Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1056
L. Kyrylova, O. Miroshnykov, O. Yuzva, V.M. Badiuk, O.O. Dolenko, Y.M. Bondarenko
Background. The purpose of the study to analyze the clinical, neurophysiological, neuroimaging and genetic characteristics of young children with developmental and epileptic encephalopathy and to determine risk predictors for the development of autism spectrum disorders, with the aim of forming a cohort of children in need of dynamic monitoring and early intervention. Materials and methods. Thirty-eight children aged 0–3 years with developmental and epileptic encephalopathy were included in the study. The examination included assessment of neurological status, history taking, assessment of semiology and determination of seizure type, assessment of development and screening for autism spectrum disorders at the age of 18 and 24 months, video-EEG monitoring during night sleep, magnetic resonance imaging of the brain, screening for pathogenic variants by whole exome sequen-cing. Results. A feature of this group of disorders is the presence of subtle, often unrecognized epileptic seizures, which are manifested by persistent focal (60.5 %) or generalized (31.6 %) activity with medium (55.3 %) or high (15.8 %) index of spike-and-wave activity during the stage of slow sleep and the amplitude emphasis over the frontal (52.6 %) or temporal (28.9 %) lobes. According to magnetic resonance imaging, structural changes in the brain were found in 91.1 % of children, including focal or diffuse changes in the white matter of the brain in 36.8 %, hypoplasia of the corpus callosum in 21.1 %, atrophic changes in the cerebral cortex in 15.8 %, congenital malformations in 13.2 % of cases. Pathogenic variants of 35 different genes were found in the examined children with the onset of seizures during the first year of life. Pathogenic variants of genes responsible for the synthesis and repair of DNA and RNA (28.9 %) and the activity of intracellular enzymes were the most common — 8 cases (21.1 %). The share of children with general developmental delay at the age of 24 months was 11.9 %, and cognitive impairment — 34.2 %. Conclusions. It was shown that children with a history of generalized tonic-clonic seizures (RR = 2.13) had a high risk of developing autism spectrum disorders at 24 months. A positive relationship was found between the presence of mutations in genes responsible for DNA synthesis and repair (RR = 1.88) and an increased risk of developing ASD at the age of 24 months (90.9 % of children).
{"title":"Developmental and epileptic encephalopathies in children: clinical, neurophysiological, neuroimaging and genetic characteristics","authors":"L. Kyrylova, O. Miroshnykov, O. Yuzva, V.M. Badiuk, O.O. Dolenko, Y.M. Bondarenko","doi":"10.22141/2224-0713.20.2.2024.1056","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1056","url":null,"abstract":"Background. The purpose of the study to analyze the clinical, neurophysiological, neuroimaging and genetic characteristics of young children with developmental and epileptic encephalopathy and to determine risk predictors for the development of autism spectrum disorders, with the aim of forming a cohort of children in need of dynamic monitoring and early intervention. Materials and methods. Thirty-eight children aged 0–3 years with developmental and epileptic encephalopathy were included in the study. The examination included assessment of neurological status, history taking, assessment of semiology and determination of seizure type, assessment of development and screening for autism spectrum disorders at the age of 18 and 24 months, video-EEG monitoring during night sleep, magnetic resonance imaging of the brain, screening for pathogenic variants by whole exome sequen-cing. Results. A feature of this group of disorders is the presence of subtle, often unrecognized epileptic seizures, which are manifested by persistent focal (60.5 %) or generalized (31.6 %) activity with medium (55.3 %) or high (15.8 %) index of spike-and-wave activity during the stage of slow sleep and the amplitude emphasis over the frontal (52.6 %) or temporal (28.9 %) lobes. According to magnetic resonance imaging, structural changes in the brain were found in 91.1 % of children, including focal or diffuse changes in the white matter of the brain in 36.8 %, hypoplasia of the corpus callosum in 21.1 %, atrophic changes in the cerebral cortex in 15.8 %, congenital malformations in 13.2 % of cases. Pathogenic variants of 35 different genes were found in the examined children with the onset of seizures during the first year of life. Pathogenic variants of genes responsible for the synthesis and repair of DNA and RNA (28.9 %) and the activity of intracellular enzymes were the most common — 8 cases (21.1 %). The share of children with general developmental delay at the age of 24 months was 11.9 %, and cognitive impairment — 34.2 %. Conclusions. It was shown that children with a history of generalized tonic-clonic seizures (RR = 2.13) had a high risk of developing autism spectrum disorders at 24 months. A positive relationship was found between the presence of mutations in genes responsible for DNA synthesis and repair (RR = 1.88) and an increased risk of developing ASD at the age of 24 months (90.9 % of children).","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"5 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1054
D. Chaulagain, V. Smolanka, A. Smolanka, T. Havryliv
Glioblastoma, classified as a grade IV astrocytoma by the World Health Organization, continues to be a very aggressive cancer that requires a comprehensive strategy comprising surgery, radiation, and chemotherapy. Traditionally, gross total resection has primarily targeted the contrast-enhanced regions shown on T1-weighted magnetic resonance images. However, current studies suggest a more aggressive approach that focuses on removing the areas around the tumor, called supramarginal resection. This innovative strategy seeks to go beyond traditional bounda-ries, offering possible advantages for survival. However, it also raises worries over the removal of brain tissue that is crucial for important functions. The extremely poor prognosis of glioblastoma, characterized by a median survival of 10 months, highlights the pressing need for novel approaches to treatment. The aim of the study is to evaluate the influence of resection with a margin that extends much beyond the contrast enhancement on the survival of certain glioblastoma patients. The potential advantages documented in previous collections of cases are consistent with the notion of personalized surgical decision-making, which questions the prevailing approach of achieving the greatest possible removal of the tumor that is enhanced by contrast. Nevertheless, the potential neurological risks should be thoroughly evaluated. The objective of this study is to provide significant insights into improving the management of glioblastoma by examining the careful trade-off between aggressive tumor removal and preserving neurological function in specific groups of patients.
胶质母细胞瘤被世界卫生组织列为 IV 级星形细胞瘤，仍然是一种侵袭性很强的癌症，需要采取包括手术、放疗和化疗在内的综合策略。传统上，全切除术主要针对 T1 加权磁共振图像上显示的对比度增强区域。然而，目前的研究表明，一种更积极的方法是重点切除肿瘤周围的区域，即边缘上切除术。这种创新策略试图超越传统的界限，为患者的生存提供了可能的优势。然而，它也引起了人们对切除对重要功能至关重要的脑组织的担忧。胶质母细胞瘤的预后极差，中位生存期仅为10个月，这凸显了对新型治疗方法的迫切需要。这项研究的目的是评估边缘超出对比度增强范围的切除术对某些胶质母细胞瘤患者生存期的影响。之前收集的病例中记录的潜在优势与个性化手术决策的理念相一致，这种理念对尽可能切除造影剂增强的肿瘤的主流方法提出了质疑。然而，对潜在的神经系统风险应进行全面评估。本研究的目的是通过研究特定患者群体在积极切除肿瘤和保护神经功能之间的谨慎权衡，为改善胶质母细胞瘤的治疗提供重要见解。
{"title":"Beyond the margins: evaluating the necessity and timing of supramarginal resection in glioblastoma management","authors":"D. Chaulagain, V. Smolanka, A. Smolanka, T. Havryliv","doi":"10.22141/2224-0713.20.2.2024.1054","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1054","url":null,"abstract":"Glioblastoma, classified as a grade IV astrocytoma by the World Health Organization, continues to be a very aggressive cancer that requires a comprehensive strategy comprising surgery, radiation, and chemotherapy. Traditionally, gross total resection has primarily targeted the contrast-enhanced regions shown on T1-weighted magnetic resonance images. However, current studies suggest a more aggressive approach that focuses on removing the areas around the tumor, called supramarginal resection. This innovative strategy seeks to go beyond traditional bounda-ries, offering possible advantages for survival. However, it also raises worries over the removal of brain tissue that is crucial for important functions. The extremely poor prognosis of glioblastoma, characterized by a median survival of 10 months, highlights the pressing need for novel approaches to treatment. The aim of the study is to evaluate the influence of resection with a margin that extends much beyond the contrast enhancement on the survival of certain glioblastoma patients. The potential advantages documented in previous collections of cases are consistent with the notion of personalized surgical decision-making, which questions the prevailing approach of achieving the greatest possible removal of the tumor that is enhanced by contrast. Nevertheless, the potential neurological risks should be thoroughly evaluated. The objective of this study is to provide significant insights into improving the management of glioblastoma by examining the careful trade-off between aggressive tumor removal and preserving neurological function in specific groups of patients.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"66 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1055
M. Trishchynska, N.I. Inhula, I.Yu. Bihun, A.Ye. Sheremet
The article highlights the main pathophysiological mechanisms of cardiovascular disorders in acute cerebral stroke, which include dysfunction of the hypothalamic-pituitary-adrenal axis, disorders of autonomic regulation of cardiac activity, immune response, and deterioration in the cardiovascular system in case of existing structural, organic lesions of the heart and blood vessels, which in turn can exacerbate the development of cerebral damage. Literature data on clinical, electrophysiological, and biochemical changes in the cardiovascular system in stroke are presented, in particular, depending on the area of brain damage. Attention is focused on possible hemodynamic disturbances, electrocardiographic changes in the heart, increased levels of cardiac troponins, brain natriuretic peptide, and C-reactive protein. Complications that arise in this category of patients are of great clinical importance and significantly affect the course of the disease and further prognosis, which requires close attention not only from neurologists but also from doctors of related specialties.
文章强调了急性脑卒中心血管功能紊乱的主要病理生理机制，包括下丘脑-垂体-肾上腺轴功能失调、心脏活动的自主神经调节紊乱、免疫反应，以及心脏和血管结构性、器质性病变导致的心血管系统恶化，这些反过来又会加剧脑损伤的发展。本文介绍了有关中风时心血管系统的临床、电生理和生化变化的文献资料，特别是根据脑损伤的部位。重点关注可能出现的血流动力学紊乱、心脏心电图变化、心肌肌钙蛋白、脑钠肽和 C 反应蛋白水平升高。这类患者出现的并发症具有重要的临床意义，会严重影响疾病的进程和进一步的预后，不仅需要神经科医生密切关注，还需要相关专业的医生密切关注。
{"title":"Brain-heart interaction in acute stroke","authors":"M. Trishchynska, N.I. Inhula, I.Yu. Bihun, A.Ye. Sheremet","doi":"10.22141/2224-0713.20.2.2024.1055","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1055","url":null,"abstract":"The article highlights the main pathophysiological mechanisms of cardiovascular disorders in acute cerebral stroke, which include dysfunction of the hypothalamic-pituitary-adrenal axis, disorders of autonomic regulation of cardiac activity, immune response, and deterioration in the cardiovascular system in case of existing structural, organic lesions of the heart and blood vessels, which in turn can exacerbate the development of cerebral damage. Literature data on clinical, electrophysiological, and biochemical changes in the cardiovascular system in stroke are presented, in particular, depending on the area of brain damage. Attention is focused on possible hemodynamic disturbances, electrocardiographic changes in the heart, increased levels of cardiac troponins, brain natriuretic peptide, and C-reactive protein. Complications that arise in this category of patients are of great clinical importance and significantly affect the course of the disease and further prognosis, which requires close attention not only from neurologists but also from doctors of related specialties.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"64 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1057
D. Khramtsov, T. Muratova, M. Vikarenko, Y. Vorokhta
Background. The purpose of the study was to assess the occurrence of disorders in the field of cognitive creativity in patients with minimal manifestations of leukoencephalopathy. Materials and methods. The study was carried out in the Expert Health Center in 2021–2022. We have examined 43 patients aged 45–60 years who had hyperintense foci in the white matter of the brain on magnetic resonance imaging, meeting Fazekas 1 criteria, and preserved cognitive abilities according to the MMSE and MoCA (≥ 25 and ≥ 26 points, respectively). As a control, 20 people of the same age with Fazekas 0 were examined, including 9 people employed in the creative professions. Additionally, all participants were examined using the Divergent Association Task (DAT). Statistical processing of the obtained results was performed by methods of dispersion and correlation analysis using Statistica 14.1 software (TIBCO, USA). Results. The average age of patients in the main group was 53.1 ± 0.3 years, while in the controls, it was 52.6 ± 0.5 years. In patients with signs of minimal microangiopathy of cerebral vessels, the MMSE score was on average 26.4 ± 0.2 points, and MoCA — 27.0 ± 0.3 points, while in the control group, 27.8 ± 0.2 and 28.1 ± 0.3 points, respectively (p < 0.05). In the main group, the DAT was on average 59.0 ± 1.3 %, while in the controls, it was 81.9 ± 1.1 % (Z = 3.8; p = 0.0001). The highest indicators of DAT were found in workers of creative specialties — 85.0 ± 0.9 % (Z = 2.7; p = 0.008). Conclusions. There was demonstrated that 95.0 % of patients with minimal manifestations of leukoencephalopathy caused by microangiopathy had a decrease in creative abilities (DAT 59.0 ± 1.3 vs. 81.9 ± 1.1 %; Z = 3.8; p = 0.0001). The coefficient of internal agreement of the DAT test αk was 0.7 with a reproducibility of 85.7 %, which allows recommending the method for use in clinical practice. The method of assessing associative tasks on divergent thinking has a higher sensitivity (97.7 %) than traditional methods of evaluating cognitive abilities at subclinical stages of chronic cerebral blood flow disorders.
{"title":"The tools of cognitive creativity assessment","authors":"D. Khramtsov, T. Muratova, M. Vikarenko, Y. Vorokhta","doi":"10.22141/2224-0713.20.2.2024.1057","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1057","url":null,"abstract":"Background. The purpose of the study was to assess the occurrence of disorders in the field of cognitive creativity in patients with minimal manifestations of leukoencephalopathy. Materials and methods. The study was carried out in the Expert Health Center in 2021–2022. We have examined 43 patients aged 45–60 years who had hyperintense foci in the white matter of the brain on magnetic resonance imaging, meeting Fazekas 1 criteria, and preserved cognitive abilities according to the MMSE and MoCA (≥ 25 and ≥ 26 points, respectively). As a control, 20 people of the same age with Fazekas 0 were examined, including 9 people employed in the creative professions. Additionally, all participants were examined using the Divergent Association Task (DAT). Statistical processing of the obtained results was performed by methods of dispersion and correlation analysis using Statistica 14.1 software (TIBCO, USA). Results. The average age of patients in the main group was 53.1 ± 0.3 years, while in the controls, it was 52.6 ± 0.5 years. In patients with signs of minimal microangiopathy of cerebral vessels, the MMSE score was on average 26.4 ± 0.2 points, and MoCA — 27.0 ± 0.3 points, while in the control group, 27.8 ± 0.2 and 28.1 ± 0.3 points, respectively (p < 0.05). In the main group, the DAT was on average 59.0 ± 1.3 %, while in the controls, it was 81.9 ± 1.1 % (Z = 3.8; p = 0.0001). The highest indicators of DAT were found in workers of creative specialties — 85.0 ± 0.9 % (Z = 2.7; p = 0.008). Conclusions. There was demonstrated that 95.0 % of patients with minimal manifestations of leukoencephalopathy caused by microangiopathy had a decrease in creative abilities (DAT 59.0 ± 1.3 vs. 81.9 ± 1.1 %; Z = 3.8; p = 0.0001). The coefficient of internal agreement of the DAT test αk was 0.7 with a reproducibility of 85.7 %, which allows recommending the method for use in clinical practice. The method of assessing associative tasks on divergent thinking has a higher sensitivity (97.7 %) than traditional methods of evaluating cognitive abilities at subclinical stages of chronic cerebral blood flow disorders.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"37 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.22141/2224-0713.20.1.2024.1040
S.E. Yaremchuk, A.H. Sabadash, V.A. Banas
Snoring and obstructive sleep apnea syndrome (OSAS) are common pathologies. Sleep disorders cause a daytime sleepiness, impaired concentration, and other cognitive impairments. All this can lead to fatal consequences. Unfortunately, only about 20 % of patients suffering from this pathology are identified. As a rule, patients do not know about the presence of OSAS, on the one hand, and on the other hand, they do not know which specialist they need to seek help from. Given the fact that impaired upper airway patency is one of the main causes of OSAS, most patients should be treated by an otolaryngologist. This work is aimed at improving the diagnosis of snoring and obstructive sleep apnea syndrome in screening studies. Screening for snoring and OSAS using the Berlin questionnaire as a result of this study allowed identifying 60 % more patients suffering from snoring and OSAS than in self-referral. The use of the Berlin questionnaire in all patients seeking medical care will help identify a hidden pathology and further conduct a more complete diagnosis of snoring and sleep apnea, as well as prescribe appropriate treatment.
打鼾和阻塞性睡眠呼吸暂停综合症（OSAS）是常见的病症。睡眠障碍会导致白天嗜睡、注意力不集中和其他认知障碍。所有这些都可能导致致命的后果。遗憾的是，只有约 20% 的患者能被发现患有这种病症。通常，患者一方面不知道自己患有 OSAS，另一方面也不知道需要向哪位专家寻求帮助。鉴于上气道通畅性受损是导致 OSAS 的主要原因之一，大多数患者都应接受耳鼻喉科医生的治疗。这项工作旨在改进筛查研究中对打鼾和阻塞性睡眠呼吸暂停综合征的诊断。通过这项研究，使用柏林问卷对打鼾和阻塞性睡眠呼吸暂停综合症进行筛查，发现的打鼾和阻塞性睡眠呼吸暂停综合症患者比自我转诊患者多 60%。在所有就医患者中使用柏林调查问卷将有助于发现隐藏的病症，进一步对打鼾和睡眠呼吸暂停进行更全面的诊断，并给予适当的治疗。
{"title":"Diagnostic value of the Berlin questionnaire in the treatment of snoring and obstructive sleep apnea syndrome","authors":"S.E. Yaremchuk, A.H. Sabadash, V.A. Banas","doi":"10.22141/2224-0713.20.1.2024.1040","DOIUrl":"https://doi.org/10.22141/2224-0713.20.1.2024.1040","url":null,"abstract":"Snoring and obstructive sleep apnea syndrome (OSAS) are common pathologies. Sleep disorders cause a daytime sleepiness, impaired concentration, and other cognitive impairments. All this can lead to fatal consequences. Unfortunately, only about 20 % of patients suffering from this pathology are identified. As a rule, patients do not know about the presence of OSAS, on the one hand, and on the other hand, they do not know which specialist they need to seek help from. Given the fact that impaired upper airway patency is one of the main causes of OSAS, most patients should be treated by an otolaryngologist. This work is aimed at improving the diagnosis of snoring and obstructive sleep apnea syndrome in screening studies. Screening for snoring and OSAS using the Berlin questionnaire as a result of this study allowed identifying 60 % more patients suffering from snoring and OSAS than in self-referral. The use of the Berlin questionnaire in all patients seeking medical care will help identify a hidden pathology and further conduct a more complete diagnosis of snoring and sleep apnea, as well as prescribe appropriate treatment.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"29 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.22141/2224-0713.20.1.2024.1039
V.V. Marshtupa, T.I. Nasonova
Background. Severe acute respiratory syndrome сoronavіrus 2 (SARS-CoV-2, formerly known as 2019-nCoV) is the cause of coronavirus disease 2019 (COVID-19), and was first reported in Wuhan, China. However, it is also contagious to humans and spreads rapidly around the world through close contact between infected people or through a relatively simple transmission mechanism (airborne transmission). COVID-19 is known to affect almost all systems of the human body. Initial reports suggest that hypertension may be a risk factor for susceptibility to SARS-CoV-2 infection, a more severe course of COVID-19, and increased mortality associated with COVID-19. It is estimated that 1–3 % of COVID-19 patients experience transient ischemic attacks with a frequency similar to other coronavirus infections (SARS-CoV-1 and MERS-CoV). The cause of ischemic stroke associated with COVID-19 is unknown, but previous studies have suggested that an inflammatory cytokine storm may cause hypercoagulation and endothelial damage. We see that COVID-19 is closely related to neurological complications because there are potential factors that can cause them. Materials and methods. Cerebrovascular diseases were analyzed in 111 patients infected with SARS-CoV-2 (n = 71) and those without a history of SARS-CoV-2 (n = 40). The subject of the study was neuropsychological and laboratory indicators. The following methods were used: psychometric — Beck Anxiety Inventory, Hamilton Depression Rating Scale, Fatigue Assessment Scale; neuropsychological — Mini-Mental State Examination, Montreal Cognitive Assessment, Frontal Assessment Battery; clinical — neurological status; polymerase chain reaction to detect COVID-19 RNA; statistical methods. Results. In patients who suffered transient ischemic attack and ischemic stroke with a minimal neurological deficit and COVID-19, there were elevations in the erythrocyte sedimentation rate, leukocytes, segmented neutrophils, while an increase in C-reactive protein was noted in all participants with cerebrovascular disease and COVID-19, with more significant levels among those with ischemic stroke. All subgroups with COVID-19 showed an increase in D-dimer and fibrinogen with higher content in patients after ischemic stroke. Also in this subgroup, the procalcitonin index exceeded the norm, which indicates the severity of the course of COVID-19 with the addition of co-infection. Data of neuropsychological tests in patients with ischemic stroke with a minimal neurological deficit with SARS-CoV-2 revealed a decrease in the Montreal Cognitive Assessment score, indicating mild cognitive changes in these patients. The level of anxiety in patients with hypertension with frequent crises and ischemic stroke with a minimal neurological deficit was above the reference values, with a slight predominance in patients who did not have COVID-19. It follows that both laboratory and neuropsychological parameters differed in three subgroups depending on cerebrovascular dise
{"title":"Analysis of neuropsychological and laboratory parameters in patients with cerebrovascular disease and SARS-CoV-2 compared to those without SARS-CoV-2","authors":"V.V. Marshtupa, T.I. Nasonova","doi":"10.22141/2224-0713.20.1.2024.1039","DOIUrl":"https://doi.org/10.22141/2224-0713.20.1.2024.1039","url":null,"abstract":"Background. Severe acute respiratory syndrome сoronavіrus 2 (SARS-CoV-2, formerly known as 2019-nCoV) is the cause of coronavirus disease 2019 (COVID-19), and was first reported in Wuhan, China. However, it is also contagious to humans and spreads rapidly around the world through close contact between infected people or through a relatively simple transmission mechanism (airborne transmission). COVID-19 is known to affect almost all systems of the human body. Initial reports suggest that hypertension may be a risk factor for susceptibility to SARS-CoV-2 infection, a more severe course of COVID-19, and increased mortality associated with COVID-19. It is estimated that 1–3 % of COVID-19 patients experience transient ischemic attacks with a frequency similar to other coronavirus infections (SARS-CoV-1 and MERS-CoV). The cause of ischemic stroke associated with COVID-19 is unknown, but previous studies have suggested that an inflammatory cytokine storm may cause hypercoagulation and endothelial damage. We see that COVID-19 is closely related to neurological complications because there are potential factors that can cause them. Materials and methods. Cerebrovascular diseases were analyzed in 111 patients infected with SARS-CoV-2 (n = 71) and those without a history of SARS-CoV-2 (n = 40). The subject of the study was neuropsychological and laboratory indicators. The following methods were used: psychometric — Beck Anxiety Inventory, Hamilton Depression Rating Scale, Fatigue Assessment Scale; neuropsychological — Mini-Mental State Examination, Montreal Cognitive Assessment, Frontal Assessment Battery; clinical — neurological status; polymerase chain reaction to detect COVID-19 RNA; statistical methods. Results. In patients who suffered transient ischemic attack and ischemic stroke with a minimal neurological deficit and COVID-19, there were elevations in the erythrocyte sedimentation rate, leukocytes, segmented neutrophils, while an increase in C-reactive protein was noted in all participants with cerebrovascular disease and COVID-19, with more significant levels among those with ischemic stroke. All subgroups with COVID-19 showed an increase in D-dimer and fibrinogen with higher content in patients after ischemic stroke. Also in this subgroup, the procalcitonin index exceeded the norm, which indicates the severity of the course of COVID-19 with the addition of co-infection. Data of neuropsychological tests in patients with ischemic stroke with a minimal neurological deficit with SARS-CoV-2 revealed a decrease in the Montreal Cognitive Assessment score, indicating mild cognitive changes in these patients. The level of anxiety in patients with hypertension with frequent crises and ischemic stroke with a minimal neurological deficit was above the reference values, with a slight predominance in patients who did not have COVID-19. It follows that both laboratory and neuropsychological parameters differed in three subgroups depending on cerebrovascular dise","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"46 s216","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.22141/2224-0713.20.1.2024.1041
О.A. Eroshkin, D. Romanukha
Background. Chronic abdominal pain is common in 50 % of patients with intra-abdominal malignancies and has a huge impact on quality of their lives. As the number and doses of systemic analgesics increase, so does the frequency of side effects that can further worsen functional status, which is important for this cohort of patients who have a five-year survival rate of only 8 %. The purpose of the study: to assess the efficacy and safety of computed tomography-guided celiac plexus neurolysis as a method of reducing persistent, severe pain in patients with pancreatic cancer that affects their functional status. Materials and methods. The analysis of the results of 17 interventional procedures on the celiac plexus in 16 participants was conducted, sympatholysis was performed twice in one patient. Inclusion criteria: pancreatic cancer with persistent pharmacoresistant neuropathic abdominal pain for ≥ 3 months, which did not respond to medications, including opioids, anti-inflammatory drugs, and other conservative methods of treatment. Age of patients was 39 to 72 years (mean of 62.6 ± 8.2 years), 10 (62.5 %) research participants were male and 6 (37.5 %) were female. Results. Interventions were successfully performed for all patients on the first attempt. There were no cases of perforations of hollow organs, damage to blood vessels, pleural sinuses, or other structures of the abdominal and thoracic cavities. No neurological complications were recorded, and no one required blood transfusion. All study patients had a significant reduction in pain on the visual analogue scale compared to baseline, both one week after the procedure, from 9.7 ± 0.6 to 4.7 ± 1.4 (P < 0.001), and in six months, from 9.7 ± 0.6 to 4.1 ± 1.4 (P < 0.001). The average Karnofsky Performance Status Scale score compared to the data before the procedure, one week after increased from 64.7 ± 7.9 to 78.2 ± 6.4 (P < 0.001). A significant improvement in functional status was maintained up to three months — 71.2 ± 6.9 (P < 0.001). However, in six months, this indicator was 63.5 ± 6.0 (Р = 0.668), which may be related not only to the intensity of the pain syndrome, but also to other complications of the underlying disease (ascites, cachexia, tumor growth, palliative surgical interventions, etc.). Conclusions. Computed tomography-guided celiac plexus neurolysis is a safe and effective procedure for patients with abdominal pain caused by inoperable pancreatic cancer. Sympatholysis provides a long-term significant reduction in pain syndrome according to the visual analogue scale after 1, 3, 6 months (Р < 0.001) and increases the functional status of patients according to the Karnofsky Performance Status Scale in 1 (Р < 0.001), 3 months (Р = 0.023). Celiac plexus neurolysis should be considered as part of a multidisciplinary approach to the comprehensive treatment of upper abdominal pain associated with cancer in the early stages of the disease.
{"title":"Minimally invasive interventions on celiac plexus in patients with persistent abdominal pain caused by pancreatic cancer","authors":"О.A. Eroshkin, D. Romanukha","doi":"10.22141/2224-0713.20.1.2024.1041","DOIUrl":"https://doi.org/10.22141/2224-0713.20.1.2024.1041","url":null,"abstract":"Background. Chronic abdominal pain is common in 50 % of patients with intra-abdominal malignancies and has a huge impact on quality of their lives. As the number and doses of systemic analgesics increase, so does the frequency of side effects that can further worsen functional status, which is important for this cohort of patients who have a five-year survival rate of only 8 %. The purpose of the study: to assess the efficacy and safety of computed tomography-guided celiac plexus neurolysis as a method of reducing persistent, severe pain in patients with pancreatic cancer that affects their functional status. Materials and methods. The analysis of the results of 17 interventional procedures on the celiac plexus in 16 participants was conducted, sympatholysis was performed twice in one patient. Inclusion criteria: pancreatic cancer with persistent pharmacoresistant neuropathic abdominal pain for ≥ 3 months, which did not respond to medications, including opioids, anti-inflammatory drugs, and other conservative methods of treatment. Age of patients was 39 to 72 years (mean of 62.6 ± 8.2 years), 10 (62.5 %) research participants were male and 6 (37.5 %) were female. Results. Interventions were successfully performed for all patients on the first attempt. There were no cases of perforations of hollow organs, damage to blood vessels, pleural sinuses, or other structures of the abdominal and thoracic cavities. No neurological complications were recorded, and no one required blood transfusion. All study patients had a significant reduction in pain on the visual analogue scale compared to baseline, both one week after the procedure, from 9.7 ± 0.6 to 4.7 ± 1.4 (P < 0.001), and in six months, from 9.7 ± 0.6 to 4.1 ± 1.4 (P < 0.001). The average Karnofsky Performance Status Scale score compared to the data before the procedure, one week after increased from 64.7 ± 7.9 to 78.2 ± 6.4 (P < 0.001). A significant improvement in functional status was maintained up to three months — 71.2 ± 6.9 (P < 0.001). However, in six months, this indicator was 63.5 ± 6.0 (Р = 0.668), which may be related not only to the intensity of the pain syndrome, but also to other complications of the underlying disease (ascites, cachexia, tumor growth, palliative surgical interventions, etc.). Conclusions. Computed tomography-guided celiac plexus neurolysis is a safe and effective procedure for patients with abdominal pain caused by inoperable pancreatic cancer. Sympatholysis provides a long-term significant reduction in pain syndrome according to the visual analogue scale after 1, 3, 6 months (Р < 0.001) and increases the functional status of patients according to the Karnofsky Performance Status Scale in 1 (Р < 0.001), 3 months (Р = 0.023). Celiac plexus neurolysis should be considered as part of a multidisciplinary approach to the comprehensive treatment of upper abdominal pain associated with cancer in the early stages of the disease.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"22 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.22141/2224-0713.20.1.2024.1044
T. Malysh
Background. Lyme disease is characterized by a wide polymorphism of clinical manifestations, including various lesions of the central and peripheral nervous systems. Along with neurological disorders, diverse manifestations and signs of cognitive impairments are often found. Despite the high prevalence of cognitive disorders in Lyme borreliosis, data on their frequency and risk factors are contradictory. The examination of cognitive status is still not included in the standard clinical examination of this category of patients. The aim of the study is to identify predictors that may independently influence the development of cognitive dysfunction in patients with Lyme borreliosis. Materials and methods. A prospective cohort study of 69 patients (47 females, 22 males) diagnosed with Lyme borreliosis, aged between 23 and 77 (average of 49.90 ± 16.26) years, was carried out. The Montreal Cognitive Assessment was used to evaluate cognitive function. To determine the relationship between cognitive dysfunction and its potential predictors, the participants were divided into two groups: patients without cognitive impairment (n = 30) and those with cognitive dysfunction (n = 39) based on the Montreal Cognitive Assessment score. Results. It was found that risk factors for the development of cognitive impairment include: diagnosis of Lyme borreliosis at the age of 45.5 years and older (hazard ratio (HR) 5.09; 95% confidence interval (CI) [1.82–14.27]; p = 0.001), presence of neuroborreliosis (HR 5.98; 95% CI [2.0–17.8]; р < 0.001), Lyme carditis (HR 8.7; 95% CI [1.04–73.06]; р = 0.021), hypertension (HR 7.19; 95% CI [2.32–22.28]; р < 0.001), anxiety disorders. Conclusions. The prospect for further research is to study and analyze the features of the correlation between cognitive and psycho-emotional disorders and the quality of life of patients with different forms and duration of Lyme borreliosis.
背景。莱姆病的临床表现多种多样，包括中枢和周围神经系统的各种病变。除神经系统疾病外，认知障碍的表现和体征也多种多样。尽管认知障碍在莱姆-博雷利病中的发病率很高，但有关其发病频率和风险因素的数据却相互矛盾。对这类患者的标准临床检查仍未包括认知状况的检查。本研究旨在找出可能独立影响莱姆-博雷利病患者认知功能障碍发展的预测因素。材料与方法。对 69 名年龄在 23 岁至 77 岁（平均 49.90 ± 16.26）之间的莱姆病患者（47 名女性，22 名男性）进行了前瞻性队列研究。评估认知功能时使用了蒙特利尔认知评估。为确定认知功能障碍与其潜在预测因素之间的关系，根据蒙特利尔认知评估得分将参与者分为两组：无认知障碍患者（30 人）和认知功能障碍患者（39 人）。结果发现结果发现，出现认知障碍的风险因素包括：45.5 岁及以上诊断出莱姆包虫病（危险比 (HR) 5.09; 95% 置信区间 (CI) [1.82-14.27]; p = 0.001）、神经性包虫病（HR 5.98；95% CI [2.0-17.8]；р < 0.001）、莱姆心肌炎（HR 8.7；95% CI [1.04-73.06]；р = 0.021）、高血压（HR 7.19；95% CI [2.32-22.28]；р < 0.001）、焦虑症。结论进一步研究的前景是研究和分析不同形式和病程的莱姆病患者的认知和心理情感障碍与生活质量之间的相关性特征。
{"title":"The role of clinical characteristics of Lyme borreliosis in predicting cognitive impairment","authors":"T. Malysh","doi":"10.22141/2224-0713.20.1.2024.1044","DOIUrl":"https://doi.org/10.22141/2224-0713.20.1.2024.1044","url":null,"abstract":"Background. Lyme disease is characterized by a wide polymorphism of clinical manifestations, including various lesions of the central and peripheral nervous systems. Along with neurological disorders, diverse manifestations and signs of cognitive impairments are often found. Despite the high prevalence of cognitive disorders in Lyme borreliosis, data on their frequency and risk factors are contradictory. The examination of cognitive status is still not included in the standard clinical examination of this category of patients. The aim of the study is to identify predictors that may independently influence the development of cognitive dysfunction in patients with Lyme borreliosis. Materials and methods. A prospective cohort study of 69 patients (47 females, 22 males) diagnosed with Lyme borreliosis, aged between 23 and 77 (average of 49.90 ± 16.26) years, was carried out. The Montreal Cognitive Assessment was used to evaluate cognitive function. To determine the relationship between cognitive dysfunction and its potential predictors, the participants were divided into two groups: patients without cognitive impairment (n = 30) and those with cognitive dysfunction (n = 39) based on the Montreal Cognitive Assessment score. Results. It was found that risk factors for the development of cognitive impairment include: diagnosis of Lyme borreliosis at the age of 45.5 years and older (hazard ratio (HR) 5.09; 95% confidence interval (CI) [1.82–14.27]; p = 0.001), presence of neuroborreliosis (HR 5.98; 95% CI [2.0–17.8]; р < 0.001), Lyme carditis (HR 8.7; 95% CI [1.04–73.06]; р = 0.021), hypertension (HR 7.19; 95% CI [2.32–22.28]; р < 0.001), anxiety disorders. Conclusions. The prospect for further research is to study and analyze the features of the correlation between cognitive and psycho-emotional disorders and the quality of life of patients with different forms and duration of Lyme borreliosis.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"6 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140227577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Hemorrhagic transformation (HT) is a frequent complication of acute cerebral infarction, which is unfavorable for the treatment and prognosis of patients. It can be divided into two main subtypes, hemorrhagic infarction, and parenchymal hematoma, depending on the type of hemorrhage. Although the pathophysiological mechanism of HT is still unclear, hypotheses have been proposed about the loss of microvascular integrity and impaired neurovascular homeostasis. The purpose of the study was to analyze the current scientific literature on risk factors, diagnosis, and new approaches to the treatment of hemorrhagic transformation of cerebral infarction. Materials and methods. A literature search using keywords was conducted in Web of Science, Scopus, PubMed, and Elsevier databases. Results. Ischemic tissues have a natural tendency to bleed. In addition, the first trials of recanalization using intravenous thrombolysis showed an increase in the incidence of mild to severe intracranial hemorrhages. Symptomatic intracerebral hemorrhage is closely associated with poor outcomes and is an important factor in recanalization decisions. The development of HT after stroke involves numerous interrelated pathological processes from peripheral blood cells to neurovascular units such as hyperactive ischemic cascades with increased levels of matrix metalloproteinases, excessive reactive oxygen species, coagulopathy, blood-brain barrier breakdown, and reperfusion injury. A number of risk factors or prognostic factors for HT after cerebral infarction have been identified, namely the use of antiplatelet agents or anticoagulants, infarct size, atrial fibrillation, hypertension, age, gender, heart failure, coronary artery disease, diabetes mellitus, lipid profile, reperfusion therapy, and white matter hyperintensity load. The incidence of HT is reported mainly in clinical studies using brain imaging techniques such as computed tomography or magnetic resonance imaging, diffusion weighted imaging, and perfusion weighted imaging. Recombinant tissue plasminogen activator therapy and mechanical thrombectomy are currently the main treatments for ischemic stroke, but reperfusion injury due to revascularization increases the risk of cerebral hemorrhage. Understanding the risk factors and in-depth evaluation of predictors can significantly help physicians develop strategies to reduce the occurrence of HT, as well as provide insight into the pathophysiological mechanism of the disease. Conclusions. Patients at risk of hemorrhagic transformation require invasive and non-invasive neuromonitoring to help make decisions in decompressive neurosurgery for large cerebellar infarction, specific cardiorespiratory treatment, nutrition, blood pressure control, biochemical parameters, and the choice of an individual management strategy.
背景。出血性转化（HT）是急性脑梗死的一种常见并发症，对患者的治疗和预后不利。根据出血类型的不同，可将其分为出血性梗死和实质血肿两大亚型。虽然出血性脑梗死的病理生理机制尚不清楚，但有人提出了微血管完整性丧失和神经血管稳态受损的假说。本研究旨在分析目前有关脑梗死出血性转化的危险因素、诊断和治疗新方法的科学文献。材料和方法。使用关键词在 Web of Science、Scopus、PubMed 和 Elsevier 数据库中进行文献检索。结果。缺血组织有自然出血倾向。此外，使用静脉溶栓进行再通的首批试验显示，轻度至重度颅内出血的发生率有所增加。无症状性脑内出血与不良预后密切相关，是决定再通的一个重要因素。脑卒中后高密度脂蛋白血症的发生涉及从外周血细胞到神经血管单元的许多相互关联的病理过程，如基质金属蛋白酶水平升高导致的缺血级联反应亢进、活性氧过多、凝血病变、血脑屏障破坏和再灌注损伤。目前已发现脑梗死后发生 HT 的一些危险因素或预后因素，即使用抗血小板药物或抗凝剂、梗死面积、心房颤动、高血压、年龄、性别、心力衰竭、冠状动脉疾病、糖尿病、血脂状况、再灌注治疗和白质高密度负荷。HT的发病率主要见于使用计算机断层扫描或磁共振成像、弥散加权成像和灌注加权成像等脑成像技术进行的临床研究。重组组织纤溶酶原激活剂疗法和机械性血栓切除术是目前治疗缺血性卒中的主要方法，但血管再通导致的再灌注损伤会增加脑出血的风险。了解风险因素并深入评估预测因素可极大地帮助医生制定减少高血压发生的策略，同时还能深入了解该疾病的病理生理机制。结论有出血转化风险的患者需要进行有创和无创神经监测，以帮助做出大面积小脑梗死减压神经外科手术、特定心肺治疗、营养、血压控制、生化指标以及个体管理策略选择等方面的决策。
{"title":"Hemorrhagic transformation of cerebral infarction: risk factors, diagnosis, and new approaches to treatment","authors":"PhD Andrii Kulmatytskyi, PhD Mariia Bilobryn, Neurologist M.B. Makarovska","doi":"10.22141/2224-0713.20.1.2024.1043","DOIUrl":"https://doi.org/10.22141/2224-0713.20.1.2024.1043","url":null,"abstract":"Background. Hemorrhagic transformation (HT) is a frequent complication of acute cerebral infarction, which is unfavorable for the treatment and prognosis of patients. It can be divided into two main subtypes, hemorrhagic infarction, and parenchymal hematoma, depending on the type of hemorrhage. Although the pathophysiological mechanism of HT is still unclear, hypotheses have been proposed about the loss of microvascular integrity and impaired neurovascular homeostasis. The purpose of the study was to analyze the current scientific literature on risk factors, diagnosis, and new approaches to the treatment of hemorrhagic transformation of cerebral infarction. Materials and methods. A literature search using keywords was conducted in Web of Science, Scopus, PubMed, and Elsevier databases. Results. Ischemic tissues have a natural tendency to bleed. In addition, the first trials of recanalization using intravenous thrombolysis showed an increase in the incidence of mild to severe intracranial hemorrhages. Symptomatic intracerebral hemorrhage is closely associated with poor outcomes and is an important factor in recanalization decisions. The development of HT after stroke involves numerous interrelated pathological processes from peripheral blood cells to neurovascular units such as hyperactive ischemic cascades with increased levels of matrix metalloproteinases, excessive reactive oxygen species, coagulopathy, blood-brain barrier breakdown, and reperfusion injury. A number of risk factors or prognostic factors for HT after cerebral infarction have been identified, namely the use of antiplatelet agents or anticoagulants, infarct size, atrial fibrillation, hypertension, age, gender, heart failure, coronary artery disease, diabetes mellitus, lipid profile, reperfusion therapy, and white matter hyperintensity load. The incidence of HT is reported mainly in clinical studies using brain imaging techniques such as computed tomography or magnetic resonance imaging, diffusion weighted imaging, and perfusion weighted imaging. Recombinant tissue plasminogen activator therapy and mechanical thrombectomy are currently the main treatments for ischemic stroke, but reperfusion injury due to revascularization increases the risk of cerebral hemorrhage. Understanding the risk factors and in-depth evaluation of predictors can significantly help physicians develop strategies to reduce the occurrence of HT, as well as provide insight into the pathophysiological mechanism of the disease. Conclusions. Patients at risk of hemorrhagic transformation require invasive and non-invasive neuromonitoring to help make decisions in decompressive neurosurgery for large cerebellar infarction, specific cardiorespiratory treatment, nutrition, blood pressure control, biochemical parameters, and the choice of an individual management strategy.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"112 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.22141/2224-0713.20.1.2024.1042
I.S. Zozulia, A. Volosovets, A. Zozulia
According to the World Health Organization experts, about 7 million deaths due to cerebrovascular disease are recorded annually worldwide, and the number of stroke deaths is projected to reach 7.8 million by 2030. The main causes of stroke and its growth are population ageing, urbanisation, unhealthy lifestyles, insufficient control of risk factors (hypertension, atherosclerosis, diabetes, stressful situations, etc.). It is also associated with untimely provision of emergency medical care at the pre-hospital stage and ineffective treatment of strokes at the hospital stage, as well as a low efficiency of preventive treatment for recurrent stroke and rehabilitation measures. The lecture presents modern methods and techniques for treating patients with acute cerebrovascular accident at different stages: pre-hospital, hospital, and rehabilitation.
{"title":"Emergency care and treatment of cerebral stroke at the stages of hospitalisation","authors":"I.S. Zozulia, A. Volosovets, A. Zozulia","doi":"10.22141/2224-0713.20.1.2024.1042","DOIUrl":"https://doi.org/10.22141/2224-0713.20.1.2024.1042","url":null,"abstract":"According to the World Health Organization experts, about 7 million deaths due to cerebrovascular disease are recorded annually worldwide, and the number of stroke deaths is projected to reach 7.8 million by 2030. The main causes of stroke and its growth are population ageing, urbanisation, unhealthy lifestyles, insufficient control of risk factors (hypertension, atherosclerosis, diabetes, stressful situations, etc.). It is also associated with untimely provision of emergency medical care at the pre-hospital stage and ineffective treatment of strokes at the hospital stage, as well as a low efficiency of preventive treatment for recurrent stroke and rehabilitation measures. The lecture presents modern methods and techniques for treating patients with acute cerebrovascular accident at different stages: pre-hospital, hospital, and rehabilitation.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"95 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140225042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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