Antiplatelet therapy in stroke prevention after non-cardioembolic transient ischemic attack

Fonyakin, A. V.; Гераскина, Л.А.; Maksimova, M. Yu.

doi:10.14412/2074-2711-2021-5-14-19

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Обязательным элементом любых профилактических мероприятий должно быть изменение образа жизни: нормализация веса тела и, что особенно важно, отношения объема талии к объему бедер; увеличение физической активности до уровня 45-60 минут упражнений средней интенсивности в большинство дней недели; прекращение курения (включая пассивное) и злоупотребления алкоголем; изменение диеты; разрешение и снижение количества стрессовых ситуаций [11]. Целью лечения является предупреждение ИИ и последующих ТИА; таким образом, у всех пациентов, перенесших ТИА, необходимо проводить мероприятия по вторичной профилактике инсультов, которые включают обязательную антитромботическую и гиполипидемическую терапию, мероприятия по нормализации АД с использованием антигипертензивной терапии и сердечно-сосудистую хирургию при наличии показаний [25][26][27][28].…”

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Транзиторная Ишемическая Атака Как Предиктор Ишемического Инсульта

Михалюк¹

2022

Рецепт

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Статья посвящена транзиторной ишемической атаке как предиктору ишемического инсульта и его фактору риска, значительно увеличивающему вероятность его развития, а также являющейся биомаркером неблагоприятного течения сердечно-сосудистых заболеваний. Рассмотрены причины, классификация, клинические проявления, вопросы диагностики и основные направления профилактической терапии. Показана значимость подходов ранней диагностики, уточнения причин и механизмов декомпенсации мозгового кровообращения, что определяет обоснованное, целенаправленное лечение транзиторной ишемической атаки как важнейшее направление профилактики инсультов. The article is devoted to transient ischemic attack being a predictor of ischemic stroke and its risk factor that significantly increases its probability. Transient ischemic attack is also a biomarker of an adverse course of cardiovascular diseases. The causes, classification, clinical manifestations, diagnostic issues and the main directions of preventive therapy are examined. The article focuses on the importance of early diagnosis and clarification of the causes and mechanisms of cerebral circulation decompensation, which determines reasonable, targeted treatment of transient ischemic attack as the most important area of stroke prevention.

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Транзиторная Ишемическая Атака Как Предиктор Ишемического Инсульта

Михалюк¹

2022

Рецепт

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Transient global amnesia as a clinical manifestation of unilateral hippocampal infarction. Case report

Martynova,

Zakharov

2023

RJTAO

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Transient global amnesia (TGA) is a rare symptom complex characterized by a brief episode of severe fixation, anterograde and retrograde amnesia. The prevalence of TGA increases with age. Risk factors for this disease include physical overexertion, severe emotional stress, exposure to cold or hot water, hypothermia and pain. The diagnosis of TGA is based on the Kaplan and Hodges–Warlow criteria, according to which TGA is characterized by: complete resolution of mnestic disturbances within 24 hours; absence of other neurological and cognitive impairments; absence of previous head trauma or seizures. In cases where the clinical picture of TGA does not meet the criteria for the disease, a differential diagnosis should be performed, especially with cases of ischemic stroke in the vertebrobasilar region and transient epileptic amnesia. If acute ischemia is confirmed by the brain MRI results, further comprehensive diagnostic investigation must be performed to determine the subtype of acute cerebrovascular accident with further appropriate secondary prevention of cardiovascular complications. If a non-cardioembolic stroke type is identified, antiplatelet therapy has a crucial role. The clinical case of a patient with a left-sided hippocampal infarction clinically manifested by a TGA is presented.

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Experience of the use of dipyridamole for secondary prevention of ischemic stroke

2023

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Acute cerebrovascular accident (ACV) is an important medical and social problem, which is associated with high morbidity, mortality and frequent disability. The current system for providing specialized medical care to patients with stroke has shown its effectiveness, as evidenced by a decrease in hospital mortality and an increase in the number of patients returning to work. However, the incidence of stroke remains high, which is also associated with the COVID-19 pandemic. Every third patient with COVID-19 had neurological symptoms, and a pathomorphological study of the brain of the deceased showed signs of hypoxic encephalopathy in every fifth. Due to the fact that with COVID-19 there is a high probability of developing ischemic stroke (IS), it is necessary to promptly identify and correct the following factors that contribute to the occurrence of stroke with COVID-19: cardiovascular diseases, diabetes mellitus, arterial hypertension, atherosclerosis. Direct exposure to the virus results in systemic inflammatory hyperactivity with a prothrombotic state secondary to protein C and S deficiency. An important problem is both the prevention of the first and recurrent stroke, regardless of the etiology. The basis of secondary prevention is the correction of risk factors, as well as the development of an individual program with antihypertensive, lipid-lowering therapy. The leading line of secondary prevention of IS is antiplatelet therapy, which reduces the risk of developing acute vascular episodes by 25%. For the purpose of secondary prevention of ischemic stroke, acetylsalicylic acid, dipyridamole, clopidogrel are used. In the discussed clinical observation, a patient developed repeated episodes of transient ischemic attack against the background of a stenosing process in the common carotid artery, hypertension, and a previous coronavirus infection. Given that the greatest risk of recurrent stroke is associated with atherosclerosis, which can be complicated by thrombus formation, chimes and acetylsalicylic acid were chosen for secondary prevention. Follow-up observation showed the correctness of the chosen tactics.

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Antiplatelet therapy in stroke prevention after non-cardioembolic transient ischemic attack

Cited by 3 publications

References 34 publications

Транзиторная Ишемическая Атака Как Предиктор Ишемического Инсульта

Транзиторная Ишемическая Атака Как Предиктор Ишемического Инсульта

Transient global amnesia as a clinical manifestation of unilateral hippocampal infarction. Case report

Experience of the use of dipyridamole for secondary prevention of ischemic stroke

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