Bokatueva V. Atrial Cardioembolic stroke determined by atrial fibrillation (the peculiarities of clinical course and outcome prognosis)

The thesis is devoted to diagnostics efficacy improvement and development of prognosis criteria for course and outcome of cardioembolic stroke determined by different types of atrial fibrillation. The results of structural and functional changes of brain, central and cerebral hemodynamics state and also couagulation hemostasis of 134 cardioembolic stroke patients with favorable outcome in 86 cases and fatal outcome in 48 cases. It was found, that outcome of cardioembolic stroke in men does not depend on type of atrial fibrillation. There was no direct influence of ischemic focus area and social and domestic outcome of ischemic stroke found in female patients with severe disease course. In a group of female patients with mild disease course the certain dependence of outcome from concomitant pathology severity and ischemic focus area. The following indexes were found to be informative for prognosis of survive (mortality) of cardioembolic stroke patients: ejection fraction, area of ischemic focus, soluble fibrin complexes concentration, Quick's value, the rates after the Movement deficit Scale, Glasgow Coma Scale, NIHSS and СНАDS2 - VASc, number and severity of concomitant diseases, presence or absence of chronic obstructive pulmonary disease, chronic renal disease, pulmonary embolism and acute left ventricle failure. The following indexes were found to be informative for prognosis of patients' daily living activity that were estimated using Bartel Index and Rankin Scale: Movement Deficit Scale, NIHSS and СНАDS2 - VASc ratings, soluble fibrin complexes concentration, levels of erythrocytes and platelets, hemoglobin level, Quick's value, area and localization of ischemic focus, heart rate, ejection fraction, concomitant pathology presence especially of diabetes mellitus and obstructive pulmonary disease, the number of concomitant diseases.