SOME ASPECTS OF THE DIAGNOSIS AND TREATMENT OF ISCHEMIC STROKE
Abstract
To improve the diagnosis and treatment of ischemic stroke (IS) is an urgent priority of modern neurology. It is stated that the vast majority of patients referred to hospital with suspected IS should urgently undergo brain computed tomography or magnetic resonance imaging (MRI) in order
to verify the diagnosis of IS and to rule out other diseases that can manifest as acute neurological disorders. Otoneurological examination should
be made in acute vestibular vertigo if there are no detectable ischemic changes on MRI. Management of a patient with IS in a specialized unit substantially
reduces death cases and disability rates in survivors. Not only can thrombolysis that is, unfortunately, accessible only in a small number
of neurology units in our country, but also the effective use of methods available in all neurology units reduce mortality and disability rates.
to verify the diagnosis of IS and to rule out other diseases that can manifest as acute neurological disorders. Otoneurological examination should
be made in acute vestibular vertigo if there are no detectable ischemic changes on MRI. Management of a patient with IS in a specialized unit substantially
reduces death cases and disability rates in survivors. Not only can thrombolysis that is, unfortunately, accessible only in a small number
of neurology units in our country, but also the effective use of methods available in all neurology units reduce mortality and disability rates.
References
1. <div><p>Дамулин И.В., Парфенов В.А., Скоромец А.А. и др. Нарушения кровообращения в головном и спинном мозге. В кн.: Болезни нервной системы. Руководство для врачей. Под ред. Н.Н.Яхно. М.: Медицина, 2005;1:232-303.</p><p>Инсульт: диагностика, лечение и профилактика. Под ред. З.А. Суслиной, М.А. Пирадова. М.: МЕДпресс-информ, 2008;288 с.</p><p>Фейгин В., Виберс Д., Браун Р. Инсульт: клиническое руководство. М.: Бином; СПб.: Диалект, 2005;608 с.</p><p>Adams H.P., del Zoppo G., Alberts M.J. Guidelines for the Early Management of Adults With Ischemic Stroke. Stroke 2007;38:1655-711.</p><p>European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis 2008;25:457-507.</p><p>Chalela J., Kidwell C., Nentwich L. et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 2007;369:293-8.</p><p>Hand P., Kwan J., Lindley R. et al. Distinguishing between stroke and mimic at the bedside: The Brain Attack Study. Stroke 2006;37:769-75.</p><p>Libman R.B., Wirkowski E., Alvir J. et al. Conditions that mimic stroke in the emergency department. Implications for acute stroke trials. Arch Neurol 1995;52:1119-22.</p><p>Парфенов В.А., Замерград М.В., Мельников О.А. Головокружение: диагностика и лечение, распространенные диагностические ошибки. М.: МИА, 2009;152 с.</p><p>Gilligan A.K., Thrift A.G., Sturm J.W. et al. Stroke units, tissue plasminogen activator, aspirin and neuroprotection: which stroke intervention could provide the greatest community benefit- Cerebrovasc Dis 2005;20:239-44.</p><p>Hacke W., Kaste M., Bluhmki E. et al. Trombolysis with alteplase 3 to 4,5 hours after acute ischemic stroke. N Engl J Med 2008;359:1317-29.</p><p>International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet 1997;349:1569-81.</p><p>CAST (Chinese Acute Stroke Trial) Collaborative Group. CAST: randomised placebocontrolled trial of early aspirin use in 20 000 patients with acute ischaemic stroke. Lancet 1997;349:1641-9.</p><p>Clark W.M., Warach S.J., Pettigrew L.C. et al. A randomized dose-response trial of citicoline in acute ischemic stroke patients. Citicoline Stroke Study Group. Neurology 1997;49:671-8.</p><p>Warach S., Pettigrew L.C., Dashe J.F. et al. Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Ann Neurol 2000;48:713-22.</p><p>Dаvalos A., Castillo J., Alvarez-Sabin J. et al. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials. Stroke 2002;33:2850-7.</p><p>Diserens K., Michel P., BogousslavskyJ. Early mobilisation after stroke: review of the literature. Cerebrovasc Dis 2006;22:183-90.</p><p>Cerebrovascular disease, cognitive impairment and dementia. Second edition of Cerebrovascular disease and dementia. Ed. by O'Brien J., Ames D., Gustafson L. et al. Martin Dunitz, 2004.</p><p>Вахнина Н.В., Никитина Л.Ю., Парфенов В.А. Когнитивные нарушения при инсульте и их лечение мемантином. Клин геронтол 2005;11:49-52.</p></div><br />
For citation:
Parfenov V.A. SOME ASPECTS OF THE DIAGNOSIS AND TREATMENT OF ISCHEMIC STROKE. Neurology, Neuropsychiatry, Psychosomatics. 2010;2(1):13-18. (In Russ.) https://doi.org/10.14412/2074-2711-2010-64
Views: 416
Email this article 