RESUMEN
The authors consider the prevalence and the clinical outcomes of cerebral stroke in Russia and the most promising methods directed towards lowering stroke incidence and raising the quality of pre-hospital and hospital aid. The authors also pay their attention to rehabilitation techniques improving the life quality of patients after cerebral stroke, and characterize the areas of scientific research into the lowering of the medicosocial consequences of cerebral stroke.
Asunto(s)
Accidente Cerebrovascular/epidemiología , Factores de Edad , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Hemorragia Cerebral/epidemiología , Hemorragia Cerebral/mortalidad , Hemorragia Cerebral/terapia , Cuidados Críticos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Grupo de Atención al Paciente , Calidad de la Atención de Salud , Calidad de Vida , Investigación , Factores de Riesgo , Federación de Rusia/epidemiología , Factores Sexuales , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/prevención & control , Accidente Cerebrovascular/terapia , Rehabilitación de Accidente Cerebrovascular , Hemorragia Subaracnoidea/epidemiología , Hemorragia Subaracnoidea/mortalidad , Hemorragia Subaracnoidea/terapia , Factores de Tiempo , Resultado del TratamientoRESUMEN
The purpose of the investigation was to evaluate the efficiency of therapy of patients with hemispheric ischemic stroke with cerebrolysin (C) (using two different regimens of its injections) versus placebo. One endolumbar C injection (5 ml) made in the first 12 hours of stroke and after the subsequent therapy with dropwise C injections (10 ml) significantly enhanced the efficiency of therapy and improved the functional recovery of patients was observed 12 hours following.
Asunto(s)
Aminoácidos/uso terapéutico , Isquemia Encefálica/tratamiento farmacológico , Encéfalo/irrigación sanguínea , Lateralidad Funcional/fisiología , Nootrópicos/uso terapéutico , Adulto , Anciano , Aminoácidos/administración & dosificación , Esquema de Medicación , Humanos , Inyecciones Espinales , Persona de Mediana Edad , Nootrópicos/administración & dosificación , Factores de TiempoRESUMEN
The article deals with the clinicians' views on the widely used methods of brain circulation disorders prevention. On their own experience and on the literature data the authors make a conclusion, that insult is being caused by a number of etiological and pathogenic factors. They discuss some methods of hemodynamics reserve estimation and formulate new ideas for the disorders' possible development.
Asunto(s)
Trastornos Cerebrovasculares/prevención & control , Personal Militar , Circulación Cerebrovascular , Trastornos Cerebrovasculares/diagnóstico , Trastornos Cerebrovasculares/etiología , Trastornos Cerebrovasculares/fisiopatología , Trastornos Cerebrovasculares/cirugía , Hemodinámica , Humanos , Arteriosclerosis Intracraneal/complicaciones , Arteriosclerosis Intracraneal/diagnóstico , Factores de RiesgoAsunto(s)
Isquemia Encefálica/terapia , Cuidados Críticos/métodos , Desequilibrio Hidroelectrolítico/terapia , Isquemia Encefálica/sangre , Isquemia Encefálica/complicaciones , Isquemia Encefálica/mortalidad , Causas de Muerte , Humanos , Concentración Osmolar , Factores de Tiempo , Desequilibrio Hidroelectrolítico/sangre , Desequilibrio Hidroelectrolítico/etiología , Desequilibrio Hidroelectrolítico/mortalidadRESUMEN
The subjects of the study were both 33 patients treated with a standard basic therapy including the use of diuretics, and 38 patients who at the same time, were treated with intravenous isotonic (5%) solution of glucose of keep blood serum osmolality at the upper normal level. This stabilisation of the blood osmolality has allowed the mortality to be decreased from 21.2 to 7.9% as well as it resulted in a decrease of the frequency of complications.
Asunto(s)
Isquemia Encefálica/mortalidad , Equilibrio Hidroelectrolítico , Anciano , Isquemia Encefálica/sangre , Isquemia Encefálica/terapia , Diuréticos/uso terapéutico , Glucosa/administración & dosificación , Humanos , Infusiones Intravenosas , Soluciones Isotónicas , Persona de Mediana Edad , Concentración Osmolar , Factores de TiempoRESUMEN
Central and cerebral hemodynamics was studied using echocardiography and transcranial dopplerography in 200 poststroke patients over 60 in the course of 5-year follow-up. It was established that cardiac hypodynamic syndrome, i.e. continuous or paroxysmal fall of minute blood volume below 3 l, is the most significant contributing factor in the onset of cerebral ischemia. Drugs are recommended for prevention of ischemic stroke. Those lowering cardiac hemodynamic reserve should be excluded in patients at high risk of acute failure of cerebral circulation.
Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Isquemia Encefálica/prevención & control , Bloqueadores de los Canales de Calcio/uso terapéutico , Hemodinámica/fisiología , Angioplastia , Isquemia Encefálica/etiología , Isquemia Encefálica/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Arteriosclerosis Intracraneal/complicaciones , Arteriosclerosis Intracraneal/diagnóstico , Arteriosclerosis Intracraneal/fisiopatología , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/fisiopatología , Estudios Retrospectivos , Factores de Riesgo , Ultrasonografía Doppler TranscranealAsunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Aminoácidos/administración & dosificación , Lesiones Encefálicas/tratamiento farmacológico , Trastornos Cerebrovasculares/tratamiento farmacológico , Demencia Vascular/tratamiento farmacológico , Trastornos Neurocognitivos/tratamiento farmacológico , Nootrópicos/administración & dosificación , Humanos , Factores de TiempoRESUMEN
Pathokinesis as the chain reaction included development and self-regulation of pathological processes which manifested themselves by different forms of cerebrovascular pathology was analysed basing on 5-year follow-up of 200 patients with initial forms of cerebrovascular deficiency and examination of patients with discirculatory encephalopathy (in 100 of them stroke had developed during this time) as well as the data on 873 patients with stroke. Pathokinetic significance of risk factors, conditions predisposing to stroke development and stroke direct reasons are characterised as well as therapy of different intensity. The possibilities of the correction of some pathokinetic mechanisms by means of emergent therapy as well as the role of some uncorrectable factors (biological and situational ones) were defined too. The pathokinetic peculiarities of the main forms of insult were defined more precisely in relation to on the degree of individual compensatory abilities.
Asunto(s)
Trastornos Cerebrovasculares/etiología , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/etiología , Isquemia Encefálica/patología , Hemorragia Cerebral/etiología , Hemorragia Cerebral/patología , Trastornos Cerebrovasculares/patología , Susceptibilidad a Enfermedades , Humanos , Persona de Mediana Edad , Factores de RiesgoRESUMEN
A sharp (16.4%) increase of blood serum osmolality very close to the critical values was found in acute period of ischemic stroke, while sodiumemia exceeded the normal levels by 50 mmol/l and more. Meanwhile, the concentrations of Na ions in liquor of such patients was not significantly increased. The levels of Ca, K, Mg ions as well as the osmolality of blood serum and liquor were stable too. The alterations of these parameters were not significantly changed in epileptic patients out of fits. Both the analysis of the reasons of hyperosmia and hypersodiumemia development and the search for the methods of their prophylaxis and correction will be quite important in further investigations.
Asunto(s)
Isquemia Encefálica/sangre , Isquemia Encefálica/líquido cefalorraquídeo , Electrólitos/sangre , Electrólitos/líquido cefalorraquídeo , Epilepsia/sangre , Epilepsia/líquido cefalorraquídeo , Fenómenos Químicos , Química Física , Humanos , Concentración Osmolar , Factores de TiempoRESUMEN
Outcomes in 1102 patients with 3 main types of stroke have been analysed to determine the significance of basic stroke outcome predictors. They are: type of the stroke, location of the focus, gravity of the patient's condition when the first aid is performed, spectrum of hospital facilities, diseases of the patient before and besides the stroke. A decrease of the mortality rate and optimal level of ADL score after stroke can be provided in cases when intensive care units-general hospitals are the first step of treatment.
Asunto(s)
Trastornos Cerebrovasculares/terapia , Actividades Cotidianas , Trastornos Cerebrovasculares/clasificación , Trastornos Cerebrovasculares/mortalidad , Coma/mortalidad , Coma/terapia , Cuidados Críticos , Primeros Auxilios , Humanos , Pronóstico , Federación de Rusia/epidemiología , Factores de Tiempo , Resultado del Tratamiento , Población Urbana/estadística & datos numéricosRESUMEN
In accordance with the clinical and coagulographic data on 172 patients with ischemic brain stroke (IBS), the authors developed a method of the use of some medicamentous agents (heparin, platelet inhibitors, fresh-frozen blood plasma, plasminogen activators, proteolytic enzymes), adapted to concrete characteristics of the coagulation status at different stages of brain infarction formation and permitting the rate of lethal outcomes to be reduced. In disseminated intravascular coagulation seen in patients with the gravest patterns of IBS, heparin may be indicated.
Asunto(s)
Isquemia Encefálica/complicaciones , Infarto Cerebral/terapia , Trastornos Cerebrovasculares/etiología , Coagulación Intravascular Diseminada/terapia , Embolia y Trombosis Intracraneal/complicaciones , Coagulación Sanguínea/efectos de los fármacos , Coagulación Sanguínea/fisiología , Transfusión Sanguínea , Isquemia Encefálica/sangre , Infarto Cerebral/sangre , Infarto Cerebral/etiología , Terapia Combinada , Coagulación Intravascular Diseminada/sangre , Coagulación Intravascular Diseminada/etiología , Heparina/administración & dosificación , Humanos , Embolia y Trombosis Intracraneal/sangre , Plasma , Activadores Plasminogénicos/administración & dosificación , Inhibidores de Agregación Plaquetaria/administración & dosificaciónRESUMEN
Based on the results of a clinicoepidemiological examination of the population of one of the medical districts of Leningrad and of the rural community (altogether 14,600 persons), marked differences were established in the general incidence of nervous system diseases (595.3% and 199.6%, respectively) as were 15 main patterns of neurological pathology. The incidence of nervous diseases was found to be fairly high, especially among women, which was supported by the data on 7 organized populations (overall 10.1 thousand persons). Factors of urbanization were shown to have an adverse effect on the population health status, manifesting, first of all, in a direct relationship between the incidence of initial signs of cerebral circulation failure and the number of the urban population. In the organized populations of the cities, the number of patients with the most unfavourable course of nervous system diseases (subcompensated and decompensated patterns) reached 21.5% of the total number of persons afflicted with chronic diseases of the nervous system. Meanwhile in the organized rural community, it was only 9.2%.
Asunto(s)
Enfermedades del Sistema Nervioso/epidemiología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/prevención & control , Población Rural , Federación de Rusia/epidemiología , Factores Sexuales , Población UrbanaAsunto(s)
Hemorragia Cerebral/complicaciones , Meningitis/complicaciones , Meningoencefalitis/complicaciones , Hipotonía Muscular/etiología , Músculos/inervación , Reflejo/fisiología , Enfermedad Aguda , Adolescente , Adulto , Anciano , Hemorragia Cerebral/fisiopatología , Femenino , Humanos , Masculino , Meningitis/fisiopatología , Meningoencefalitis/fisiopatología , Persona de Mediana Edad , Factores de TiempoRESUMEN
The quality of emergency aid in acute neurological pathology was assessed using the linear discriminant analysis of data obtained in 1436 cases. The aid may be substantially improved provided the questions of exactly targeted hospitalization be solved. The information obtained at the prehospital stage does not ensure the reliable differentiation between the 12 major forms of acute neurological states. The methods are designed allowing the correct choice of hospital for the patients' admission (infectious, toxicological, neurosurgical units) with due consideration of a minimum of clinico-anamnestic indices. This also makes possible the differentiation of the groups of patients needing emergency neurosurgery or intensive care.
Asunto(s)
Servicio de Urgencia en Hospital , Enfermedades del Sistema Nervioso/diagnóstico , Grupos Diagnósticos Relacionados , Humanos , Garantía de la Calidad de Atención de SaludRESUMEN
Clinically verified files of 1436 patients with 12 most frequent forms of acute neurological pathology were studied for the rate and causes of prehospital diagnostic errors. The information obtained before the patient's admission was evidenced to be insufficient for the reliable differentiation of the ailment nature. In cases when precise diagnosis appears impossible at the site of first medical aid, its efficiency can be increased by correct choice of special hospital.
Asunto(s)
Primeros Auxilios , Enfermedades del Sistema Nervioso/diagnóstico , Técnicos Medios en Salud , Errores Diagnósticos , Urgencias Médicas , Hospitalización , Humanos , Federación de Rusia , Población UrbanaRESUMEN
The study deals with the effectiveness of nitrosourea derivatives (nitrosomethylurea and CCNU) used for monochemotherapy or polychemotherapy in combination with vinca alkaloids, natulan and prednisolone in 22 patients suffering Hodgkin's disease with spinal cord and intracranial involvement. Complete regression of neurologic symptoms was seen in 61.1% of patients with spinal cord dysfunction and in 3 of 4 cases of brain involvement. The effectiveness of nitrosomethylurea-based regimens did not differ-significantly from those including CCNU. The longest complete remission obtained was 124+ months. No relationship was found between the type, degree and duration of symptoms, on the one hand, and the likelihood of achieving complete remission, on the other.