Neuroimaging and Clinical Parallels in Young Patients with Ischemic Stroke Caused by Cerebral Arteries Malformation

Yu.I. Kotsenko, Ye.A. Statinova, Ye.M. Solovyova, S.V. Seleznyova

Abstract


Ischemic stroke is one of the global problems in modern clinical neurology. Over the last decade cerebral ischemic stroke (CII) has impaired younger population. Patients with the focal brain lesions after the CII may have neuropsychological disorders. The study included 64 (50.4 %) patients in the acute stage CII with cerebral arteries (CA) malformation. They were divided into 2 groups depending on the administered drug therapy. The most frequent abnormalities of internal cerebral arteries (ICA) and external carotid arteries (ECA) in the patients with CII were tortuosity of the internal carotid artery (ICarA) (62.5 %), hypoplasia of the vertebral artery (VA) (75 %), hypoplasia of a posterior cerebral artery (PCA) (29.7 %), full posterior trifurcation of one ICA (14.1 %).
The assessment of the severity and extent of disability by NIHSS score and MRS showed that the patients in the group I mostly had medium severity (80 %) and a moderate degree of disability (68.6 %). Among the patients of the group II 18 (6.1 %) persons had the medium severity of the neurological deficiency and a moderate degree of disability. The evaluation of the correlation between the emotional and personality disorders in patients with CII with the anomalies of ICA and ECA did not demonstrate any specific characteristics. The comparison of the severity of cognitive impairment in patients with type CII and anomalies of CA revealed that among the patients in the group I with full posterior trifurcation of right ICarA, hypoplasia of the right PCA, the ICarA S-shaped pathological tortuosity and looping intensive cognitive impairment was observed in 12.6 % persons. In the case of a combination of anomalies of ICA and ECA (full back trifurcation of the left ICarA and hypoplasia of the left PCA) in 8 (27.6 %) patients in the group II moderate intellectual-mental disorder was diagnosed.
It has been shown that the use of citicoline (Ceraxon) combined with Actovegin in young patients with CII caused by CA malformation led to a more rapid regression of neurological deficiency (53.7 %), improved cognitive performance (4.6 ± 2.1 score), and reduce emotional and personality disorders in the earlier period (19.6 %).


Keywords


cerebral ischemic stroke; cerebral arteries malformation; neuroprotection; clinical and neuroimaging parallels

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DOI: https://doi.org/10.22141/2224-0713.5.59.2013.85561

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