DOI: https://doi.org/10.22141/2224-0713.7.109.2019.183007

Clinical analysis of cerebrovascular disease among militaries evacuated to Military Medical Clinical Center of the West Region from the zone of combat in the Eastern Ukraine

O.V. Saiko

Abstract


At present, stroke is an important medical and social problem. There are about 17 million brain strokes annually in the world. Six million patients die due to this disease. According to experts from the World Health Organization, by 2030, 23 million new cases of cerebral stroke are expected every year. Over the past 25 years the prevalence of cerebral stroke increased by 113 %, the incidence — by 70 %, mortality from stroke — by 36 %, disability — by 73 %, number of stroke in people aged 20–64 years — by 25 %, cerebral hemorrhages — by 16 %. The population investigation INTERSTROKE showed that most significant risk factors for ischemic stroke after arterial hypertension (35 %) are lack of regular physical activity, obesity (26 %), ratio of apolipoprotein B and A1 (25 %), tobacco smoking (19 %), unhealthy diet (19 %), cardiology factors (7 %), diabetes mellitus, depression, and psychosocial stress (5 %). The concept of “stress” under the condition of hostilities received a multi-valued interpretation, which required the introduction of a definition of “traumatic”, which, on the one hand, emphasizes the intensity of stress factors, and on the other, the potential possibility of mental injury under their influence. The risk factors of stroke among military personnel who are at the forefront in the armed conflict zone are arterial hypertension, coronary heart disease, lipid metabolism disorders, congenital and acquired heart defects, congenital and acquired pathology of cerebral intra- and extracranial vessels, postponed cerebral stroke, diabetes mellitus and obesity. The mentioned above risk factors, permanent psycho-emotional trauma and chronic combat stress, smoking also serve as triggers of serious cardiovascular events. Depressive-anxiety symptoms occurring in a significant number of military servicemen only intensify manifestations of acquired somatic pathology and accelerate the onset of sudden acute cerebral disasters, the progression of chronic cerebral ischemia.

Keywords


cerebral stroke; chronic cerebral ischemia; laboratory-instrumental research; clinical neurological characteristic; risk factors; military conflict

References


Psihiatriya vojn i katastrof : Uchebnoe posobie pod redakciej VK. Shamreya. [ Psychiatry of wars and catastrophes: Textbook edited by V.K. Shamrey ]. SPb.: SpecLit, 2015. 22 s. (in Russian).

Alyapkin SF. Psihicheskie rasstrojstva i organizaciya psihiatricheskoj pomoshi voennosluzhashim v afganskoj vojne: avtoref. diss. kand. med. nauk. [ Psychiatric disorders and the organization of psychiatric care for servicemen in the Afghan war: author. diss. cand. honey. of science ]. SPb., 2005. S. 3-10. (in Russian).

Yakovlev GM., Novikov VS., Havinson VH. Rezistentnost'. Stress. Regulyaciya : monografiya. [ Resistance Stress. Regulation: monograph ]. Leningrad, «Nauka». Leningradskoe otdelenie, 1990. S. 89–90. (in Russian).

Sajko OV., Luchkevich MP. Osnovni pryncypy organizaciyi medychnoyi reabilitaciyi vijskovosluzhbovciv, yaki braly uchast u myrotvorchyx operaciyax (nadzvychajnyx sytuaciyax, zbrojnyx konfliktax) na bazi likuvalnyx zakladiv ministerstva oborony Ukrayiny. [ Basic principles of the organization of medical rehabilitation of servicemen who participated in peacekeeping operations (emergencies, armed conflicts) on the basis of medical institutions of the Ministry of Defense of Ukraine ]. Praktychna medycyna. 2012. 4 (tom XVIII). S. 82–90. (in Ukrainian).

Shamrej VK. Kliniko-diagnosticheskie aspekty boevyh posttravmaticheskih stressovyh rasstrojstv. [ Clinical and diagnostic aspects of combat post-traumatic stress disorders ]. Voenno-medicinskij zhurnal. 2011. T. 332, № 8. S. 28–35. (in Russian).

Rha J.H., Saver J.L. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007. Vol. 38(3). Р. 967–973.

Amarenco P., Bogousslavsky J., Caplan L.R. et al. Classification of stroke subtypes. Cerebrovasc. Dis. 2009. Vol. 27(5). Р. 493–501.

Mіshchenko TS. Epidemiologiya cerebrovaskulyarnyh zabolevanij i organizaciya pomoshchi bolnym s mozgovym insultom v Ukraine. [ Epidemiology of cerebrovascular diseases and organization of care for patients with cerebral stroke in Ukraine ]. Ukrayinskyj visnyk psyxonevrologiyi. 2017. T. 25, № 1(90). S. 22–24. (in Ukrainian).

Sapon NA., Nikiforova AN. Vliyanie faktorov dostupnosti medicinskoj pomoshchi na uroven smertnosti ot insulta. [ Influence of factors of accessibility of medical care on the mortality rate from stroke ]. Ukrayinskyj nejroxirurgichnyj zhurnal. 2016. № 2. S.78–81. (in Ukrainian).

Lee J.G., Lee K.B., Jang I.M. et al. Low glomerular filtration rate increases hemorrhagic transformation in acute ischemic stroke. Cerebrovasc. Dis. 2013. Vol. 35(1). Р. 53–59.

Mukheijee D., Patil C.G. Epidemiology and the global burden of stroke. World Neurosurg. 2011. Vol. 76, (Suppl.6). Р. 85–90.

Toyoda К. Epidemiology and registry studies of stroke in Japan. Stroke. 2013. Vol. 15 (1). Р. 21–26.

Stres i xvoroby systemy krovoobigu : posibnyk [ Stress and Diseases of the Circulatory System: A Guid ]. Za red.: V. M. Kovalenko, V. M. Kornacz`kogo. Kyyiv: Kolomishyn V. Yu., 2015. 352 s. (in Ukrainian).

Zinchenko OM., Mishhenko TS. Stan nevrologichnoyi sluzhby v Ukrayini v 2015 roci : statystychno-analitychnyj dovidnyk. [The state of the neurological service in Ukraine in 2015: a statistical and analytical guide ]. Xarkiv. 2016. 23 s. (in Ukrainian).

Coull A.J. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organization of services. BMJ. 2004. Vol. 328. 326 р.

WRITING GROUP MEMBERS, Lloyd-Jones D., Adams RJ, Brown TM, Carnethon M., Dai S, et al. Heart disease and stroke statistic: 2010 update: a report from the American Heart Association. Circulation. 2010. Vol. 121. Р. 46–215.

Golovach IYu. Dyscyrkulyatorna encefalopatiya: deyaki patogenetychni, klinichni ta likuvalni aspekty. [ Discirculatory encephalopathy: some pathogenetic, clinical and therapeutic aspects ]. Liky Ukrayiny. 2011. №4 (150). S.60–67. (in Ukrainian).




Copyright (c) 2019 INTERNATIONAL NEUROLOGICAL JOURNAL

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

 

© Publishing House Zaslavsky, 1997-2020

 

   Seo анализ сайта