ABSTRACT
The present work was aimed at studying the state of the inferior vena cava system according to the findings of duplex scanning in dynamics of acute cerebral circulation impairments (ACCI). Amongst 100 patients with ACCI, lower limb vein deep thrombosis (LLVDT) was revealed in 57% of cases. The incidence of LLVDT in patients with intracerebral haemorrhage was higher than in those with ischaemic stroke, however there were no statistically significant differences between the type of ACCI (p=0.06) and subtypes of ischaemic stroke (atherothrombotic, ceardioembolic) (p = 0.68). The main risk factors for LLVDT are the presence of pronounced motion deficit in the extremities, induced by the underlying disease (p=0.02) and immobilization. In the overwhelming majority of patients (81%) thrombosis localized isolatedly in the crural veins. Ascending thrombosis and the development of a floating thrombus were represented mainly on the side of motility deficit in the extremities. We have confirmed a strong association between positive dynamics in the neurological status of patients and frequency of recanalization of thrombi (p=0.043). Ultrasonographic examination of lower limb veins in dynamics of ACCI is an important component of preventive and therapeutic process.
Subject(s)
Lower Extremity/blood supply , Paresis , Stroke , Ultrasonography, Doppler, Duplex/methods , Vena Cava, Inferior , Venous Thrombosis , Aged , Female , Humans , Immobilization/adverse effects , Lower Extremity/physiopathology , Male , Middle Aged , Monitoring, Physiologic/methods , Paresis/etiology , Paresis/physiopathology , Reproducibility of Results , Severity of Illness Index , Stroke/complications , Stroke/physiopathology , Vena Cava, Inferior/diagnostic imaging , Vena Cava, Inferior/physiopathology , Venous Thrombosis/diagnosis , Venous Thrombosis/etiology , Venous Thrombosis/physiopathologyABSTRACT
Venous thromboembolism (VTE), a deep and superficial thrombosis and pulmonary embolism, is a very important problem of severe stroke. Pulmonary embolism (PE) significantly influences the course and outcome of severe stroke. The cause of this effect lies not only in severe patient's condition, high risk of VTE and difficulties in diagnosis of VTE but in still common limits in prophylaxis and treatment of PE in severe stroke, first of all, in brain hemorrhages and large brain infarctions with secondary hemorrhage. The paper presents the main principles and methods of prophylaxis of VTE in severe stroke. The suggested approach allows to decrease the frequency of VTE and fatal outcomes in severe stroke in the modern neuro-intensive care units.
