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№3' 2021

NEUROLOGY

International Medical Journal, Vol. 27., Iss. 3, 2021, P. 48−52.

DOI (https://doi.org/10.37436/2308-5274-2021-3-10)

HEMOSTASIS INDICES IN TRANSIENT ISCHEMIC ATTACKS

Kharkiv National Medical University, Ukraine

Currently, the number of patients admitted to hospitals with a diagnosis of transient ischemic attacks is increasing, due to possible effective management of this group with early treatment. Problems of their diagnosis, prognosis and prevention are relevant because the importance of early examination and treatment of patients, which should be a signal for the primary prevention of vascular diseases of the brain. The study of hemorheological parameters allows to substantiate the approach to the pathogenetic treatment of cardioembolic and atherothrombotic ischemic attacks. For this purpose, endothelial dysfunction was studied in 142 patients. Comparative analysis of indices determines clinical and biochemical correlations to improve the detection and treatment of this pathology. Patients' blood was sampled 12 hours after the onset of neurological symptoms. The clinical diagnosis was set on the basis of clinical and paraclinical data using standard protocols of neurological examination, the results of neuroimaging methods. The main vasodilators and vasoconstrictors of blood plasma were studied. In patients with cardioembolic seizures, the hemocoagulation properties of blood were not prone to thrombosis, despite increased platelet aggregation. Other data of hemocoagulation and hemostasis remained without significant deviations from the norm, that indicated the primary causes of occlusion of vessels of extravasal nature and a mild form of the disease. In patients from the group of atherothrombotic ischemic attacks, these indices were much worse, due to severe course of the disease and slower regression of focal neurological symptoms. Such differences in the pathogenetic mechanisms of occlusion in cardioembolic and atherothrombotic ischemic attacks necessitate a differentiated approach to treatment.

Key words: hemostasis, cardioembolic transient ischemic attack, atherothrombotic transient ischemic attack, hemocoagulation, hemorheology.

REFERENCES

1. Voloshin P. V., Mіshchenko T. S., Lekomtseva Є. V. Analіz poshirenostі ta zakhvoryuvanostі na nervovі khvorobi v Ukraїnі // Mіzhnarodnii nevrologіchnii zhurn. 2006. № 3 (7). S. 9−13.

2. Vinnichuk S. M. Lakunarnye i nelakunarnye infarkty v vertebro−bazilyarnom basseine // Novі strategії v nevrologії: materіali KhІ Mіzhnar. konf., 26−29 kvіtnya 2009 r., m. Sudak; za red. S. M. Kuznetsovoї. K., 2009. S. 6−13.

3. Mishchenko T. S. Epidemiologiya tserebrovaskulyarnykh zabolevanii i organizatsiya pomoshchi bol'nym s mozgovym insul'tom v Ukraine // Ukraїns'kii vіsn. psikhonevrologії. 2017. T. 25. Vip. 1 (90). S. 22−24.

4. Goida N. G. Borot'ba іz sertsevo−sudinnimi zakhvoryuvannyami − problema zagal'noderzhavnogo rіvnya // Mistetstvo lіkuvannya. 2007. № 2 (038). S. 1−3.

5. Mishchenko T. S. Analiz sostoyaniya rasprostranennosti, zabolevaemosti i smertnosti ot tserebrovaskulyarnykh zabolevanii v Ukraine // Sudinnі zakhvoryuvannya golovnogo mozku. 2007. № 3. S. 2−4.

6. Polіshchuk M. Є. Pro zakhodi shchodo poperedzhennya smertnostі ta іnvalіdnostі vіd sertsevo−sudinnikh ta sudinno−mozkovikh zakhvoryuvan' // Neiron revyu. Informatsionno−obrazovatel'nyi byulleten' klinicheskikh neironauk. 2003. № 5. S. 1−3.

7. Imaging analysis of vertebrobasilar artery in posterior circulation transient ischemic attack / C. Liao et al. // Hainan Med. J. 2017. Vol. 28, № 9. P. 1445−1447.

8. Have clinicians adopted the use of brain MRI for patients with TIA and minor stroke? / S. Chaturvedi et al. // Neurology. 2017. Vol. 88, № 3. P. 237−244. doi: https://doi.org/10.1212/wnl.0000000000003503

9. MR perfusion lesions after TIA or minor stroke are associated with new infarction at 7 days / J. Lee et al. // Neurology. 2017. Vol. 88, № 24. P. 2254−2259. doi: https://doi.org/10.1212/wnl.0000000000004039

10. Ranta A., Barber P. A. Transient ischemic attack service provision: a review of available service models // Neurology. 2016. № 86. R. 947−953. doi: https://doi.org/10.1212/wnl.0000000000002339

11. One−year risk of stroke after transient ischemic attack or minor stroke / P. Amarenco et al. // N. Engl. J. Med. 2016. № 374. R. 1533−1542. doi: https://doi.org/10.1016/j.jvs.2016.08.067

12. Computed tomography perfusion imaging may predict cognitive impairment in patients with first−time anterior circulation transient ischemic attack / J. Wang et al. // The International J. of Cardiovascular Imaging. 2016. Vol. 32, № 4. P. 671−677. doi: https://doi.org/10.1007/s10554−015−0828−2

13. Evaluation of computed tomography perfusion imaging in a rat acute cerebral ischemia−reperfusion model / X. Ma et al. // Turkish Neurosurgery. 2016. Vol. 26, № 2. P. 246−252. doi: https://doi.org/10.5137/1019−5149.jtn.12938−14.2

14. Khare S. Risk factors of transient ischemic attack: An overview // J. of Mid−life Health. 2016. Vol. 7, № 1. P. 2−7. doi: https://doi.org/10.4103/0976−7800.179166

15. An update on brain imaging in transient ischemic attack / R. Souillard−Scemama et al. // J. of Neuroradiology. 2015. Vol. 42, № 1. P. 3−11.

16. Sehatzadeh S. Is transient ischemic attack a medical emergency? An evidence−based analysis // Ontario Health Technology Assessment Series. 2015. Vol. 15, № 3. P. 1.

17. Response to endovascular reperfusion is not time−dependent in patients with salvageable tissue / M. G. Lansberg et al. // Neurology. 2015. Vol. 85, № 8. P. 708−714.

18. A novel SPECT−based approach reveals early mechanisms of central and peripheral inflammation after cerebral ischemia / K. Szigeti et al. // J. of the International Society of Cerebral Blood Flow & Metabolism. 2015. Vol. 35, № 12. P. 1921. doi: https://doi.org/10.1038/jcbfm.2015.174

19. Mendigaña Ramos M., Cabada Giadas T. Vascular assessment in stroke codes: Role of computed tomography angiography // Radiologіa. 2015. Vol. 57, № 2. P. 156−166. doi: https://doi.org/10.1016/j.rx.2013.11.006

20. An update on brain imaging in transient ischemic attack / R. Souillard−Scemama et al. // J. of Neuroradiology. 2015. Vol. 42, № 1. P. 3−11.

21. Alves J. E., Xavier J. Reliability of CT perfusion in the evaluation of the ischemic penumbra // Neuroradiology J. 2014. Vol. 27, № 1. P. 91−95.

22. Application of 68Ga−PRGD2 PET/CT for αvβ3−integrin imaging of myocardial infarction and stroke / Y. Sun et al. // Theranostics. 2014. Vol. 4, № 8. P. 778−786. doi: https://doi.org/10.7150/thno.8809

23. Lavallée P., Amarenco P. TIA clinic: A major advance in management of transient ischemic attacks // Frontiers of Neurology and Neuroscience. 2014. Vol. 33, № 33. P. 30−40. doi: https://doi.org/10.1159/000351890

24. Donahue J., Sumer S., Wintermark M. Assessment of collateral flow in patients with cerebrovascular disorders // J. of Neuroradiology. 2014. Vol. 41, № 4. P. 234−242. doi: https://doi.org/10.1016/j.neurad.2013.11.002