Інформація призначена тільки для фахівців сфери охорони здоров'я, осіб,
які мають вищу або середню спеціальну медичну освіту.

Підтвердіть, що Ви є фахівцем у сфері охорони здоров'я.

Міжнародний неврологічний журнал Том 18, №6, 2022

Повернутися до номеру

Особливості лакунарного інсульту варолієвого моста: результати госпітального проспективного когортного дослідження

Автори: M.M. Prokopiv (1), S.K. Yevtushenko (2), O.Ye. Fartushna (3)
(1) — Bogomolets National Medical University, Kyiv, Ukraine
(2) — Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
(3) — Ukrainian Military Medical Academy, Kyiv, Ukraine

Рубрики: Неврологія

Розділи: Довідник фахівця

Версія для друку


Резюме

Вступ. Нових даних про проспективні госпітальні когортні дослідження, у яких проаналізовано клінічні та візуалізаційні ознаки лакунарного інфаркту моста, майже не опубліковано. Мета: визначити клінічні та нейровізуалізаційні особливості лакунарного інфаркту варолієвого моста на ранній стадії в госпітальному проспективному когортному дослідженні. Матеріали та методи. Ми проспективно відібрали 120 пацієнтів, госпіталізованих до неврологічного центру із гострим інсультом у вертебробазилярному басейні, підтвердженим магнітно-резонансною томографією. Особи з інсультом моста були включені в дослідження протягом 6 годин від розвитку симптомів інсульту. Усім пацієнтам проведено комплексне неврологічне, клінічне, лабораторне, ультразвукове та візуалізаційне обстеження. Результати. Із 120 пацієнтів віком від 28 до 89 років у 15 (12,5 %) був діагностований лакунарний інфаркт моста. Проведено комплексне клінічне, неврологічне, лабораторне та інструментальне дослідження особливостей лакунарного інфаркту моста. Висновки. Визначено, проаналізовано та описано специфічні клінічні та візуалізаційні ознаки раннього лакунарного інфаркту моста.

Background. Little to no new data are published on the prospective hospital-based cohort studies that report and analyze clinical and imaging features of lacunar pontine infarction. This study aims to determine clinical and imaging features of lacunar pontine infarction at an early stage in a prospective hospital-based cohort study. Materials and methods. We prospectively recruited 120 patients with acute MRI-positive posterior circulation stroke who were admitted to the Neurological Center of the University Hospital. Patients with pontine stroke were enrolled in the study within 6 hours from the onset of stroke symptoms. Comprehensive neurological, clinical, laboratory, ultrasound, and imaging examinations were performed for all participants. Results. Out of 120 adult patients aged 28 to 89 years, 15 (12.5 %) were diagnosed with lacunar pontine infarction and formed a study group. We provided a comprehensive clinical, neurological, laboratory, and instrumental analysis of lacunar pontine infarction. Conclusions. Specific clinical and imaging features of lacunar pontine infarction were determined, analyzed, and described.


Ключові слова

інсульт; вертебробазилярний басейн; міст; лакунарний інфаркт моста; нейровізуалізація

stroke; posterior circulation stroke; pons; lacunar pontine infarction; imaging


Для ознайомлення з повним змістом статті необхідно оформити передплату на журнал.


Список літератури

1. Malla G., Jillella D.V. Pontine Infarction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021 Jan-. Avai-lable from: https://www.ncbi.nlm.nih.gov/books/NBK554418.
2. Prokopiv M.M., Yevtushenko S.K., Fartushna O.Ye. Classification of pontine infarctions. International Neurological Journal. 2022. 18(1). 30-34. doi: 10.22141/2224-0713.18.1.2022.926.
3. Prokopiv M.M., Slabkiy G.O., Fartushna O.Y. Prospective analysis of the epidemiology of cerebrovascular disease and stroke among the adult population of Kyiv City, Ukraine. Wiad. Lek. 2021. 74 (10, p. II). 2599-2604. doi: 10.36740/WLek202110213.
4. Sciacca S., Lynch J., Davagnanam I., Barker R. Midbrain, Pons, and Medulla: Anatomy and Syndromes. Radiographics. 2019 Jul-Aug. 39(4). 1110-1125. doi: 10.1148/rg.2019180126.
5. Gowda S.N., De Jesus O. Brainstem Infarction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2021 Jan-.
6. Prokopiv M., Fartushna O.Ye. Modern classification of posterior circulation stroke: clinical decision making and diagnosis (review). Georgian Med. News. 2021. 320. 96-100.
7. Erro M.E., Gállego J., Herrera M., Bermejo B. Isolated pontine infarcts: etiopathogenic mechanisms. Eur. J. Neurol. 2005. 12(12). 984-8. doi: 10.1111/j.1468-1331.2005.01119.x.
8. Kataoka S., Hori A., Shirakawa T., Hirose G. Paramedian pontine infarction. Neurological/topographical correlation. Stroke. 1997. 28(4). 809-15. doi: 10.1161/01.str.28.4.809.
9. Silverman I.E., Liu G.T., Volpe N.J., Galetta S.L. The crossed paralyses. The original brain-stem syndromes of Millard-Gubler, Foville, Weber, and Raymond-Cestan. Arch. Neurol. 1995 Jun. 52(6). 635-8. doi: 10.1001/archneur.1995.00540300117021.
10. Yevtushenko S.K., Filimonov D.A., Simonyan V.A. et al. The Main and New Risk Factors that Contribute to the Development of Ischemic Strokes in Young Adults. International Neurological Journal. 2013. 6(60). 92-100 (in Russian).
11. Prokopiv M.M., Fartushna O.Y. Classification of posterior circulation stroke: a narrative review of terminology and history. International Neurological Journal. 2021. 5(19). 11-19. doi: 10.22141/2224-0713.17.5.2021.238517.
12. Vinychuk S.M., Fartushna O.Ye. Case analysis of crossed pontine-cerebellar diaschisis in acute stroke patients. International Neurological Journal. 2018. 8(102). 20-24. doi: 10.22141/2224-0713.8.102.2018.153537.
13. Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019. 50(12). e344-e418. doi: 10.1161/STR.0000000000000211.
14. Prokopiv M.M., Yevtushenko S.K., Fartushna O.Ye. Clinical manifestations of acute pontine infarction: a narrative review. International Neurological Journal. 2022. 5.
15. Prokopiv M.M., Fartushna O.Y. Сlinical and imaging features of lacunar and non-lacunar subtypes of ischemic posterior circulation stroke. Wiad. Lek. 2021. 74(12). 3214-3220. doi: 10.36740/WLek202112116.
16. Prokopiv M.M., Vinychuk S.M. Vertebrobasilar strokes. Kyiv: PH “Avitsena”, 2021. 240 p. (in Ukrainian).
17. Prokopiv M.M., Rohoza S.V., Fartushna O.Ye. Lateral me-dullary infarction: a prospective hospital-based cohort study of clinical and imaging features and a case report in a white adult. Wiad. Lek. 2022. 75 (4, pt. 2). 938-943. doi: 10.36740/WLek202204203.
18. Prokopiv M.M., Fartushna O.Ye. Clinical syndromes of the thalamic stroke in the classical vascular territories: a prospective hospital-based cohort study. Wiad. Lek. 2020. 73(3). 489-493. doi: 10.36740/WLek202003115.
19. Vinychuk S.M., Prokopiv M.M., Trepet L.M., Fartushna O.Ye. Thalamic stroke outcomes: a prospective hospital-based cohort study. International Neurological Journal. 2019. 8(110). 23-27. doi: 10.22141/2224-0713.8.110.2019.187888.
20. Vinychuk S.M., Prokopiv M.M., Trepet L.M., Fartushna O.Ye. Clinical vascular syndromes of thalamic strokes in anterior and paramedian vascular territories: a prospective hospital-based cohort study. International Neurological Journal. 2020. 2(16). 7-12. doi: 10.22141/2224-0713.16.2.2020.200957.
21. Vinychuk S.M., Prokopiv M.M., Trepet L.M., Fartushna O.Ye. Clinical syndromes of a thalamic stroke in the lower lateral vascular territory: a prospective hospital-based cohort study. International Neurological Journal. 2020. 3(16). 1-6. doi: 10.22141/2224-0713.16.3.2020.203443.
22. Vinychuk S.M., Prokopiv M.M., Trepet L.M., Fartushna O.Ye. Clinical syndromes of thalamic strokes in posterolateral vascular territory: a prospective hospital-based cohort study. International Neurological Journal. 2020. 4(16). 8-12. doi: 10.22141/2224-0713.16.4.2020.207344.
23. Vinychuk S.M., Prokopiv M.M., Trepet L.M., Fartushna O.Ye. Clinical syndromes of thalamic stroke in the central vascular territory: a prospective hospital-based cohort study. International Neurological Journal. 2020. 5(16). 23-27.doi: 10.22141/2224-0713.16.5.2020.209245.
24. Vinychuk S.M., Fartushna O.Ye. Case analysis of crossed pontine-cerebellar diaschisis in acute stroke patients. International Neurological Journal. 2018. 8(102). 20-24. doi: 10.22141/2224-0713.8.102.2018.153537.
25. Yang L., Qin W., Li Y., Yang S., Gu H., Hu W. Differentiation of Pontine Infarction by Size. Open Med. (Wars.). 2020. 15. 160-166. doi: 10.1515/med-2020-0025.
26. Fartushna O.Ye. TIA with new ischemic lesions: clinical features and stroke risk for patients with different TIA pathological subtypes. Eur. J. Neurol. 2011. 18(2). 108.
27. Vinychuk S.M., Fartushna O.Ye. Terminology and definitions of transient ischemic attacks. A historical journey. International Neurological Journal. 2017. 4(90). 17-20. doi: 10.22141/2224-0713.4.90.2017.107257 (in Ukrainian).
28. Kumral E., Bayülkem G., Evyapan D. Clinical spectrum of pontine infarction. Clinical-MRI correlations. J. Neurol. 2002. 249(12). 1659-70. doi: 10.1007/s00415-002-0879-x.
29. Fartushna O.Ye., Vinychuk S.M. Transient ischemic attacks. Kyiv: PH “Avitsena”, 2014. 216 p. (in Ukrainian).
30. Fartushna O.Y., Vinychuk S.M. Brain injury in patients with acute TIA: clinical features for patients with different TIA subtypes. International Neurological Journal. 2017. 3(89). 34-39. doi: 10.22141/2224-0713.3.89.2017.104238.
31. Vemmos K.N., Spengos K., Tsivgoulis G. et al. Aetiopathogenesis and long-term outcome of isolated pontine infarcts. J. Neurol. 2005. 252. 212-217.
32. Yevtushenko S.K., Filimonov D.A., Simonyan V.A. et al. The Main and New Risk Factors that Contribute to the Development of Ischemic Strokes in Young Adults. International Neurological Journal. 2013. 6(60). 92-100 (in Russian).
33. Tun N.N., Arunagirinathan G., Munshi S.K., Pappachan J.M. Diabetes mellitus and stroke: A clinical update. World J. Diabetes. 2017 Jun 15. 8(6). 235-248. doi: 10.4239/wjd.v8.i6.235.
34. Vinychuk S.M., Fartushna O.Ye. Pathogenesis of transient ischemic attacks: the problem of subtypes. International Neurological Journal. 2017. 6(92). 11-16. doi: 10.22141/2224-0713.6.92.2017.111581 (in Ukrainian).
35. Saposnik G., Noel de Tilly L., Caplan L.R. Pontine Warning Syndrome. Arch. Neurol. 2008. 65(10). 1375-1377. doi: 10.1001/archneur.65.10.1375.
36. Ling L., Zhu L., Zeng J. et al. Pontine infarction with pure motor hemiparesis or hemiplegia: a prospective study. BMC Neurol. 2009. 9. 25. doi: 10.1186/1471-2377-9-25.
37. Prokopiv M.M. Vertebrobasilar infarctions: principles of classification, clinical and neuroimaging analysis and terminological definitions of the diagnosis. UMJ Heart & Vessels. 2019. 2(66). 7-17. doi: 10.30978/HV2019-2-7 (in Ukrainian).
38. Fisher C.M. A lacunar syndrome: the dysarthria-clumsy hand syndrome. Neurology. 1967. 17. 614-617.
39. Fartushna O.Ye., Prokopiv M.M. Actuality of the problem of cerebrovascular diseases, transient ischemic attacks, and improvement of their diagnostics in the health care system in Ukraine. Problems in military health care. Collection of Science of the Ukrainian Military Medical Academy. Kyiv: UMMA, 2007. 19. 335-342 (in Ukrainian).
40. Fartushna O.Ye., Vinychuk S.M. Epidemiology of transient ische-mic attacks in the structure of acute cerebrovascular disorders in Ukraine and in other countries. International Neurological Journal. 2017. 5 (91). 105-111. doi: 10.22141/2224-0713.5.91.2017.110863 (in Ukrainian).
41. Fartushna O.Y. Pathogenetic subtypes of transient ischemic attacks: features of neurological clinic, hemodynamics, and treatment. Kyiv, 2012. 217 p. (in Ukrainian).
42. Prokopiv M.M., Fartushna O.Ye., Mischenko V. Early and late rehabilitation after stroke in review: definition, classification, methods, and effectiveness. Acta Balneol. 2021. 4(166). 303-308. doi: 10.36740/ABAL202104110.
43. Vinychuk S.M., Fartushna O.Ye. Early rehabilitation after acute ischemic cerebrovascular events. International Neurological Journal. 2016. 8(86). 34-39. doi: 10.22141/2224-0713.8.86.2016.90909 (in Ukrainian).
44. Prokopiv M.M. The quality of life of metropolitan residents who have suffered a cerebral stroke. Ukraine. Nation’s Health. 2020. 1(58). 43-46. doi: 10.24144/2077-6594.1.2020.196420 (in Ukrainian).
45. Vinychuk S.M., Fartushna O.Ye. Differential treatment of transient ischemic attack is an effective way to prevent recurrent acute cerebral events. International Neurological Journal. 2014. 6(68). 87-92 (in Ukrainian).
46. Prior P.L., Suskin N. Exercise for stroke prevention. Stroke Vasc. Neurol. 2018 Jun 26. 3(2). 59-68. doi: 10.1136/svn-2018-000155.
47. Vinychuk S.M., Fartushna O.Y. History of the Kyiv Neurological School, about great teachers and wise predecessors (History of the Kyiv Neurological School). Kyiv: PH “Advance-Print”, 2015. 55 p. (in Russian).
48. Vinychuk S.M., Fartushna O.Ye. Diaschisis: brief historical review. International Neurological Journal. 2018. 4(98). 6-10. doi: 10.22141/2224-0713.4.98.2018.139419.
49. Vinychuk S.M., Fartushna O.Ye. Cerebrospinal and commissural diaschisis in acute stroke patients: case study. International Neurological Journal. 2018. 5(99). 20-25. doi: 10.22141/2224-0713.5.99.2018.142959.
50. Oza R., Rundell K., Garcellano M. Recurrent Ischemic Stroke: Strategies for Prevention. Am. Fam. Physician. 2017. 96(7). 436-440.

Повернутися до номеру