INFLUENCE OF NON-CORRUPTED RISK FACTORS OF DEVELOPMENT ON THE STRENGTH OF COGNITIVE DISORDERS IN PATIENTS MOVING HEMISPHERIC ISHEMIC STROKE
About the author:
Shkolnyk V. M., Gudarian Yu. I.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The high urgency of the problem of ischemic stroke is predetermined by the breadth and continuing increase in morbidity with high rates of disability and the development of a number of complications and high mortality. Patients with the consequences of cerebral stroke constitute the heaviest contingent of neuro-rehabilitation institutions. This situation is due, according to researchers, primarily long-term preservation and insufficient regression of the main symptoms of ischemic stroke – cognitive disorders that have arisen because of acute vascular disorders of the brain. Despite the fundamental nature of research on the effects of ischemic stroke, today there is not enough clarified and sometimes contradictory information concerning factors that have a negative impact on the manifestation of cognitive disorders in the recovery period and their consequences. Most researchers unanimously recognize the negative role of manifestations of cognitive impairments of a single hypertensive illness, dyslipidemia, and increased activity of the blood coagulation system. However, in the available literature there is no information about the combined effect of these factors on cognitive functions.Comprehensive clinical, neuropsychiatric and laboratory studies using the MMSE, NIHSS scales, the Barthel scale and methods for determining the lipid and carbohydrate spectrum of the blood, the state of homeostasis were carried out in the recovery period in 103 patients who had hemispheric ischemic stroke. Analysis of the results of clinical studies and changes in the indices of neuropsychological tests of cognitive disorders in patients with ischemic stroke, in the early recovery period, made it possible not only to determine the nature of cognitive impairments and the characteristics of their manifestation, but also to establish their dependence on the number of such adverse factors as arterial hypertension, increased blood viscosity, dyslipidemia and hyperglycemia. All these risk factors were included in a single cluster that combines the main causes of the formation and further course of cognitive disorders. Conjugacy of disorders in the system of homeostasis, in the lipid spectrum of blood, carbohydrate metabolism and arterial hypertension with the severity of cognitive disorders diagnosed in the early recovery period was noted. In the recovery period, patients who have undergone hemisphere ischemic stroke, along with focal neurological symptoms, form cognitive disorders of varying severity (mild in 46.6% and moderate in 53.4% of cases), which impede social activity and livelihoods. The presence and severity of cognitive disorders in the recovery period, after suffering hemispheric ischemic stroke, is due to the completeness of a cluster of risk factors, which are based on arterial hypertension, dyslipidemia, increased activity of the blood coagulation system and hyperglycemia. In the early recovery period, the simultaneous presence of no more than two pathogenetic risk factors causes’ mild cognitive impairment, with moderate their number increases from 2 to 4. A high correlation between the severity of cognitive disorders in patients undergoing hemisphere ischemic stroke, with disorders in the hemostasis system, lipid and carbohydrate spectra of blood and blood pressure was established.
hemisphere ischemic stroke, risk factors, cognitive disorders.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (149), 2019 year, 201-207 pages, index UDK 616.89-008-08:616.831-005.04