Vertebrobasilar infarctions: principles of classification, clinical and neuroimaging analysis and terminological definitions of the diagnosis
Journal Title: Серце і судини - Year 2019, Vol 0, Issue 2
Abstract
The aim — to describe the neurological clinic, specific symptoms and syndromes in patients with acute infarction of various anatomical and vascular territories of the posterior circular pool, to justify the use in clinical practice of the terminological formulation of the diagnosis which will reflect the affected intracranial vascular territory of the posterior circulation, localization of the infarction center and its clinical version. Materials and methods. A comprehensive clinical, neurological and neuroimaging examination of 120 patients with acute infarction of various areas of the posterior circular pool was performed. The localization and size of the infarction focus, the dynamics of the degree of impairment of neurological functions, the upset of daily vital activity, the degree of social maladjustment of patients were assessed. Results and discussion. The features of the neurological clinic of lacunar and non‑lacunar infarctions are described depending on the affected intracranial territory of the posterior circular pool. The significance in clinical practice of the terminological formulation of the diagnosis is substantiated. Conclusions. In the event of ischemic infarction in different parts of the brain stem or the cerebellum, it is not appropriate to formulate the diagnosis as «ischemic stroke in the vessels of the vertebrobasilar basin», since it only partially reveals the essence of the stroke. In case a medullary, bridging, mesencephalic, cerebellar or thalamic infarction develops, it is methodologically justified and adequate to use the terminological formulation of the diagnosis which will reflect the damaged vascular territory (proximal, median, distal), the clinical variant of the infarction and the anatomical‑topographic localization of the damaged posterior circular pool, and brain stem isolated or connected to other intracranial territories. Knowledge of the features of the neurological clinic and the modern terminological definition of the diagnosis of infarctions in the vertebrobasilar basin is important for the practitioner, the choice of adequate therapies and the assessment of the long‑term functional prognosis.
Authors and Affiliations
M. М. Prokopiv
Predictors of renal dysfunction in patients with chronic heart failure and reduced left ventricular ejection fraction
The aim — to elucidate the predictors of renal dysfunсtion (RD) in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF). Materials and methods. 134 patients were examined with...
Differences in the effects of various classes of antihypertensive drugs in combination therapy on indicators of arterial hemodynamics, vascular wall stiffness and structural-functional state of heart in patients with arterial hypertension of 1 — 2 degrees
The aim — to compare the effect of 6‑month treatment of patients with arterial hypertension (AH) of 1 — 2 degrees with angiotensin converting enzyme (ACE) or angiotensin II receptor blockers (ARB) in combination with a...
Register of percutaneous coronary interventions: expanded comparative analysis of results of 2016 and 20 17. From reperfusion paradox to decrease of mortality
Ukrainian Association of Interventional Cardiology established Percutaneous Coronary Interventions Registry (PCI Registry) in 2010. The first protocol was filled on 12.04.2010. By now (23.07.2018, 17 h 58 min) the Regist...
Results of treatment of patients with carotid artery stenosis in pathology of vision
The aim — to analyze the results of complex treatment of patients with carotid artery stenoses and abnormalities of the organ of vision. Materials and methods. The analysis was conducted of the results of the examinati...
Clinical, demographic and instrumental characteristics of patients with chronic heart failure and reduced left ventricular ejection fraction depending on iron deficiency
The aim — to establish clinical and other factors associated with iron deficiency (ID) in patients with chronic heart failure (CHF) and reduced left ventricular (LV) ejection fraction (EF). Materials and methods. 134 st...