Mykytei O. Prognostic significance of risk factors and clinical and instrumental indices in patients with repeated ischemic stroke

The thesis presents a theoretical synthesis and new scientifically confirmed results that provide a solution to a specific scientific task of Neurology - improving diagnostic approach and efficiency prognosis of patients with recurrent ischemic stroke based on an analysis of risk factors and dynamics of disability based clinical and instrumental parameters. Based on complex multifactorial clinical and instrumental examination which included a study of risk factors, clinical features, daily monitoring of blood pressure, the condition of the central and cerebral hemodynamics, new data on features of development and dynamics of disability in patients with recurrent ischemic stroke, certain features of clinical manifestations and correlation relationships with these risk factors and the frequency of vascular comorbidity in patients with recurrent ischemic stroke. Established according to the daily monitoring of blood pressure variations unfavorable course of recurrent ischemic stroke, which include integral indicators systolic, diastolic and pulsed arterial pressure (area code BP index time BP) and BP variability, blood pressure daily index. The violations daily profile of BP (night-piker, non-dipper), which helps to make adverse and daily blood pressure as prognostic sign of progression of recurrent ischemic stroke. For the first time in patients with recurrent ischemic stroke studied quantitative and qualitative performance characteristics of cerebral and central hemodynamics to improve diagnosis FDI and demonstrated the importance of taking into account the frequency of cardiovascular comorbidity. The new results obtained in the study allowed determining prognostic significant directions of improvement of clinical management and treatment tactics of patients with the development of recurrent ischemic stroke.