Cerebrovascular diseases (CVD) have remained an urgent medical and social problem of modern society over the past decades. One of the main pathogenetic subtype of ischemic stroke is cardioembolic stroke (CES), which accounts for 22-39% of all stroke subtypes. CES is characterized by the rapid development of neurological symptoms (80% of cases) with its maximum severity in the first 5 minutes (47-74%) and large and medium-sized ischemic infarcts, which in 85% of cases are located in the carotid artery system, more often in the left middle cerebral artery (MCA). The aim of the study: In this study, pathomorphological and clinical features of cardioembolic stroke, such as neurological signs, cerebral and myocardial infarcts in each sectional case, macroscopic and microscopic examinations were conducted and analyzed. Materials and methods: This study is based on the analysis of the results of a comprehensive clinical and pathomorphological examination. The patients were selected for 1 year. Clinical observations were carried out at the first clinic of the Tashkent Medical Academy in the Department of Intensive Neurology. The selection criteria were: 1) patients with ischemic stroke (IS) in combination with acute myocardial infarction and atrial fibrillation (main group); 2) persons with ischemic stroke (IS) without cardiac etiology (control group). Exclusion criteria: oncological and hematological diseases, severe renal and hepatic insufficiency. The analysis of 138 sectional cases with ischemic stroke and myocardial infarctions with atherostenosis of cerebral and coronary arteries were carried out. Autopsies of all deceased patients were performed in the laboratory of the Republican Center of Pathological Anatomy. Macroscopic examination of the brain in all 138 cases determined the type, magnitude, localization, degree of organization of each cerebral infarction and the number of cerebral infarctions in each sectional case. In each case, microscopic examination of the brain and cerebral arteries with atherosclerotic changes were also performed. For microscopic examination, preparations were cut from the area of cerebral infarction, as well as from the borderline zone with infarction. Areas of the brain were poured into paraffin wax, preparations with 5-7 microns thick were prepared into the blocks, which were stained with hematoxylin and eosin, cresyl violet according to the modified Nissl method, according to the methods of Wangizon, Weigert, as well as laxol blue durable. Results: Patients with IS and cardiac pathology – 120 people (group I) – 65 men and 55 women aged 48 to 77 years (62.6±5.8 years). Patients with IS without cardiac pathology – 160 people (group II). Of these, 83 men and 77 women aged 56 to 81 years (68.4±5.4 years). Among the deceased were 93 men and 45 women aged 45 to 93 years (average age 69 ± 11 years). The average age of men was 60 years, of women - 69 years. In 113 cases (82%), an autopsy revealed a combination of atherosclerosis with arterial hypertension, in 9 (6.5%) - atherosclerosis with diabetes mellitus. The cause of death in 64 patients (47%) was pronounced edema of the brain with dislocation and insertion of brain stem and parts of the cerebellum into the large occipital foramen due to infarction of the brain. All cases are divided into 3 groups: Group 1 includes cases with infarcts localized in the carotid system (68 cases), group 2 - cases with infarcts localized in the vertebrobasilar system (36 cases), group 3 - cases with infarcts localized in the arteries of both systems (34 cases). Conclusion: Brain infarctions in AS are characterized by great diversity regarding their localization; degree of organization, quantity; type; as well as: the main factors of their occurrence. The most numerous were medium infarcts and small deep infarcts, extensive, large infarcts and small superficial infarcts were less common. In our study, multiple atherosclerotic plaques, narrowing the lumen of the arteries by 30-80%, were found in 46% of cases. Moreover, in 28% of cases, plaques were located in different parts of the ICA - in the cerebral arteries of the MCA.
| Mualliflar | Эгамназарова Зулайхо Равшанбек кизи, Мусаева Юлдуз Алписовна |
|---|---|
| Jurnal | Журнал неврологии и нейрохирургических исследований / Journal of Neurology and Neurosurgical Research |
| Nashr sanasi | 2024-05-27 |
| Jild | 5 |
| Son | 2 |
| Til | Ingliz |
кардиоэмболический инсульт, ишемические инфаркты, каротидная система, вертебробазилярная система, инфаркт миокарда, мерцательная аритмия, аутопсия, cardioembolic stroke, ischemic infarcts, carotid system, vertebral basilary system, myocardial infarction, atrial fibrillation, autopsy, kardioembolik insult, ishemik infarkt, uyqu arteriyasi tizimi, vertebrobazilar tizim, miokard infarkti, bo’lmachalar fibrilatsiyasi, autopsiya
Juvenile myoclonic epilepsy (JME) is a common idiopathic epilepsy, accounting for 10% of all epilepsies. It is characterized as a syndrome of generalized genetic epilepsy with a peak development at the age of 12-18…
despite the existence of several projects in the world for the study of neoplasms of the central nervous system, the data of primary spinal cord tumors(PSCT) have been little studied, there are no single…
Childhood Cerebral Palsy (CP) occurs due to brain damage during the perinatal period. CP is characterized by impaired motor functions, increased muscle tone, and other symptoms. Selective dorsal rhizotomy is the most…
The results of clinical, neurological and electroneuromyographic (ENMG) examination of 26 patients with intramedullary tumor lesions of the cervical spinal cord, who were diagnosed and treated at the RSNPMTsN of the…
This article analyzed literary information about the features of the development of neurological disorders in cystic fibrosis (CF), about modern views on the early diagnosis of this pathology. A generalized analysis of…
We compared the clinical and neurological picture of hereditary spastic paraplegia (HSP) and cerebral palsy of spastic diplegia. The results of a neurological examination indicate that in patients in the comparison…
The purpose of the study: to approximate the dynamics of clinical and hemodynamic indicators in the acute period of ischemic stroke disease, as well as to improve the standard treatment measure. Research material…
Goal. To study the relationship and prevalence of migraine in patients with hypertension, to determine the nature of headache, the severity of the course, the distinctive sides, possible complications according to the…
A modern approach to the complex diagnosis of both transcranial and nasal liquorrhea is considered. The terminology and the most common and used variants of classification of liquorrhea are given. The epidemiology and…
The article is devoted to new methods of treatment of diabetic neuropathy in children. The results are based on reduction of complications of the disease and return of children to a healthier life. Diagnosis and…