scholarly journals Experimental research of cerebroprotective activity of the new 4-aminobutatanoic acid derivative

2021 ◽  
pp. 95-100
Author(s):  
Oksana Mishchenko ◽  
Natalia Palagina
Keyword(s):  
Acid Derivative ◽  
Neurological Deficit ◽  
Cognitive Functions ◽  
Cerebrovascular Accident ◽  
Neurological Deficits ◽  
Sodium Thiopental ◽  
Acute Cerebrovascular Accident ◽  
Surgery First ◽  
Extrapolation Escape Test ◽  
Cerebroprotective Activity

The aim. To study the cerebroprotective activity of a new derivative of 4-aminobutanoic acid the compound KGM-5 on the effect on survival and behavioural responses, cognitive impairment and neurological deficits in rats with acute cerebrovascular accident. Materials and methods. Acute cerebrovascular accident (ACVA) was simulated in rats by irreversible unilateral carotid occlusion (UCO) under anesthesia with sodium thiopental (35 mg/kg, intraperitoneally, IP). Five groups of animals were used: intact control (IC, n=6), a group of animals with ACVA, which were not treated (control pathology, CP, n=13); group of animals with ACVA, which were treated for 5 days after surgery (first injection 30 min before surgery) with the compound KGM-5 (ACVA+KGM-5, n=14) at a conditionally effective dose of 30 mg/kg body weight of animals, a group of animals with ACVA (ACVA+CD “Picamilon”, n=13), who received IP for 5 days, the comparison drug (CD) “Picamilon” at a dose of 17 mg/kg and pseudo-operated animals (POA), n=8), which were operated without ligation of the carotid artery, which allows to level the effect of anesthesia and surgery on the studied indicators. The cerebroprotective effect of the studied agents was assessed by an integral criterion – survival of animals (throughout the experiment), indicators of neurological deficit (24, 48, 72, 94 hours after ACVA modelling), the state of cognitive functions in the test of extrapolation escape test (EET) (72 hours after ACVA modelling) Results. The KGM-5 compound contributed to a significant reduction in the severity of neurological deficit, as evidenced by significant differences in this indicator compared with CP, respectively, the first (0.5 points vs. 1.25 points, p<0.05), the third (0.0 points against 1.0 point, p<0.05) and the fourth day (0.0 points vs. 0.5 points, p<0.05) after OCO. Under the influence of CD “Picamilon” reduction of neurological deficit compared with CP was observed on the first, third and fourth days, but these differences were insignificant (p>0.05). Both studied agents - the compound KGM-5 and CD “Picamilon” contributed to the improvement of cognitive functions of rats with ACVA, as evidenced by a significant reduction (p<0.05) of the latent period of diving in the EET, respectively, 1.8 and 1.7 times compared with CP and did not show a significant effect on animal survival. Conclusion. The cerebroprotective activity of a new 4-aminobutanoic acid derivative in the conditions of acute cerebrovascular accident in rats was established in terms of the ability to reduce the severity of neurological deficits and improve cognitive functions in the extrapolation escape test. The severity of cerebroprotective activity of the new compound is not inferior to GABA-ergic drug “Picamilon”.

STAGES OF REHABILITATION OF PATIENTS WITH ACUTE CEREBROVASCULAR ACCIDENT

2021 ◽  
pp. 56-62
Author(s):  
I. V. Kas ◽  
I. S. Petukhova ◽  
T. P. Ustymenko
Keyword(s):  
Neurological Deficit ◽  
Cerebrovascular Accident ◽  
Modern Medicine ◽  
Rehabilitation Program ◽  
The Body ◽  
Medical Rehabilitation ◽  
Multidisciplinary Teams ◽  
Physical Factors ◽  
Acute Cerebrovascular Accident ◽  
Number Of Factors

One of the urgent tasks of modern medicine is organizing the rehabilitation for patients who have suffered a stroke at different stages of rehabilitation. Restoration of impaired functions in such patients occurs in the first 3−5 months from the onset of the disease, that is influenced by a number of factors: duration of the stroke, size of the lesion and pool of lesions, active participation in the process of a patient him−/herself. The main principles of rehabilitation include its early onset in an acute period of stroke; regularity and duration; complexity and multidisciplinarity (formation of multidisciplinary teams); adequacy of rehabilitation measures, i.e. creation of individual programs taking into account the severity of neurological deficit and dysfunction; stages. Different methods of recovery are applied to each patient individually or in combination, or sequentially according to the rehabilitation program, which is based on the analysis of the patient's condition by all members of the multidisciplinary team, taking into account the results of functional testing and objective examination. Medical support, postural correction, kinesitherapy, mechanotherapy (including robotic), field therapy, hardware physiotherapy, massage, acupuncture according to the indications, functional neurotraining and cardiotraining, neuropsychological training are used. The results of research confirm that the integrated use of kinesitherapy, physical factors, balneotherapy, the methods of psychological rehabilitation of patients after stroke provides a faster recovery of neurological deficit, activates non−specific brain systems, restores mental and somatic functions of the body. Therefore, in addition to health, the patient needs to renew his ability to work and social status. Key words: acute cerebrovascular accident, medical rehabilitation, stages of rehabilitation.

Assessment of the Willis circle pathology in patients with acute cerebrovascular accident

2020 ◽  
Vol 18 (5) ◽  
pp. 99-104
Author(s):  
S. K. PERMINOVA ◽  
◽  
A. A. YAKUPOVA ◽  
A. Ya. NAZIPOVA ◽  
R. T. GAYFUTDINOV ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Neurological Deficit ◽  
Cerebrovascular Accident ◽  
National Institutes Of Health ◽  
Stroke Severity ◽  
Functional Disorders ◽  
Good Recovery ◽  
Acute Cerebrovascular Accident ◽  
The Brain

The purpose — to evaluate the Willis circle pathology in patients with acute cerebral circulatory disorders using the National Institutes of Health Stroke Scale, to assess the degree of functional disorders and the long-term perspective. Material and methods. Data from magnetic resonance imaging of the brain and magnetic resonance angiography of the brain were analyzed in 47 patients with acute cerebrovascular accident. The study included 21 (44,6%) men and 26 (55,4%) women, with an average age of 67,08 ± 16,03. All patients underwent neurological examination using the National Institutes of Health Stroke Scale, assessment of functional disorders using the Rivermead scale, and assessment of long-term perspective using the Rankin scale before and after treatment. Results. Patients with the absence of one posterior connective artery showed a significant stroke severity according to the National Institutes of Health Stroke Scale. The largest subgroup with the absence of both posterior connective arteries was identified, having the best indicators on the Rivermead scale before treatment and a good recovery for neurological deficit after treatment. Significant positive results by the Rivermead scale after treatment were shown in the subgroup with the absence of all connecting arteries. Conclusion. The variant of the Willis circle structure in the form of the absence of both posterior connective arteries in patients with acute cerebrovascular accident is most often found with a good recovery of neurological deficit.

CLINICAL CASE OF ACUTE CEREBROVASCULAR ACCIDENT IN A CHILD WITH HEREDITARY THROMBOPHILIA

2020 ◽  
Vol 99 (1) ◽  
pp. 232-236
Author(s):  
P.V. Shumilov ◽  
◽  
A.Ya. Ilyina ◽  
A.L. Mishchenko ◽  
A.S. Barinova ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Acute Cerebrovascular Accident ◽  
Hereditary Thrombophilia

Progressive Early Rehabilitation Program Applied to Patients with Acute Cerebrovascular Accident

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Lung Ventilation ◽  
Rehabilitation Program ◽  
Artificial Lung ◽  
Early Rehabilitation ◽  
Gravity Gradient ◽  
Acute Cerebrovascular Accident ◽  
Artificial Lung Ventilation ◽  
Bed Days ◽  
Severity Of The Disease

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.

Neurological Deficit after Carotid Infusion of Cisplatin and 1,3-Bis(2-chloroethyl)-1-nitrosourea (BCNU) for Malignant Glioma: An Analysis of Risk Factors

Neurosurgery ◽  
1986 ◽  
Vol 19 (5) ◽  
pp. 779-783 ◽  
Author(s):  
P. Kapp John ◽  
A. Sanford Robert
Keyword(s):  
Risk Factors ◽  
Neurological Deficit ◽  
Infusion Pump ◽  
Malignant Gliomas ◽  
Internal Capsule ◽  
Neurological Deficits ◽  
Infusion Therapy ◽  
Infusion Line ◽  
Permanent Neurological Deficit ◽  
Infusion Technique

Abstract The records of 24 patients with malignant gliomas treated with carotid infusion of cisplatin and 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) are reviewed for risk factors that might suggest the development of a permanent neurological deficit after infusion. Permanent neurological deficits were seen with doses of cisplatin as low as 69 mg/m2, although doses as high as 100 mg/m2 were tolerated by other patients. All 3 patients who developed permanent neurological deficits received fixed doses of cisplatin of 150 mg and supplied only 2 major intracranial branches from the infused carotid artery. In none of these patients was a filter used in the infusion line. Other risk factors identified in 2 of the 3 patients were diffuse neoplasm involving the region of the internal capsule and the use of an infusion pump rather than a pulsatile bolus infusion technique. The development of a permanent neurological deficit appeared unrelated to the dose of BCNU within the range utilized, and preinfusion administration of corticosteroids did not prevent neurological deficit. These possible risk factors should be considered in the future development of protocols for arterial infusion therapy of malignant gliomas.

scholarly journals Incidence and Risk Factors for Neurological Deterioration in Posterior Corrective Surgeries for Severe Angular Kyphotic Deformities: A 10-Year Institutional Retrospective Study

2020 ◽  
pp. 219256822097912
Author(s):  
Kalyan Kumar Varma Kalidindi ◽  
Sulaiman Sath ◽  
Jeevan Kumar Sharma ◽  
Gayatri Vishwakarma ◽  
Harvinder Singh Chhabra
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Neurological Deficit ◽  
Operative Time ◽  
Deformity Correction ◽  
Neurological Deterioration ◽  
Kyphotic Deformity ◽  
Neurological Deficits ◽  
Retrospective Case ◽  
Significant Difference

Study Design: Retrospective case-control study. Objective: Neurological deficit is one of the dreaded complications of kyphotic deformity correction procedures. There is inconsistency in the reports of neurological outcomes following such procedures and only a few studies have analyzed the risk factors for neurological deficits. We aimed to analyze the factors associated with neurological deterioration in severe kyphotic deformity correction surgeries. Methods: We performed a retrospective study of 121 consecutive surgically treated severe kyphotic deformity cases (49 males, 56 females) at a single institute (May 1st 2008 to May 31st 2018) and analyzed the risk factors for neurological deterioration. The demographic, surgical and clinical details of the patients were obtained by reviewing the medical records. Results: 105 included patients were divided into 2 groups: Group A (without neurological deficit) with 92 patients (42 males, 50 females) and Group B (with neurological deficit) with 13 patients (7 males, 6 females) (12.4%). Statistically significant difference between the 2 groups was observed in the preoperative sagittal Cobbs angle (p < 0.0001), operative time (p = 0.003) and the presence of myelopathic signs on neurological examination (p = 0.048) and location of the apex of deformity (p = 0.010) but not in other factors. Conclusions: Preoperative Sagittal Cobbs angle, presence of signs of myelopathy, operative time and location of apex in the distal thoracic region were significantly higher in patients with neurological deterioration as compared to those without neurological deterioration during kyphotic deformity correction surgery. Distal thoracic curve was found to have 4 times more risk of neurological deterioration compared to others.

SOME ASPECTS OF ACUTE CEREBROVASCULAR PATHOLOGY IN POSTPARTUM WOMEN

Vestnik ◽  
2021 ◽  
pp. 51-56
Author(s):  
Д.А. Митрохин ◽  
Ж.Б. Дюсембаева ◽  
М.М. Ибрагимов ◽  
А.А. Оспанов ◽  
А.Н. Сембинова ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Postpartum Period ◽  
Cerebrovascular Accident ◽  
Hemorrhagic Stroke ◽  
Speech Disorders ◽  
Cerebral Stroke ◽  
Postpartum Women ◽  
Bioelectrical Activity ◽  
Acute Cerebrovascular Accident ◽  
Epileptiform Discharges

В данной статье, представлены результаты обследования 17 женщин, перенесших острое нарушение мозгового кровообращения в послеродовом периоде, с 2017 по 2021 годы, в возрасте от 19 до 39 лет. Показано, что у женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, выявлено преобладание ишемического инсульта над геморрагическим, что составило 64,7% и 35,3% соответственно. Неврологические признаки церебрального инсульта в послеродовом периоде характеризуются двигательными, речевыми расстройствами, нарушением чувствительности, а также часто психоэмоциональными проявлениями. Генерализованные тонико-клонические приступы чаще наблюдались у пациенток с геморрагическим инсультом (33,3%), в сравнении с ишемическим инсультом (9,1%). У женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, наиболее значимыми факторами риска являются: наличие хронических заболеваний, в том числе отягощенный акушерско-гинекологический анамнез, прием пероральных контрацептивов, а также курение. Биоэлектрическая активность головного мозга характеризовалась выраженной дельта и тета активностью, эпилептиформными разрядами в виде острых волн, спайков и комплексов «пик-волна», с преобладанием у пациенток с геморрагическим инсультом. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. Отмечено повышение интегрального индекса диапазона медленно-волновой активности и преобладание процентного отношения спектральных мощностей медленных волн (дельта, тета) к быстрым волнам (альфа, бета), особенно выраженное у больных с геморрагическим инсультом (р < 0,05), в сравнении с ишемическим инсультом. Наиболее тяжелое течение послеродового периода наблюдалось у пациенток с геморрагическим инсультом, именно в этом случае было 2 летальных исхода. This article presents the results of a survey of 17 women with acute cerebrovascular accident in the postpartum period, from 2017 to 2021, aged 19 to 39 years. It is shown that the period in women in the postpartum period, who underwent acute cerebrovascular accident, revealed the prevalence of ischemic stroke over hemorrhagic, which amounted to 64,7% and 35,3%, respectively. Neurological signs of cerebral stroke in the postpartum period are characterized by movement, speech disorders, impaired sensitivity, and often psychoemotional manifestations. Generalized tonic-clonic seizures were more often observed in patients with hemorrhagic stroke (33,3%) in comparison with ischemic stroke (9,1%). In postpartum women who have suffered acute cerebrovascular accident, the most significant risk factors are: the presence of chronic diseases, including a burdened obstetric and gynecological history, taking oral contraceptives, as well as smoking. The bioelectrical activity of the brain was characterized by pronounced delta and theta activity, epileptiform discharges in the form of sharp waves, spikes and peak-wave complexes, with a predominance in patients with hemorrhagic stroke. A more significant increase in the coherence index in the delta and theta ranges in patients after hemorrhagic stroke may indicate more severe interhemispheric disorders in comparison with ischemic stroke. An increase in the integral index of the range of slow-wave activity and a predominance of the percentage of the spectral powers of slow waves (delta, theta) to fast waves (alpha, beta), especially pronounced in patients with hemorrhagic stroke (p <0,05), in comparison with ischemic stroke. The most severe postpartum period was observed in patients with hemorrhagic stroke, in this case there were 2 deaths.

Safety and efficacy of electroconvulsive therapy for depression following cerebrovascular accident

2012 ◽  
Vol 24 (4) ◽  
pp. 226-229 ◽  
Author(s):  
Magdalena Romanowicz ◽  
Bruce Sutor ◽  
Christopher Sola
Keyword(s):  
Electroconvulsive Therapy ◽  
Cerebrovascular Accident ◽  
Chart Review ◽  
Short Term Memory ◽  
Retrospective Chart Review ◽  
Neurological Deficits ◽  
Response To Treatment ◽  
Short Term ◽  
Memory Problems ◽  
Depressive Syndromes

Introduction: Depressive syndromes are common following cerebrovascular accident (CVA) and many patients do not respond to pharmacotherapy. Electroconvulsive therapy (ECT) is a safe and effective treatment for mood disorders arising with many comorbid medical conditions. In this paper, we describe the successful treatment of post-CVA depression with ECT.Methods: Retrospective chart review of 24 patients hospitalised for depression on an in-patient Medical Psychiatry unit between 2000 and 2010. Medical, neurologic and psychiatric histories, physical examination findings, results of laboratory, imaging and neurophysiologic investigations and treatment response with medications and ECT were recorded.Results: Twenty patients (83%) showed a positive response to treatment with ECT. None had worsening of depression after the ECT or experienced exacerbation of post-stroke neurological deficits. Three patients suffered from minor complications of ECT (prolonged confusion or short-term memory problems).Conclusions: This review supports the use of ECT after a stroke with appropriate clinical observation. The treatment was well tolerated and the majority obtained clinical benefit.

Early Stroke Detection in Perioperative Patients: A Simple Educational Intervention and Feasibility Study

2021 ◽  
Vol 104 (1) ◽  
pp. 150-158
Keyword(s):  
Neurological Deficit ◽  
Heart Surgery ◽  
Negative Impact ◽  
Open Heart Surgery ◽  
Neurological Deficits ◽  
Number Needed To Treat ◽  
High Morbidity ◽  
Neurological Assessment ◽  
Post Intervention ◽  
Perioperative Stroke

Background: Perioperative stroke is uncommon. However, it carries high morbidity and mortality. Unfortunately, the diagnosis is usually delayed resulting in reduced possibility for therapeutic intervention. Objective: To develop a protocol directed at shortening the time to detect neurological deficits in postoperative patients. Materials and Methods: By using a pre-post intervention design to evaluate the time to stroke recognition in post-open heart surgery patients. The intervention consisted of 1) A new protocol to evaluate new neurological deficits within 14 days after surgery, composed of six items of simple neurological assessment applied by CVT nurses during routine vital sign measurement. 2) An educational program for nurses, patients, and family focusing on postoperative stroke complications. Results: Between January 2014 and October 2015, the authors retrospectively reviewed 27 consecutive patients with acute neurological deficit within 14 days after surgery as the pre-intervention population. Twenty-seven consecutive patients with postoperative neurological deficits were enrolled during a post-intervention period, which was between November 2015 and September 2016. Comparing pre- and post-intervention periods, the authors found that stroke fast track activation was significantly increased from 4/27 (14.80%) to 15/27 (55.60%) (p=0.002). The median (min-max) duration from time last seen normal to first neurological deficit detection was reduced from 690 (19 to 9,190) to 130 (5 to 5,935) minutes (p=0.003). The number needed to treat for early detection when the protocol was used was 2.94. There was an increasing trend to endovascular treatment. Conclusion: Perioperative stroke is rare. However, it has negative impact to postoperative patients’ outcome. A simple protocol for postoperative neurological assessment after cardiac surgery is feasible to detect perioperative stroke. Keywords: Postoperative, In-hospital, Detection, Recognition, Stroke

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