UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine
ISSN 2079-0325(p)
DOI 10.36927/2079-0325
Home » Archive of numbers » 2019 » Volume 27, issue 3 (100) » Evaluation of functional outcomes of vertebrobasilar infarction depending on the aff ected intracranial vascular territory of the posterior circulation

Evaluation of functional outcomes of vertebrobasilar infarction depending on the aff ected intracranial vascular territory of the posterior circulation

Authors

Type of Article

  • Scientific Article

In the Section

  • MECHANISMS OF FORMATION AND MODERN PRINCIPLES OF TREATMENT OF NEUROLOGICAL DISORDERS

Key words

Index UDK:
  • 616.831-005.8-008-036.8:[616.134.9+616.134.93]-005

Abstract

The aim of the work is to examine the features of recovery of lost neurological functions and the quali ty of life of patients with acute vertebrobasilar infarction, to evaluate and compare the short-term and long-term outcome of a stroke depending on the aff ected intracranial anatomical areas of the posterior circulation basin. 120 patients with acute vertebrobasilar infarction were examined, among them 22 (18.3 %) patients had a cerebral infarction, 38 (31.7 %) — pontine infarction, 13 (10.8 %) — midbrain infarction, 22 (18.3 %) — thalamic infarction and 25 (20.8 %) patients — cerebellar infarction. Strokes were distributed into three intracranial anatomical territories of the posterior circular basin: proximal, medial, distal. The diagnosis was established on the basis of data from the neurological clinic and magnetic resonance imaging in standard and DV modes. Clinical and neurological comparisons and a comparative statistical analysis of the functional outcomes of infarctions on the 21st and 90th day of a prospective observation. Despite the fact that there is no clear functional boundary between the proximal, medial and distal intracranial anatomical territories of the posterior circulation basin, which once again confi rms their functional unity, the potential for resuming lost neurological functions, a short-term and long-term outcome after infarction of diff erent anatomical and topographic areas of posterior circulation basin do not always match. Statistical analysis pointed that the short-term and long-term functional outcome after a infarction in diff erent intracranial vascular territories of the posterior circulation basin had certain features of the evolution of functional and neurological recovery. In particular, cerebellar infarctions had a signifi cantly better functional outcome compared to infarctions of the medulla oblongata in the short and long term perspective and midbrain infarctions — on the 90th day of the prospective observation (p 0.05) correlation between factorial and eff ective signs during short-term and longterm follow-up.

Pages

  • 26-33

Year / Issue

Download PDF

References

  1. Antonenko K. V. Risk factors, features of the clinical picture and consequences of ischemic infarctions of the verebral-basilar basin: PhD thesis for the degree of Candidate of Medical Sciences: 14.01.15 - Nervous diseases. К., 2014. 20 с.
  2. Vilensky B. S. Stroke. St. Petersburg. : Medical Information Agency. 1995. 288 с.
  3. Vinichuk S. M., Ilyash T. I., Prokopiv M. M. Treatment and outcome of acute ischemic disorders of cerebral circulation in the vertebral-basilar basin // International Neurological Journal. 2005. Т. 3. С. 22-26.
  4. Виничук С. М., Прокопив М. М., Трепет Л. Н. Изолированный инфаркт таламуса: клинические синдромы, диагностика, лечение и исход // Укр. мед. часопис. 2012. № 2 (88). С. 87—93.
  5. Vinichuk S. M., Trepet L. N., Vinichuk I. S. Brain stroke: clinical-diagnostic, therapeutic and prognostic algorithms, strategy of neurological scales selection. Kiev : Business-Intellect, 2012. 143 с.
  6. Vinichuk S. M., Yalynska T. A., Vinichuk I. S. Infarcts in the vertebral-basilar basin: clinic and diagnosis // International Neurological Journal. 2005. Т. 3. С. 13-21.
  7. Віничук С. М., Прокопів М. М. Гострий ішемічний інсульт. К. : Наукова думка. 2005. 286 с.
  8. Volosovets A. O. Neurogenic oropharyngeal dysphagia in the acute period of cerebral stroke: mechanisms of occurrence, methods of diagnosis and management of patients : PhD thesis for the degree of Candidate of Medical Sciences: 14.01.15 - Nervous diseases. К., 2011. 20 с.
  9. Kislitsyn Yu. V., Konopatkina I. Yu. Comparative characterization of the quality of life of patients with atherothrombotic stroke in the carotid and vertebrobasilar basins // Perm Medical Journal. 2016. Т. 33 (2). С. 30-33.
  10. Kostenko V., Polunini N. V. Influence of comorbidities on the peculiarities of rehabilitation of the stroke process // Physician. affl. 2017. Т. 4. С. 27-33.
  11. Risk factors, structure and consequences of acute stroke in Kyiv based on the results of pragmatic observation / Prokopiv MM, Rohoza SV, Trepet LM [et al. 2017. Т. 2 (118). С. 1-4.
  12. Trephet GS Features of restoration of lost motor functions after acute isolated cerebral infarction and its consequences on the background of complex therapy // International Neurological Journal. 2015. VOL. 1. PP. 71-80.
  13. Duvernoy H. M. Human brainstem vessels. Berlin : Springer Verlag, 1978. P. 11—15.
  14. Guidelines for management of ischaemic stroke and transient ischaemic attak / European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee // Cerebrovasc. Dis. 2008. Vol. 25 (5). P. 457—507. DOI: https://doi.org/10.1159/000131083.
  15. Functional recovery after rehabilitation for cerebellar stroke / Kelly P. , Stein J., Shafgat S. [et  al.]  // Stroke. 2001. Vol. 32 (2). P. 530—534. DOI: https://doi.org/10.1161/01.STR.32.2.530.
  16. Predictors of Outcome in patients presenting with acute Ischemic stroke and Mild Stroke Scale scores / Kenmuir C. , Hammer M., Jovin T. [et al.] // J. Stroke Cerebrovasc. Dis. 2015. 24 (7). P. 1685—1689. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.042.
  17. Clinical outcome of myocardial infarction of the posterior and posterior circulation with low National Institutes of Health Stroke Scale / Kim J. T., Park M. S., Choi K. H. [et al.] // J. Tromb. Trombolizis. 2014. Vol. 37 (4). P. 565—570. DOI: https://doi.org/10.1161/STROKEAHA.116.013432.
  18. Memis D., Kozanoglu E., Kelle B., Goncu M. K. Assement of demographic and clinical characteristics on patients with stroke // Neurosciences (Riyadh). 2016. Vol. 21 (4). P. 352—357. DOI: https://doi.org/10.17712/nsj.2016.4.20160212.
  19. Baseline NIH Stroke Scale Score predicting outcome in anterior and posteroir circulation strokes / Sato S., Toyoda K., Vehara T. [et al.] // Neurology. 2008. Vol. 70. P. 2371—2377. DOI: https://doi.org/10.1212/01.wnl.0000304346.14354.0b.
  20. Cerebellar infarction. Clinical and neuromaging analysis in 293 patients. The tohoku cerebellar infarction study group  /  [Tohgi H., Tokahashi S., Chiba K., Hirata Y.]  // Stroke. 1993. Vol. 24. P. 1697—1701. PMID: 8236346.
  21. Yang N., Zheng B., Gao C. The baseline NIHSS Score in female and male patients and short-time outcome: a study in young ischemic stroke // J. Thromb Thrombolysis. 2014. Vol. 37  (4). P. 565—570. DOI: https://doi.org/10.1007/s11239-013-0986-9.

Journal’s Indexing:

UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine

ДУ «ІНПН імені
П.В. ВОЛОШИНА
НАМН УКРАЇНИ»