Diagnostic criteria for ischemic strokes of various pathogenic subtypes in patients with atherosclerosis and arterial hypertension

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Abstract

Results of postmortem morphological studies of 30 cases with multiple cerebral infarctions caused by atherosclerosis and arte rial hypertension (152 infarctions) were compared with the data of patients preceding clinical examination. The morphological study included determination of the localization, size, and degree of organization of all cerebral infarctions, as well as the assessment of atherosclerotic and hypertonic changes of the
heart and extra and intracerebral arteries. On retrospective ana lysis of the results of patients clinical examination, the following data were assessed: anamnesis, neurologic status, arterial pressure monitoring, CT/MRI, standard methods of clinical instrumental examination of the brain arterial system (ultrasound Doppler or duplex sonography, transcranial duplex sonography, and roentgen contrast angiography), as well as electrocardiography and echocardiography. As a result of this correlative study, pathogenic subtypes of 65 ischemic strokes and diagnostic criteria of these subtypes were determined.

About the authors

T. A. Bolotova

Research Center of Neurology

Email: anufriev@neurology.ru
Russian Federation, Moscow

Pavel L. Anufriev

Research Center of Neurology

Author for correspondence.
Email: anufriev@neurology.ru
ORCID iD: 0000-0002-5327-2275

Cand. Sci. (Med.), senior researcher, Laboratory of neuromorphology

Russian Federation, 125367, Moscow, Volokolamskoye shosse, 80

References

  1. Гулевская Т.С., Моргунов В.А. Патологическая анатомия нарушений мозгового кровообращения при атеросклерозе и артериальной гипертонии. М.: Медицина, 2009.
  2. Гулевская Т.С., Моргунов В.А., Чайковская Т.С. Повторные инфаркты головного мозга при атеросклерозе и артериальной гипертонии. Архив патол. 2003; 4: 21–28.
  3. Гусев Е.И., Скворцова В.И., Стаховская Л.В. Эпидемиология инсульта в России. Журн. неврол. и психиатрии им. С.С. Корсакова (Прилож. «Инсульт») 2003; 8: 4–9.
  4. Инсульт. Принципы диагностики, лечения и профилактики. Под ред. Н.В. Верещагина, М.А. Пирадова, З.А. Суслиной. М.: Интермедика, 2002: 61–66.
  5. Кадыков А.С., Манвелов Л.С., Шахпаронова Н.В. Хронические сосудистые заболевания головного мозга (дисциркуляторная энцефалопатия). М.: ГЭОТАР-Медиа, 2006.
  6. Максимова М.Ю. Малые глубинные (лакунарные) инфаркты головного мозга при артериальной гипертонии и атеросклерозе. Автореф. дис. … докт. мед. наук. М., 2002.
  7. Очерки ангионеврологии. Под ред. З.А. Суслиной. М.: Атмо; сфера, 2005: 82–85.
  8. Суслина З.А., Варакин Ю.Я., Верещагин Н.В. Сосудистые заболевания головного мозга: Эпидемиология. Основы профилактики. М.: МЕДпресс-информ, 2006.
  9. Тодуа Ф.И., Гачечиладзе Д.Г., Ахвледиани М.В. Состояние сонных артерий и основные сосудистые риск-факторы при инфарктах мозга «передней циркуляции». Ангиолог. и соcуд. хирург. 2004; 1: 70–76.
  10. Фонякин А.В., Суслина З.А., Гераскина Л.А. Кардиологическая диагностика при ишемическом инсульте. СПб.: Инкарт, 2005.
  11. Adams H., Bendixen B., Kappelle L. et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial. Stroke 1993; 24: 35–41.
  12. Amarenco P., Bogousslavsky J., Caplan L. et al. Classification of stroke subtypes. Cerebrovasc. Dis. 2009; 27: 93–501.
  13. Ay H., Furie K., Singhal A. et al. An evidence-based causative classification system for acute ischemic stroke. Ann. Neurol. 2005; 58: 688–697.
  14. Baumgartner R., Sidler C., Mosso M., Georgiadis D. Ischemic lacunar stroke in patients with and without potential mechanism other than small-artery disease. Stroke. 2003; 34: 653–659.
  15. Bejot Y., Caillier M., Ben Salem D. et al. Ischemic stroke subtypes and associated risk factors: a French population based study. J. Neurol. Neurosurg. Psychiatry. 2008; 79: 1344–1348.
  16. Bogousslavsky J., Van Melle G., Regli F. The Lausanne Stroke Registry: analysis of 1,000 consecutive patients with first stroke. Stroke 1988; 19: 1083–1092.
  17. Collins R., MacMahon S. Blood pressure, antihypertensive drug treatment and the risk of stroke and coronary heart disease. Br. Med. Bull. 1994; 50: 272–298.
  18. Fisher C. Lacunes: small, deep cerebral infarcts. 1965. Neurology 1998; 50: 841–851.
  19. Goldstein L., Jones M., Matchar D. et al. Improving the reliability of stroke subgroup classification using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Stroke 2001; 32: 1091–1097.
  20. Guercini F., Acciarresi M., Agnelli G., Paciaroni M. Cryptogenic stroke: time to determine aetiology. J. Thromb. Haemost. 2008; 6: 549–554.
  21. Hoshide S., Kario K., Mitsuhashi T. et al. Different patterns of silent cerebral infarct in patients with coronary artery disease or hypertension. Amer. J. Hypertens. 2001; 14: 509–515.
  22. Hulette C., Nochlin D., MacKeel D. et al. Clinical-neuropathologic findings in multi;infarct dementia: a report of six autopsied cases. Neurology 1997; 48: 668–672.
  23. Incidence of stroke in Europe at the beginning of the 21st сentury. The European registers of stroke (EROS) investigators. Stroke 2009; 40: 1557–1563.
  24. Ionita C., Xavier A., Kirmani J. et al. What proportion of stroke is not explained by classic risk factors? Prevent. Cardiol. 2005; 8: 41–46.
  25. Kolominsky’Rabas P., Weber M., Gefeller O. et al. Epidemiology of ischemic stroke subtypes according to TOAST criteria. Stroke 2001; 32: 2735–2740.
  26. Landau W., Nassief A. Time to burn the TOAST. Stroke 2005; 36: 902–904.
  27. Lee B., Hwang S., Jung S. et al. The Hallym Stroke Registry: a web; based stroke data bank with an analysis of 1,654 consecutive patients with acute stroke. Eur. Neurol. 2005; 54: 81–87.
  28. Loeb C., Gandolfo C., Bino G. Intellectual impairment and cerebral lesions in multiple cerebral infarcts: a clinical-computed tomography study. Stroke 1988; 19: 560–565.
  29. MacMahon S., Rodgers A. The epidemiological association between blood pressure and stroke: implications for primary and secondary prevention. Hypertens. Res. 1994; 17: 23–32.
  30. Momjian’Mayor I., Baron J. The pathophysiology of watershed infarction in internal carotid artery disease. Stroke 2005; 36: 567–577.
  31. Sacco R., Ellenberg J., Mohr J. et al. Infarcts of undetermined cause: the NINCDS Stroke Data Bank. Ann. Neurol. 1989; 25: 382–390.
  32. Suarez P., Castillo J., Pardellas H. et al. Comparison of hypertensive and non-hypertensive lacunar infarcts. Rev. Neurol. 1998; 26: 807–811.
  33. Touboul P., Elbaz A., Koller C. et al. GENIC Investigators: Common carotid artery intima-media thickness and ischemic stroke subtypes: the GENIC case-control study. Circulation. 2000; 102: 313–318.

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Copyright (c) 2009 Bolotova T.A., Anufriev P.L.

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