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.

scholarly journals Effect of mexidol on the efficiency of intravenous thrombolytic therapy for ischemic stroke during the therapeutic window

2018 ◽  
Vol 10 (3) ◽  
pp. 86-90 ◽  
Author(s):  
K. S. Knni ◽  
T. V. Dyomin ◽  
L. B. Adeeva
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Neurological Deficit ◽  
Time Course ◽  
Neurological Status ◽  
Therapeutic Window ◽  
X Ray Computed ◽  
The Republic ◽  
Severity Of The Disease ◽  
Positive Effect

Objective: to evaluate the effect of intravenous mexidol on the efficiency of intravenous thrombolytic therapy (TLT) during the therapeutic window. Patients and methods. The retrospective study enrolled 123 patients with ischemic stroke (IS) who had undergone intravenous TLT in the vascular centers of the Republic of Tatarstan. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the time course of changes in their neurological status. According to the baseline severity of a neurological deficit, all the patients were divided into three subgroups: 1) mild IS (<8 NIHSS scores at admission); 2) moderate IS (>8 scores); and 3) severe IS (<16 scores). All the patients underwent X-ray computed tomography at admission, at 24 hours after TLT, and in case of worsening of their health status. Results. The prehospital use of mexidol followed by TLT in patients with IS had a positive effect on the regression of neurological deficit regardless of the severity of the disease. There were significant differences in the degree of regression of neurological deficit according to NIHSS at 24 hours and 10 days after hospital admission in patients with severe IS, who received intravenous mexidol at the prehospital stage and who did not take this drug before TLT. The pre-TLT use of mexidol contributed to higher regression of neurological deficit. There was a lower frequency of hemorrhagic transformations in the patients who used mexidol at the prehospital stage versus those who did not. Conclusion. The findings demonstrate the positive effect of mexidol on the efficiency and safety of TLT in patients with IS.

scholarly journals Endothelium-dependent vascular tone regulation mechanisms in patients with ischemic stroke

2013 ◽  
Vol 94 (1) ◽  
pp. 9-13
Author(s):  
A M Dolgov ◽  
A Y Ryabchenko ◽  
E N Denisov ◽  
N G Gumanova
Keyword(s):  
Nitric Oxide ◽  
Ischemic Stroke ◽  
Neurological Deficit ◽  
Vascular Tone ◽  
Circulatory System ◽  
Neurological Status ◽  
The Usa ◽  
Regulation Mechanisms ◽  
Severity Of The Disease

Aim. To study the role of nitroxidergic reactions of the circulatory system in the development of ischemic stroke. Methods. 51 patients (both males and females) with the diagnosis of ischemic stroke were examined. All patients were distributed to 3 groups according to the severity of neurological deficit. All patients underwent brain computed tomography or magnetic resonance imaging. Cerebral blood flow was examined by extra and transcranial ultrasonic dopplerography. Central hemodynamics was evaluated by echocardiography. General clinical examination, neurological and neuroophthalmological examinations were also performed. Vasomotor endothelial function was assessed using a 7 MHz linear transducer on the ultrasound unit «Medison SonoAce X8». The level of nitric oxide was assessed using its stable metabolites, nitrite and nitrate definition in serum. Neurological status was assessed according to the USA National Institutes of Health Stroke Scale. Results. Disorders of nitroxidergic mechanisms of blood vessels regulation were observed in patients with ischemic stroke. Endothelium-dependent brachial artery dilation disorders and nitric oxide persistent metabolites level decrease were related to the severity of the disease and the neurological deficit degree. Conclusion. The study of endothelium-dependent vascular tone regulation mechanisms revealed that these mechanisms are involved in the pathogenesis of ischemic stroke; the study of these mechanisms can be used to clarify the severity of neurological deficit, and possible prognosis.

scholarly journals Neurovascular Unit as a Source of Ischemic Stroke Biomarkers—Limitations of Experimental Studies and Perspectives for Clinical Application

2019 ◽  
Vol 11 (4) ◽  
pp. 553-579 ◽  
Author(s):  
Aleksandra Steliga ◽  
Przemysław Kowiański ◽  
Ewelina Czuba ◽  
Monika Waśkow ◽  
Janusz Moryś ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Brain Damage ◽  
Neurovascular Unit ◽  
Experimental Studies ◽  
High Specificity ◽  
Neurological Status ◽  
Developed Countries ◽  
Cerebral Stroke ◽  
Specificity And Sensitivity ◽  
Different Types

Abstract Cerebral stroke, which is one of the most frequent causes of mortality and leading cause of disability in developed countries, often leads to devastating and irreversible brain damage. Neurological and neuroradiological diagnosis of stroke, especially in its acute phase, is frequently uncertain or inconclusive. This results in difficulties in identification of patients with poor prognosis or being at high risk for complications. It also makes difficult identification of these stroke patients who could benefit from more aggressive therapies. In contrary to the cardiovascular disease, no single biomarker is available for the ischemic stroke, addressing the abovementioned issues. This justifies the need for identifying of effective diagnostic measures characterized by high specificity and sensitivity. One of the promising avenues in this area is studies on the panels of biomarkers characteristic for processes which occur in different types and phases of ischemic stroke and represent all morphological constituents of the brains’ neurovascular unit (NVU). In this review, we present the current state of knowledge concerning already-used or potentially applicable biomarkers of the ischemic stroke. We also discuss the perspectives for identification of biomarkers representative for different types and phases of the ischemic stroke, as well as for different constituents of NVU, which concentration levels correlate with extent of brain damage and patients’ neurological status. Finally, a critical analysis of perspectives on further improvement of the ischemic stroke diagnosis is presented.

Effi cacy and safety of carboxytherapy in patients with ischemic stroke

2022 ◽  
Vol 26 (6) ◽  
pp. 52-62
Author(s):  
G. R. Ramazanov ◽  
E. A. Chukina ◽  
E. V. Shevchenko ◽  
S. A. Abudeev ◽  
E. V. Klychnikova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Laboratory ◽  
Integrated Approach ◽  
Neurological Status ◽  
The Body ◽  
Physical Factors ◽  
Negative Consequences ◽  
Duration Of Treatment ◽  
Duration Of Hospitalization ◽  
The Impact

The modern integrated approach to the treatment of ischemic stroke (IS), in addition to pharmacotherapy, provides for the impact of physical factors. Among them is injectable carboxytherapy (ICBT). Objective. The aim of the study was to evaluate the effi cacy and safety of using ICBT in combination with a standard treatment program in patients with acute ischemic stroke. Material and methods. The main group (MG) included 39 patients with acute IS, the comparison group (GC) — 31 patients. On the second day of hospitalization, patients with MG underwent ICBT on the background of standard therapy, and GC — procedures that mimic ICBT. Clinical, laboratory and instrumental data, IS outcomes, complications, timing were assessed.Results. There were no statistically signifi cant diff erences in physiological parameters (heart rate, blood pressure, SpO2) between MG and GC during and after the course of treatment. Positive dynamics of the neurological status was observed in both groups in the form of a decrease in the NIHSS score — in the MG from 6 to 4 (p = 0.047), in the GC — also from 6 to 4 (p = 0.25). In patients with MG, trophic disorders were less likely to develop in comparison with GC — 1 (2.6%) versus 6 (19.4%), p = 0.039. ICBT did not aff ect the duration of hospitalization of patients, the duration of treatment in the intensive care unit and carrying of resuscitation and also did not contribute to reducing mortality. Changes in the indicators of the acid-base state of the blood were compensatory in nature and did not lead to changes in the pH of the blood. The decrease in pH from 7.5 to 7.4 in 30–90 minutes after the procedures was a physiological reaction of the body to the introduction of CO2 and was not accompanied by negative consequences. Conclusions. ICBT is a safe method, does not aff ect the duration of hospital stay and mortality, help lower the likelihood of complications.

scholarly journals Endothelial dysfunction and aspectsof pharmacological correction in patientswith primary developed ischemic stroke

2013 ◽  
Vol 11 (1) ◽  
pp. 39-45
Author(s):  
Aleksandr Yuryevich Malygin ◽  
Aleksandr Leonidovich Khokhlov
Keyword(s):  
Ischemic Stroke ◽  
Endothelial Dysfunction ◽  
Antihypertensive Therapy ◽  
Neurological Deficit ◽  
Cardiovascular Events ◽  
Neurological Status ◽  
Acute Period ◽  
Pharmacological Correction

The aim of the paper was to assess mortality, frequency of repeated cardiovascular events, neurological deficit dynamics and endothelial dysfunction in patients with primary determined ischemic stroke after treatment with simvastatin 40 mg in acute period of disease. Prescription of simvastatin 40 mg to patients in acute period of ischemic stroke accompanied by neuroprotective and antihypertensive therapy decreased a number of repeated cardiovascular events, positive dynamics of neurological status and regress of endothelial dysfunction appearance.

scholarly journals Rehabilitation treatment in patients with cerebral stroke

2021 ◽  
Vol 12 (4) ◽  
pp. 33-38
Author(s):  
Nataliya M. Tertyshnaya ◽  
Vitalii V. Goldobin ◽  
Elena G. Klocheva ◽  
Anastasiya S. Lobzina ◽  
Galina G. Agbaii ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Right Hemisphere ◽  
Clinical Manifestations ◽  
Social Adaptation ◽  
Functional Improvement ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Rehabilitation Treatment ◽  
Group I ◽  
Significant Difference

Introduction. Treatment and rehabilitation of ischemic stroke patients is an important medical and social problem. The purpose of the study is to compare effectiveness of different complex rehabilitation methods for improving patient functional abilities and social adaptation. Materials and methods. 114 patients, aged 61.1 10.7 years, in early and late rehabilitation period of ischemic stroke were examined. Group I (n = 73, age 63.2 10.9) was represented by the patients that received conventional rehabilitation treatment ambulatory or in neurological department with additional biological feedback; patients of group II (n = 41, aged 60.4 10.3) received ambulatory conventional rehabilitation treatment. Results. There was no significant difference in the patients age of groups I and II. The most frequent stroke location in the middle cerebral artery in the II group patients was in the right hemisphere (p 0.05). The improvement of damaged function was revealed in both groups. Clinical scale data on discharge indicated more severe manifestations in the I group patients. In the main group, the restriction of daily activity in women was more pronounced than in men (p 0.05). Conclusions. Rehabilitation treatment in post-stroke patients led to functional improvement. Clinical manifestations in the patients that require rehabilitation in hospital, were more severe in comparison with ambulatory rehabilitated group. Data on more pronounced disturbances in activities of daily living in women compared to men require further study.

scholarly journals THE EXPERIENCE WITH THE APPLICATION OF THE «EKZARTA» (REDCORD) KINESIOTHERAPEUTIC EQUIPMENT FOR THE REHABILITATION OF THE PATIENTS WITH SPINAL CORD PATHOLOGY AT THE CERVICAL LEVEL

2017 ◽  
Vol 16 (2) ◽  
pp. 102-106
Author(s):  
N. G Konovalova ◽  
E. V Filatov ◽  
V. V Lyakhovetskaya ◽  
Yu. S Frolenko
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Deficit ◽  
Pain Syndrome ◽  
Neurological Status ◽  
The Body ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Normal Sensitivity ◽  
Cervical Level

The patients suffering a traumatic spinal cord injury (TSCI) at the cervical level need motor rehabilitation the adequate achievement of which is hampered due to the development of tetraparesis up to and including tetraplegia. For this reason, they require creation of the special conditions for making the prescribed physical exercises. The objective of the present study was to evaluate the influence of exercises performed with the use of the “Ekzarta” (Redcord) kinesiotherapeutic equipment on the neurological status of the patients with spinal cord pathology at the cervical level. A total of 102 patients referred to group 1 disability were available for the observation before, during the intermediate and late rehabilitation periods after the traumatic spinal cord injury at the cervical level representing the A, B, C, and D neurological types as estimated based on the ASIA/ISCSCI scale. The examination included gathering complaints, assessment of the neurological status with the evaluation of the motor, manual, locomotor functions, estimation of the inferior segment with normal sensitivity, and the presence of sensitivity in the paralyzed parts of the body. Spastic syndrome intensity was assessed based on the Ashworth scale, and the intensity of pain syndrome with the application of the visual analogue scale. The treatment resulted in the elevation of arterial pressure, reduction of the intensity of spastic and pain syndrome, and significant increase of the motor scores. The statistically significant increase of the locomotor scores was also documented in the patients with types C and D neurological deficit while the patients with neurological deficit of types A, B, C exhibited the significant increase of the manual scores.

Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails

2020 ◽  
Vol 15 (4) ◽  
pp. 420-422
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Jayanti K. Gurumukhani ◽  
Maitri M. Patel ◽  
Himal J. Mahadevia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Neurological Deficit ◽  
Clinical Case ◽  
Complete Recovery ◽  
Acute Onset ◽  
Diabetic Patients ◽  
Focal Neurological Deficit ◽  
Random Blood Sugar ◽  
Resident Doctor

Background: Hypoglycemia may rarely present as hemiparesis and sometimes it is difficult to differentiate from ischemic stroke. When random blood sugar (RBS) value is between 50 and 80 mg % in patients presenting with focal neurological deficit, no guideline exists to consider the possibility of hypoglycemia before initiating thrombolytic therapy. Clinical Case: A 58-year-old male, who was a known case of diabetes and hypertension, was brought to the emergency room with acute onset of right hemiparesis and dysarthria of 90 minutes duration. His NIHSS Score was 9, blood pressure was 150/90 mm of Hg and RBS was 79 mg% on admission. His CT scan brain was normal and was considered for thrombolysis. Resident doctor not aware of previous sugar repeated RBS before thrombolysis which was surprisingly 60 mg% 60 minutes after the first RBS. Even though he was a candidate for thrombolysis, intravenous 25 % dextrose was administered considering the possibility of hypoglycemia. He made a complete recovery within 20 minutes and thrombolytic therapy was withheld. : In Diabetic patients with focal neurological deficit and RBS less than 80 mg% on admission, RBS should be rechecked and in appropriate cases should be challenged with IV dextrose considering the possibility of hypoglycemia before commencing thrombolytic therapy.

scholarly journals Characteristics of ischemic stroke and intracranial hemorrhage in patients with nephrotic syndrome

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wen-Yi Huang ◽  
Chun-Wei Chang ◽  
Chiung-Mei Chen ◽  
Kuan-Hsing Chen ◽  
Chien-Hung Chang ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Ischemic Stroke ◽  
Intracranial Hemorrhage ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Chang Gung Memorial Hospital ◽  
Cerebral Stroke ◽  
Research Database ◽  
Anterior Circulation ◽  
Cox Regression Analysis

Abstract Background The incidence of cerebral stroke, including ischemic infarction and intracranial hemorrhage (ICH), increases in patients with nephrotic syndrome (NS). However, the clinical characteristics of patients with NS and stroke remain elusive. We aimed to investigate the clinical presentation and prognosis among patients with NS and ischemic stroke (IS) or ICH. Methods We conducted a population-based retrospective cohort study of patients with NS and acute stroke using the Chang Gung Research Database of Taiwan from January 1, 2001, to December 31, 2017. The participants were recruited from the 7 branches of Chang Gung Memorial Hospital. Results A total of 233 patients with IS and 57 patients with ICH were enrolled. The median age was 60 (52–70) years. The prevalence rates of hyperlipidemia, hyperuricemia, and smoking were higher in IS than in ICH. IS demonstrated lower white blood cell count (7.80 vs. 8.92 × 109/L) and high-sensitivity C-reactive protein level (33.42 vs. 144.10 nmol/L) and higher cholesterol (5.74 vs. 4.84 mmol/L), triglyceride (1.60 vs. 1.28 mmol/L), and albumin (24 vs. 18 g/L) levels compared with ICH. The dependent functional status and 30-day mortality were higher in ICH than in IS. The risk factors for 30-day mortality for patients with NS and stroke were coronary artery disease (CAD), ICH, and total anterior circulation syndrome. The multivariate Cox regression analysis revealed that CAD was positively associated with 30-day mortality in patients with IS (hazard ratio 24.58, 95 % CI 1.48 to 408.90). In patients with ICH, CAD and subarachnoid hemorrhage were positively associated with 30-day mortality (hazard ratio 5.49, 95 % CI 1.54 to 19.56; hazard ratio 6.32, 95 % CI 1.57 to 25.53, respectively). Conclusions ICH demonstrated a higher risk of dependence and 30-day mortality compared with IS in patients with NS. Intensive monitoring and treatment should be applied particularly in patients with NS and ICH.

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