RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS

Purpose of the study. Identification of the main causes of ischemic stroke in patients with aortic dissection, features of the clinical picture, the choice of optimal tactics for the management of such patients.Patients and methods. During 2017, 11 patients with aortic dissection were hospitalized f...

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Main Authors: I. P. Dudanov, N. O. Vasilchenko, M. A. Askerov, O. V. Rubleva, D. V. Merkulov, V. V. Akhmetov, O. M. Shulga, M. O. Telukhina
Format: Article
Language:Russian
Published: QUASAR, LLC 2019-04-01
Series:Исследования и практика в медицине
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Online Access:https://www.rpmj.ru/rpmj/article/view/362
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author I. P. Dudanov
N. O. Vasilchenko
M. A. Askerov
O. V. Rubleva
D. V. Merkulov
V. V. Akhmetov
O. M. Shulga
M. O. Telukhina
author_facet I. P. Dudanov
N. O. Vasilchenko
M. A. Askerov
O. V. Rubleva
D. V. Merkulov
V. V. Akhmetov
O. M. Shulga
M. O. Telukhina
author_sort I. P. Dudanov
collection DOAJ
description Purpose of the study. Identification of the main causes of ischemic stroke in patients with aortic dissection, features of the clinical picture, the choice of optimal tactics for the management of such patients.Patients and methods. During 2017, 11 patients with aortic dissection were hospitalized for emergency indications and underwent complex, surgical interventions. In 4 patients, the reason for hospitalization was ischemic stroke, in 7 patients, the onset of the disease was manifested by chest pain. Subsequently, in all cases, ischemic stroke developed within 48 hours from the onset of pain symptoms. Fatal outcomes occurred in 5 (45.45%).Results. All patients were operated on for aortic dissection. Various types of surgery were performed. The best results were achieved with a hybrid operation — prosthetics of the aortic arch with endoprosthetic replacement of the de­scending aorta. The main reason for the development of ischemic stroke with aortic dissection and surgery for its elimi­nation is the development of brain malfunction. The cause of death was the dissemination of the dissection into the vis­ceral arteries with the development of multiple organ failure or aortic rupture of the aorta with hemo tamponade.Conclusion. As a rule, several pools of blood supply to the brain, episodes of psychomotor excitement are involved in the dissection of the aorta and branches of the aortic arch, cognitive impairments are progressing, since cortical branch­es of the brain are usually involved. With the timely assignment of neuroprotective therapy, revascularization, early complex rehabilitation, there is a significant positive dynamics of neurological status, restoration of cognitive functions.
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spelling doaj-art-9030fc5d418943388eadccd76e36d39c2025-02-03T07:12:14ZrusQUASAR, LLCИсследования и практика в медицине2410-18932019-04-0161919810.17709/2409-2231-2019-6-1-9250RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELSI. P. Dudanov0N. O. Vasilchenko1M. A. Askerov2O. V. Rubleva3D. V. Merkulov4V. V. Akhmetov5O. M. Shulga6M. O. Telukhina7Mariinsky City Hospital Petrozavodsk State UniversityMariinsky City HospitalMariinsky City HospitalMariinsky City HospitalMariinsky City HospitalPetrozavodsk State UniversityMariinsky City HospitalMariinsky City HospitalPurpose of the study. Identification of the main causes of ischemic stroke in patients with aortic dissection, features of the clinical picture, the choice of optimal tactics for the management of such patients.Patients and methods. During 2017, 11 patients with aortic dissection were hospitalized for emergency indications and underwent complex, surgical interventions. In 4 patients, the reason for hospitalization was ischemic stroke, in 7 patients, the onset of the disease was manifested by chest pain. Subsequently, in all cases, ischemic stroke developed within 48 hours from the onset of pain symptoms. Fatal outcomes occurred in 5 (45.45%).Results. All patients were operated on for aortic dissection. Various types of surgery were performed. The best results were achieved with a hybrid operation — prosthetics of the aortic arch with endoprosthetic replacement of the de­scending aorta. The main reason for the development of ischemic stroke with aortic dissection and surgery for its elimi­nation is the development of brain malfunction. The cause of death was the dissemination of the dissection into the vis­ceral arteries with the development of multiple organ failure or aortic rupture of the aorta with hemo tamponade.Conclusion. As a rule, several pools of blood supply to the brain, episodes of psychomotor excitement are involved in the dissection of the aorta and branches of the aortic arch, cognitive impairments are progressing, since cortical branch­es of the brain are usually involved. With the timely assignment of neuroprotective therapy, revascularization, early complex rehabilitation, there is a significant positive dynamics of neurological status, restoration of cognitive functions.https://www.rpmj.ru/rpmj/article/view/362aortic dissectionacute ischemic strokestaged revascularizationcomprehensive rehabilitation
spellingShingle I. P. Dudanov
N. O. Vasilchenko
M. A. Askerov
O. V. Rubleva
D. V. Merkulov
V. V. Akhmetov
O. M. Shulga
M. O. Telukhina
RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS
Исследования и практика в медицине
aortic dissection
acute ischemic stroke
staged revascularization
comprehensive rehabilitation
title RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS
title_full RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS
title_fullStr RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS
title_full_unstemmed RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS
title_short RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS
title_sort rare causes of ischemic stroke features of acute stroke in patients with dissection of the great vessels
topic aortic dissection
acute ischemic stroke
staged revascularization
comprehensive rehabilitation
url https://www.rpmj.ru/rpmj/article/view/362
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