Tsiokha I. 1. Prognostic meaning of clinical, clinical-laboratory and neurovisual characteristics of ischemic stroke. Кількісні характеристики дисертації

Based on the results of clinical-neurological and neurovisual examination of 220 patients with ischemic stroke the presence of clinical, clinical-laboratory neurovisual peculiarities of illness has been determined. Thus, the peculiarities of dynamics of clinical displaying in front of primary ischemic stroke have a connection with the variants of structural changes of the cerebrum (based on neurovisual examination data): presence of acute ischemic focal spots with no any other neurovisual phenomena, presence of ischemic focal spots against a background of small focal and/or diffusional changes of the cerebrum, absence of acute ischemic lesion with presence of small focal and/or diffusional changes in the cerebrum. While diagnosing primary ischemic stroke against a background of present small focal and/or diffusional changes of the cerebrum found was more frequent detection of pseudobulbar, extrapyramidal syndrome and vegetative disorders. Ascertained were the prognostic aspects of arterial hypertension (AH) and a level of AP in history in primary ischemic stroke regarding severity and type of dynamics of neurological deficiency and adverse outcome. Thus, the history data about AH showed higher initial levels of systolic and diastolic AP, statistically proved higher rate of neurological deficiency of mild and severe degrees and fatal outcome rate in primary ischemic stroke and combined with initial level of AP more than 180/90 – higher rate of progressive dynamics type of neurological deficiency. In AP less than 140/80 and more 180/90 in spite of presence of AH in history observed was higher risk of adverse course of acute period of ischemic stroke. Determined was the high coefficient of correlation between neurological deficiency and motor disorders weight in primary illness and while acute period, and between neurological deficiency and presence of consciousness disorders and symptom of look paresis reflects their prognostic meaning in primary ischemic stroke. Specified were advisability and effectiveness of early pharmacological correction of motor deficiency in ischemic stroke by using neuromidyn (in peroral and parenteral forms). For the first time researched and determined was presence of lowing level of coefficient of thiol-sulfide correlation of blood and liquor in patients with ischemic stroke reflecting the changes of organism compensatoric possibilities status. Determined were individual peculiarities of index reactions of thiol-sulfide system status on medicines which are used in a case of this pathology, in particular magnesium sulfate, actovegin, neuromidyn, with the aim of individual sorting out medicines. Indices of echoelectroscopy in dynamics of acute period of ischemic stroke, in particular presence and wideness of additional signals, have prognostic relation with neurological deficiency weight and adverse outcome, that helps optimize the treatment tactics in time. Made prognosis of neurological deficiency weight on 14th day of ischemic stroke duration taking into account dynamics of neurological deficiency on 1st, 3rd, 7th days, gender, age and vascular pool using method of searching polymeasured analogs had coefficients of correlation from R=0.87 till R=0.91 between real and prognostic meanings, that increased level of early results proving as for ischemic stroke clinical characteristics prognostic meaning.