Pleural effusion in a cancerous patient with acute cerebrovascular accident: A case study

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.

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SOME ASPECTS OF ACUTE CEREBROVASCULAR PATHOLOGY IN POSTPARTUM WOMEN

Vestnik ◽

10.53065/kaznmu.2021.26.78.010 ◽

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.

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AYURVEDIC UNDERSTANDING AND MANAGEMENT OF CEREBROVASCULAR ACCIDENT (STROKE WITH ISCHEMIAAND HEMORRHAGE): A CASE STUDY

10.36106/ijsr/7203034 ◽

2020 ◽

pp. 1-3

Author(s):

Anoop. A. S ◽

Anupama. A. S ◽

Kannan Sagar

Keyword(s):

Cerebrovascular Accident ◽

Heart Diseases ◽

The Third ◽

Oral Medications ◽

Chief Complaints ◽

The Right ◽

Inpatient Department

Stroke or cerbreovascular accidents are the leading cause of morbidity and mortality across the world.Infact the third leading cause after heart diseases and cancer.Strokes can be classied broadly as ischemic and hemorrhagic which accounts for 80% and 20% of the total cases.The prognosis of CVA depends on the type and its fast and appropriate management.A 50 year old male patient who is k/c/o type 2 diabetes mellitus,hypertension and hypercholistremia was admitted to the inpatient department of Sri Jayendra Saraswathi Ayurveda College and Hospital,Chennai on 20.01.2020 with the conrmed diagnosis of stroke(CVA) having both infarct and hemorrhage.The chief complaints were difculty in walking without support,reduced strength, stiffness and heaviness in the right hand and leg, difculty in speech, pain in right shoulder joint and knee joint since 4 months.This condition can be understood as Pakshaghata in Ayurveda.After proper evaluation of the avastha of the patient,Avarana chikitsa along with the Pakshaghata chikitsa was adopted in this case,Signicant improvements were observed on various subjective and objective parameters.The patient was discharged after 10 days of treatment with oral medications and advised for a follow up after 1 month.

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