga terbanyak di dunia. Lokasi lesi di hemisfer kanan merupakan lokasi lesi yang paling sering dikaitkan dengan timbulnya kecemasan.Tujuan: Mengetahui hubungan antara lokasi lesi dan derajat kecemasan pada penderita pascastroke iskemik akut.Metode: Desain potong lintang pada 40 sampel penderita pascastroke iskemik di RS Wahidin Sudirohusodo dan rumah sakit jejaring pada bulan Januari-April 2018. Derajat kecemasan diukur dengan Hamilton Anxiety Rating Scale (HARS). Uji Chi-square dan Mann-Whitney digunakan untuk menganalisis hubungan antar variabel dengan nilai p<0,05 dianggap bermakna.Hasil: Terdapat hubungan yang signifikan antara lokasi lesi di hemisfer dengan skor HARS (p=0,01); dan antara lokasi lesi infark (kortikal dan subkortikal) dengan derajat kecemasan pada penderita stroke iskemik (p=0,012).Diskusi: Derajat kecemasan sedang-berat lebih tinggi terjadi pada lesi di hemisfer kanan.  Instrumen klinis yang digunakan tidak dapat menghilangkan unsur subjektifitas.Kata kunci: Cemas pada stroke, hemisfer kanan, hemisfer kiri, letak lesi, stroke iskemik

scholarly journals Anosognosia in acute stroke and functional recovery after stroke

2019 ◽  
Vol 49 (1) ◽  
Author(s):  
Mirjana Vidović ◽  
Adnan Burina ◽  
Omer Ć. Ibrahimagić ◽  
Dževdet Smajlović
Keyword(s):  
Acute Stroke ◽  
Hemorrhagic Stroke ◽  
Right Hemisphere ◽  
Statistical Significance ◽  
Post Stroke ◽  
Level Of Functioning ◽  
Clinical Center ◽  
The Right ◽  
The University ◽  
Scale 8

The aim of this study was to evaluate anosognosia in acute stroke phase in order to type of stroke (ischemia, hemorrhage) and stroke localization as well as post-stroke patients recovery. Subjects and methods: In this prospective analysis were included 191 patients (96 males and 95 females) with first-ever stroke who were treated at the Department of neurology of the University Clinical Center in Tuzla. All patients were tested to anosognosia presence in acute stroke phase according to the modified Bisiach scale (7), while the level of disability was assessed using the Rankin scale (8) and level of functioning in daily activities using the Barthel index (9). Re-testing was done in week five post-stroke. Results: The average age of patients was 66.41 (mean age 10.21). Ischemic stroke had 168 patients (88%) while 23 (12%) the hemorrhagic one. The lesions localized to the right hemisphere were in 111 (58.11%) patients as well as in 80 (41.89%) patients with lesions localized to the left hemisphere. Anosognosia with no statistical significance was verified in 28% of patients in acute stroke phase, more often caused by lesions to the right hemisphere. Otherwise, significantly more frequent anosognosia was present in patients with hemorrhagic stroke mostly caused by massive lesions localized to the right hemisphere. Conclusion: Presence of anosognosia in patients with stroke vitally influenced patient’s functional status in re-testing phase just as well as in the acute stroke phase.

Sign in / Sign up

Export Citation Format

Share Document