RESUMEN
The present work was aimed at studying the state of the inferior vena cava system according to the findings of duplex scanning in dynamics of acute cerebral circulation impairments (ACCI). Amongst 100 patients with ACCI, lower limb vein deep thrombosis (LLVDT) was revealed in 57% of cases. The incidence of LLVDT in patients with intracerebral haemorrhage was higher than in those with ischaemic stroke, however there were no statistically significant differences between the type of ACCI (p=0.06) and subtypes of ischaemic stroke (atherothrombotic, ceardioembolic) (p = 0.68). The main risk factors for LLVDT are the presence of pronounced motion deficit in the extremities, induced by the underlying disease (p=0.02) and immobilization. In the overwhelming majority of patients (81%) thrombosis localized isolatedly in the crural veins. Ascending thrombosis and the development of a floating thrombus were represented mainly on the side of motility deficit in the extremities. We have confirmed a strong association between positive dynamics in the neurological status of patients and frequency of recanalization of thrombi (p=0.043). Ultrasonographic examination of lower limb veins in dynamics of ACCI is an important component of preventive and therapeutic process.
Asunto(s)
Extremidad Inferior/irrigación sanguínea , Paresia , Accidente Cerebrovascular , Ultrasonografía Doppler Dúplex/métodos , Vena Cava Inferior , Trombosis de la Vena , Anciano , Femenino , Humanos , Inmovilización/efectos adversos , Extremidad Inferior/fisiopatología , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico/métodos , Paresia/etiología , Paresia/fisiopatología , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Vena Cava Inferior/diagnóstico por imagen , Vena Cava Inferior/fisiopatología , Trombosis de la Vena/diagnóstico , Trombosis de la Vena/etiología , Trombosis de la Vena/fisiopatologíaRESUMEN
Venous thromboembolism (VTE), a deep and superficial thrombosis and pulmonary embolism, is a very important problem of severe stroke. Pulmonary embolism (PE) significantly influences the course and outcome of severe stroke. The cause of this effect lies not only in severe patient's condition, high risk of VTE and difficulties in diagnosis of VTE but in still common limits in prophylaxis and treatment of PE in severe stroke, first of all, in brain hemorrhages and large brain infarctions with secondary hemorrhage. The paper presents the main principles and methods of prophylaxis of VTE in severe stroke. The suggested approach allows to decrease the frequency of VTE and fatal outcomes in severe stroke in the modern neuro-intensive care units.