DOI: https://doi.org/10.22141/2224-0713.8.94.2017.120699

Selection of the strategy for the treatment of isolated cerebellar infarctions of different vascular areas

G.S. Trepet

Abstract


Background. The aim of the study was to evaluate the dynamics of restoration of lost cerebellar functions on the background of treatment during different observation periods in patients with acute isolated cerebellar infarction and in case of crossed cerebellar-hemispheric diaschisis. Materials and methods. The study included 60 patients who were divided into 2 groups: group I — 44 persons whose neurological disorders manifested only by cerebellar motor syndrome; group II — 16 individuals who, after suffering an isolated heart attack, showed both symptoms of cerebellar motor syndrome and clinical symptoms of crossed cerebellar-hemispheric diaschisis. Results. The obtained results suggest that unilateral cerebellar infarction can manifest not only by typical symptoms of cerebellar motor syndrome, but also by motor and sensory deficits due to ischemia in the cortical parts of the frontal and parietal lobes of the contralateral hemisphere of the brain, through which the cerebellum is connected with a system of conduction pathways. The dynamic of cerebellar motor syndrome restoration on the background of сiticoline treatment in different periods of stroke was revealed. Conclusions. The obtained results indicate that unilateral cerebellar infarction may be manifested by motor and sensory deficiency due to ischemia in the cortical parts of the frontal and parietal lobes of contralateral cerebral hemisphere. The cerebellum is a system connected with conducting pathways through these parts of the brain. The dynamics of restoration of cerebellar motor syndrome on the background of citicoline treatment in different stages of stroke was revealed.


Keywords


cerebellar infarction; neurological deficit; crossed cerebellar-hemispheric diaschisis; neuroimaging; observation period; citicoline

References


Виничук С.М. Диашиз и его роль в развитии рефлекторно-двигательных расстройств при мозговом инсульте // Укр. мед. часопис. — 2013. — 5(73). — 1-5.

Віничук С.М., Фартушна О.Є. Прогнозування ризику розвитку повторного інсульту після перенесеної транзиторної ішемічної атаки у пацієнтів з осередком інфаркту за даними МРТ та без нього // Укр. мед. часопис. — 2009. — 5(73). — 53-57.

Лебедев В.В., Крилов В.В., Тиссен Т.П., Халчевский В.М. Компьютерная томография в неотложной нейрохирургии. — М., 2005. — 360 с.

Переверзев И.В. Метаболические нарушения в головном мозге у больных, перенесших инсульт мозжечка // Врач. — 2010. — 5. — 77-79.

Шмырев В.И., Рудас М.Н., Переверзев И.В. Метаболические нарушения при инсультах мозжечка (сопоставление с данными позитронно-эмиссионной томографии) // Кремлевская медицина. Клинический вестник. — 2009. — 2. — 152-155.

Amarenco P. The spectrum of cerebellar infarctions // Neuro­logy. — 1991. — 41. — 973-979.

Amarenco P., Cuse C.S., Rosengart A. et al. Very small (border zone) cerebellar infarcts: distribution, mechanisms, causes and clinical features // Brain. — 1993. — 116. — 161-186.

Baron J.C., Bousser M.G., Comar D. et al. Crossed cerebellar diaschisis in human supratentorial brain infarction // Trans. Am. Neurol. Assoc. — 1981. — 105. — 459-461.

Botez M.I., Léveilé J., Lambert R. et al. Single photon emission computed tomography (SPEСT) in cerebellar disease: cerebello-cerebral diaschisis // Eur. Neurol. — 1991. — 31(6). — 405-412.

Broich K., Hartmann A., Biersack H.J., Horn R. Crossed cerebello-cerebral diaschisis in a patient with cerebellar infarction // Neurosc. Lett. — 1987. — 83(1–2). — 7-12.

Canaple S., Bogousslavsky J. Multiple large and small cerebellar infarcts // J. Neurol. Neurosurg. Psychiatry. — 1999. — 66. — 739-745.

Cristomoto R.A., Gorcia M.M., Tong D.C. Detection of diffusion — weighted attack and minor stroke patients using acute magnetic resonanse imaging // Ann. Neurol. — 2003. — 57(6). — 848-859.

Fulham M.J., Brooks R.A., Hallet M. et al. Cerebellar diaschisis revisited: pontine-hypometabolism and dentate sparing // Neurology. — 1992. — 42. — 2267-2273.

Grips E., Sedlaczek O., Bazner H. et al. Supratentorial age-related white matter changes predict outcome in cerebellar stroke // Stroke. — 2005. — 36. — 1988-1993.

Heiss W.D., Pawlik G., Wagner R. et al. Functional hypometabolism of noninfarcted brain regions in ischemic stroke // J. Cereb. Blood Flow Metab. — 1983. — 3 (Suppl. 1). — 582-583.

Infeld B., Davis S.M., Lichtenstein M. et al. Crossed cerebellar diaschisis and brain recovery after stroke // Stroke. — 1985. — 26. — 90-95.

Juttler E. Expansive cerebellar stroke-how to deteсt and treat? // 14th Congress of the European Federation of Neurological Societies, Geneva, Switzerland, September 28–30, Teaching Course 3. — 2010. — 1-22.

Kim H.-A., Lee H., Sohn S.I. et al. Bilateral infarcts in the territory of the superior cerebellar artery: clinical presentation, presumed cause and outcome // J. Neurol. Sci. — 2006. — 246. — 103-109.

Korbel E., Razdera L., Searls E. Clinical features of vertebrobasilar infarcts in the New England medical center posterior circulation registry / 19th World Congress of Neurology, Poster Abstracts // J. Neurol. Sci. — 2009. — 285(SI). — 174.

Kumral E., Kisabay A., Atac C. et al. Spectrum of the posterior inferior cerebellar artery territory infarcts. Clinical-diffusion-weighted imaging correlates // Cerebrovasc. Dis. — 2005. — 20. — 370-380.

Lyden P., Trott T., Tilley B. et al. Improved reability of the NIN Stroke Scale using video training. NINDS tPA Stroke Study Group // Stroke. — 1994. — 25. — 2220-2226.

Mohoney F., Barthel D. Functional evolution: the Barthel Index // MD State Med. J. — 1965. — 14. — 61-65.

Moon I.S., Kim J.S., Choi K.D. et al. Isolated nodular infarction // Stroke. — 2009. — 40. — 487-491.

Rankin J. Cerebral vascular accidents in patients over the age of 60: prognosis // Scott. Med. J. — 1957. — 2. — 200-215.

Reinhard M., Waldkircher Z., Timmer J. et al. Cerebellar autoregulation dynamics in humans // Journal of Cerebral Blood Flow. Metabolism. — 2008. — 28. — 1605-1612.

Rousseaux M., Steinling M. et al. Crossed hemispheric diaschisis in unilateral cerebellar lesions // Stroke. — 1992. — 23. — 511-514.

Schmahmann J.D., Caplan D. Cognition, emotion and cerebellum // Brain. — 2006. — 129. — 288-292.

Secades J.J., Alvarez-Sabín J., Castillo J. at al. Citicoline for Acute Ischemic Stroke: A Systematic Review and Formal Meta-analysis of Randomized, Double-Blind, and Placebo-Controlled Trials // Stroke. — 2016. — 25(8). — 1984-96. — doi: 10.1016/j.jstrokecerebrovasdis.2016.04.010. Epub 2016 May 24.

Tatu L., Maulin T., Bogousslavsky J. et al. Arterial territories of human brain: brainstem and cerebellum // Neurology. — 1996. — 47(5). — 1125-1135.

Trouillas P., Takayanagi T., Hallet M. et al. International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome // J. Neurol. Science. — 1997. — 145. — 205-211.

von Monakow C. Neuegesichtspubcte in der frage nach der lokalisation im grosshirm. — Wiesbaden: J.F. Bergman, 1911. — 20 р.

Yamauchi H., Fukuyama H., Kimura J. Hemodynamic and metabolic changes in crossed cerebellar hypoperfusion. — 1992. — 23. — 855-860.

Ye B.S., Kim J.D., Nam H.S. et al. Clinical manifestations of cerebellar infarcts according to specific lobular involvement // Cerebellum. — 2010. — 9. — 571-579.

Ішемічний інсульт (екстренна, первинна, вторинна (спеціалізована) медична допомога, медична реабілітація). Уніфікований клінічний протокол медичної допомоги: Наказ МОЗ України № 602 від 03.08.2012 р. — Київ. — С. 120

(http://www.moz.gov.ua).

Dávalos A., Castillo J., Álvarez-Sabín J. et al. Oral Citicoline in Acute Ischemic Stroke: An Individual Patient Data of pooling analysis of Clinical Trials // Stroke. — 2002. — 33. — 2850-2857. — doi: 10.1161/01.STR.0000038691.03334.71.




Copyright (c) 2018 INTERNATIONAL NEUROLOGICAL JOURNAL

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2018

 

   Seo анализ сайта