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Vojnosanitetski pregled
2019, vol. 76, br. 3, str. 307-312
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP170118092V

Creative Commons License 4.0
Hipoplazija ipsilateralne unutrašnje jugularne vene je udružena sa lošijim ishodom akutnog moždanog udara u prednjoj cirkulaciji
aSpecial Hospital for Cerebrovascular Diseases 'Sveti Sava', Belgrade
bMilitary Medical Academy, Clinic of Neurology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade

e-adresa: mirjanavuk@yahoo.com

Sažetak

Uvod/Cilj. Poremećaj odvođenja venske krvi iz mozga dovodi do cerebralne venske kongestije, povećanja intrakranijalnog pritiska i pada cerebralnog perfuzionog pritiska. Tačna uloga cerebralnog venskog sistema u akutnom moždanom udaru još uvek nije dovoljo poznata. Glavni izvodni put krvi iz mozga, gornjeg dela lica i vrata su unutrašnje jugularne vene (VJI). Urođene anomalije VJI remete odvođenje venske krvi iz mozga, što dovodi do kongestije u venskom sistemu mozga. Cilj ove studije je bio da utvrdi povezanost između hipolazije istostrane VJI i kliničkog ishoda akutnog ishemijskog moždanog udara (AIMU) u prednjoj cirkulaciji. Metode. Ova prospektivna studija slučaja obuhvatila je bolesnike sa AIMU u prednjoj cirkulaciji i jednostranom hipoplazijom istostrane VJI prema ultrasonografskim kriterijumima. U studiju su slučajnim izborom bila uključena 74 bolesnika sa AIMU u prednjoj cirkulaciji koji su hospitalizovani u Specijalnoj bolnici za cerebrovaskularne bolesti 'Sveti Sava' u Beogradu, od septembra 2015 do kraja januara 2016. Kod svih bolesnika je ultrazvučnim pregledom određivan dijametar VJI. Težina neurološkog deficita na prijemu procenjivana je pomoću National Institutes of Health Stroke Scale (NIHSS). Klinički ishod bolesti procenjivan je preko modifikovanog Rankin Skora (mRS) od 0 do 6, na dan otpusta. Dobar i loš ishod su definisani preko mRS skora. Skor 0-2 je smatran dobrim, dok je 3-6 smatran lošim. Rezultati. Istostrana hipoplastična VJI dijagnostikovana je kod 13 (17,6%) bolesnika sa AIMU u prednjoj cirkulaciji. U ovoj grupi devet (69,2%) bolesnika imalo je mRS ≥ 3. Od preostala četiri bolesnika sa mRS ≤ 2, tri su imala obostranu hipoplaziju VJI, dok je četvrti bolesnik imao užu VJI koja nije ispunjavala ultrazvučne kriterijume za hipoplaziju VJI. Zaključak. Bolesnici sa akutnim infarktom mozga u prednjoj cirkulaciji sa jednostranom hipoplazijom istostrane VJI (na strani infarkta mozga) imaju lošiji ishod u odnosu na bolesnike sa obostranom hipoplazijom VJI.

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