scholarly journals CLINICAL-NEUROPHYSIOLOGICAL FEATURES IN PATIENTS WITH REPEATED CEREBRAL ISCHEMIC HEMISPHERIC STROKE IN ACUTE PHASE OF DISEASE

2019 ◽  
pp. 22-28
Author(s):  
O. A. Kozolkin ◽  
L. V. Novikova
Keyword(s):  
Ischemic Stroke ◽  
Acute Phase ◽  
Neurological Deficit ◽  
Hemispheric Asymmetry ◽  
Cognitive Deficit ◽  
Spectral Power ◽  
Nihss Score ◽  
Moderate Dementia ◽  
Cerebral Ischemic ◽  
Δ Rhythm

Summary. In order to study the clinical and neurophysiological features in patients with recurrent cerebral ischemic hemispheric ischemic stroke (RCHIS), a comprehensive clinical-paraclinical study of 49 patients (28 men and 21 female, mean age 72 (63; 76) years) in the acute period of the disease was conducted. It was found domination of mild and moderate dementia, the median total NIHSS score in the debut of the disease consisted 10 (7; 13), which corresponded to the average severity of the stroke. It was found that the parameters of δ-rhythm APS, δ-rhythm RSP and β rhythm  relative spectral power have the strongest correlation with level of neurological deficit by NIHSS score and with  level of disability by MRS, as well as parameters of occipital-frontal grade of  βhi-rythm and hemispheric asymmetry of αlo-subband correlated with the level of cognitive deficit.

scholarly journals CLINICAL-NEUROPHYSIOLOGICAL FEATURES IN PATIENTS WITH REPEATED CEREBRAL ISCHEMIC HEMISPHERIC STROKE IN ACUTE PHASE OF DISEASE

2019 ◽  
pp. 22-28
Author(s):  
O. A. Kozolkin ◽  
L. V. Novikova
Keyword(s):  
Ischemic Stroke ◽  
Acute Phase ◽  
Neurological Deficit ◽  
Hemispheric Asymmetry ◽  
Cognitive Deficit ◽  
Spectral Power ◽  
Nihss Score ◽  
Moderate Dementia ◽  
Cerebral Ischemic ◽  
Δ Rhythm

Summary. In order to study the clinical and neurophysiological features in patients with recurrent cerebral ischemic hemispheric ischemic stroke (RCHIS), a comprehensive clinical-paraclinical study of 49 patients (28 men and 21 female, mean age 72 (63; 76) years) in the acute period of the disease was conducted. It was found domination of mild and moderate dementia, the median total NIHSS score in the debut of the disease consisted 10 (7; 13), which corresponded to the average severity of the stroke. It was found that the parameters of δ-rhythm APS, δ-rhythm RSP and β rhythm  relative spectral power have the strongest correlation with level of neurological deficit by NIHSS score and with  level of disability by MRS, as well as parameters of occipital-frontal grade of  βhi-rythm and hemispheric asymmetry of αlo-subband correlated with the level of cognitive deficit.

scholarly journals Anosognosia for Motor and Cognitive Deficit as a Clinical Manifestation of Ischemic Stroke: Review of Literature

Doctor Ru ◽  
2020 ◽  
Vol 19 (9) ◽  
pp. 33-38
Author(s):  
V.N. Grigorieva ◽  
◽  
T.A. Sorokina ◽  
◽  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Deficit ◽  
Cognitive Deficit ◽  
Negative Impact ◽  
Behavioral Therapy ◽  
Vestibular Stimulation ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Caloric Vestibular Stimulation

Objective of the Review: To present data from the latest research studies focusing on anosognosia for neurological deficit in patients with acute ischemic stroke. Key Points: Anosognosia for motor and cognitive deficit is a quite common disorder in acute ischemic stroke patients. This condition is of interest for neurologists because it manifests itself in an unusual way and has a negative impact on patients’ medical rehabilitation. The understanding of the pathophysiology of anosognosia and its neuroanatomical underpinnings is changing and improving. New information about approaches to the diagnosis and treatment of this condition is becoming available, making this review timely. Conclusion: Patients with acute ischemic stroke may have reduced perception of their neurological deficit and cognitive, emotional, and behavioral disorders. Hemispatial neglect is the most common cognitive disorder associated with anosognosia for paralysis. Medical rehabilitation of post-stroke patients with anosognosia is challenging and requires the participation of a multidisciplinary team and a differentiated approach, tailored to the type of anosognosia. At present, rehabilitation specialists have started discussing the possibility of therapeutic application of instrumental investigation techniques, such as caloric vestibular stimulation and transcranial brain stimulation, in addition to cognitive behavioral therapy. Keywords: reduced perception of disease, anosognosia, regulatory dysfunction, neglect, ischemic stroke.

scholarly journals COVID-19 Disease and Hypercoagulability Leading to Acute Ischemic Stroke

2020 ◽  
pp. 194187442096032
Author(s):  
Naresh Mullaguri ◽  
Madihah Hepburn ◽  
James Matthew Gebel ◽  
Ahmed Itrat ◽  
Pravin George ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ischemic Stroke ◽  
Respiratory Failure ◽  
Acute Phase ◽  
Case Series ◽  
Disease Case ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Exposure Risks ◽  
Cerebral Ischemic

Introduction: SARS-Coronavirus-2 infection leading to COVID-19 disease presents most often with respiratory failure. The systemic inflammatory response of SARS-CoV-2 along with the hypercoagulable state that the infection elicits can lead to acute thrombotic complications including ischemic stroke. We present 3 cases of patients with COVID-19 disease who presented with varying degrees of vascular thrombosis. Cases: Cases 1 and 2 presented as cerebral ischemic strokes without respiratory failure. Given their exposure risks, they were both tested for COVID-19 disease. Case 2 ultimately developed respiratory failure and pulmonary embolism. Cases 2 and 3 were found to have simultaneous arterial and venous thromboembolism (ischemic stroke and pulmonary embolism) as well as positive antiphospholipid antibodies. Conclusion: Our case series highlight the presence of hypercoagulability as an important mechanism in patients with COVID-19 disease with and without respiratory failure. Despite arterial and venous thromboembolic events, antiphospholipid and hypercoagulable panels in the acute phase can be difficult to interpret in the context of acute phase response and utilization of thrombolytics. SARS-CoV-2 testing in patients presenting with stroke symptoms may be useful in communities with a high case burden or patients with a history of exposure.

scholarly journals Presynaptic Caytaxin prevents apoptosis via deactivating DAPK1 in the acute phase of cerebral ischemic stroke

2020 ◽  
Vol 329 ◽  
pp. 113303 ◽  
Author(s):  
Shan Wang ◽  
Keng Chen ◽  
Jia Yu ◽  
Xiaojiao Wang ◽  
Qiang Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Phase ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

scholarly journals BK Channel-Mediated Microglial Phagocytosis Alleviates Neurological Deficit After Ischemic Stroke

2021 ◽  
Vol 15 ◽  
Author(s):  
Shuxian Huang ◽  
Tingting Chen ◽  
Qian Suo ◽  
Rubing Shi ◽  
Haroon Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Neurological Deficit ◽  
Glucose Deprivation ◽  
Artery Occlusion ◽  
Bk Channels ◽  
Acute Stage ◽  
Bk Channel ◽  
Microglial Phagocytosis ◽  
Cerebral Ischemic ◽  
Channel Activator

Microglial phagocytosis benefits neurological recovery after stroke. Large-conductance Ca2+-activated K+ currents are expressed in activated microglia, and BK channel knockout aggravates cerebral ischemic injury. However, the effect of BK channels on microglial phagocytosis after ischemic stroke remains unknown. Here, we explored whether BK channel activation is beneficial for neurological outcomes through microglial phagocytosis after ischemic stroke. ICR mice after transient middle cerebral artery occlusion (tMCAO) were treated with dimethyl sulfoxide (DMSO), BK channel activator NS19504, and inhibitor Paxilline. The results showed a decrease in BK channel expression after tMCAO. BK channel activator NS19504 alleviates neurological deficit after experimental modeling of tMCAO in mice compared to the control. Furthermore, we treated primary microglia with DMSO, NS19504, and Paxilline after oxygen glucose deprivation (OGD). NS19504 promoted primary microglial phagocytosing fluorescent beads and neuronal debris, which reduced neuronal apoptosis after stroke. These effects could be reversed by BK channel inhibitor Paxilline. Finally, NS19504 increased relative phosphorylated extracellular signal-regulated kinase 1/2 expression compared to the Paxilline group at the third day after stroke. Our findings indicate that microglial BK channels are a potential target for acute stage of ischemic stroke therapy.

scholarly journals THE EFFICACY OF COMBINED NEUROPROTECTION IN MOTOR AND COGNITIVE RECOVERY FOLLOWING THE ACUTE PHASE OF ISCHEMIC STROKE

2019 ◽  
Vol 33 (4) ◽  
pp. 131-135
Author(s):  
A. E. Shoboev ◽  
I. M. Balkhayev
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Analysis ◽  
Acute Phase ◽  
Functional Recovery ◽  
Neurological Deficit ◽  
Cognitive Status ◽  
Modified Rankin Scale ◽  
Focal Neurological Deficit ◽  
Clinical Indicators ◽  
Acute Period

The clinical efficacy of combined neuroprotection with citicoline and cortexin in the acute period of ischemic stroke is discussed in the paper. A retrospective analysis of 127 cases with a primary ischemic stroke was carried out. For unbiased evaluation of the severity of the condition, extent of the focal neurological deficit and the assessment of the dynamics in clinical indicators, the National Institute of Health Stroke Scale was used; the degree of functional recovery was assessed by the modified Rankin Scale; the cognitive status score was measured by the MMSE scale. The obtained data suggest the effectiveness of combined neuroprotection with cortexin and citicoline in the acute period of ischemic stroke in comparison with monotherapy.

Effect of age on outcome in patients with cerebral stroke

2020 ◽  
pp. 41-45
Author(s):  
G. R. Kuchava ◽  
E. V. Eliseev ◽  
B. V. Silaev ◽  
D. A. Doroshenko ◽  
Yu. N. Fedulaev
Keyword(s):  
Ischemic Stroke ◽  
Neurological Deficit ◽  
Neurological Status ◽  
Statistical Correlation ◽  
Multiple Organ ◽  
The Body ◽  
Social Adaptation ◽  
Cerebral Stroke ◽  
Septic Complications ◽  
Risk Of Death

The aim of the study was to assess the course and outcome of cerebral infarction, depending on the age factor and duration of stay in the neuroblock. Materials and methods: a dynamic observation of 494 patients, men and women, aged 38–84 years with acute ischemic stroke of hemispheric localization, which were divided into the three groups depending on age, was performed. Group 1 – younger than 60 years old, group 2–60–70 years old, group 3 – older than 60 years. All patients underwent standard therapy, according to the recommendations for the treatment of ischemic stroke. The patients underwent comprehensive clinical and instrumental monitoring, which included assessment of somatic and neurological status according to the NIH‑NINDS scales at 1st, 3rd, 10th days and at discharge or death; assessment of the level of social adaptation according to the Bartel scale on 1st, 3rd, 10th days and at discharge, clinical and biochemical blood tests, computed tomography of the brain. Assessment of the quality of therapy was carried out according to specially developed maps using methods of statistical correlation analysis. Results: the most pronounced positive dynamics of neurological status was in the 1st group of patients. The regression of neurological deficit in the 2nd group was worse. The minimal dynamics of neurological deficit was in the 3rd group of patients with cerebral stroke. Most often, the death of patients with cerebral stroke occurred from the development of multiple organ disorders. Conclusions: patients over 70 years of age have the greatest risk of death, due to: a decrease in the reactivity of the body, the presence of initially severe concomitant somatic pathology in patients with admission to hospital; accession of secondary somatic and purulent‑septic complications.

Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke

2019 ◽  
Vol 23 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Bing Zhou ◽  
Xiao-Chuan Wang ◽  
Jun-Yi Xiang ◽  
Ming-Zhao Zhang ◽  
Bo Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Balloon Dilation ◽  
Stent Retriever ◽  
National Institutes Of Health ◽  
Clinical Prognosis ◽  
Nihss Score ◽  
Grade 3

OBJECTIVEMechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS.METHODSBetween January 2012 and December 2017, 7 cases of pediatric AIS were treated via mechanical thrombectomy using a Solitaire stent retriever. The clinical practice, imaging, and follow-up results were reviewed, and the data were summarized and analyzed.RESULTSThe ages of the 7 patients ranged from 7 to 14 years with an average age of 11.1 years. The preoperative National Institutes of Health Stroke Scale (NIHSS) scores ranged from 9 to 22 with an average of 15.4 points. A Solitaire stent retriever was used in all patients, averaging 1.7 applications of thrombectomy and combined balloon dilation in 2 cases. Grade 3 on the modified Thrombolysis In Cerebral Infarction scale of recanalization was achieved in 5 cases and grade 2b in 2 cases. Six patients improved and 1 patient died after thrombectomy. The average NIHSS score of the 6 cases was 3.67 at discharge. The average modified Rankin Scale score was 1 at the 3-month follow-up. Subarachnoid hemorrhage after thrombectomy occurred in 1 case and that patient died 3 days postoperatively.CONCLUSIONSThis study shows that mechanical thrombectomy using a Solitaire stent retriever has a high recanalization rate and excellent clinical prognosis in pediatric AIS. The safety of mechanical thrombectomy in pediatric AIS requires more clinical trials for confirmation.

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