ABSTRACT
AIM: To study a possible pathogenetic role of the blood clot contraction and its disturbances in the acute stage of ischemic stroke (IS). MATERIAL AND METHODS: Using a new instrumental technique to study the dynamics of clot contraction in vitro, the authors have determined quantitative parameters of clot contraction (the extent and rate of contraction, duration of the lag-period) in the blood of 85 patients with acute IS. RESULTS AND CONCLUSION: The contractile activity of blood clots was substantially reduced compared to the blood of healthy subjects. Correlations between hemostatic and contractile parameters suggest that the reduced clot contraction in stroke is due to the lower platelet count and impaired platelet functionality, higher levels of fibrinogen and antithrombin III as well as higher hematocrit and hemoglobin contents, leukocytosis, and changes in the biochemical blood composition. The results show that the reduced ability of clots may be a novel pathogenic mechanism that aggravates the course and outcomes of IS.
Subject(s)
Brain Ischemia/physiopathology , Stroke/physiopathology , Thrombosis , Blood Platelets/physiology , Fibrinogen , Hemostasis , HumansABSTRACT
A rat model of big brain ischemia with the middle brain artery occlusion was used for the study of amantadine sulfate (PK-Merz) effect on the expression of Hsp70 measured with immunohistochemical method and Western blot 12 h and 4 days after surgery. The neuroprotective effect of PK-Merz associated with the enhancement of Hsp70 expression in ischemic stroke in rats. To confirm the multivector neuroprotective action of the drug, a comparative study of clinical effectiveness of PK-Merz and magnesium sulfate was carried out in 40 patients (20 patients in each group) in the most acute period of atherothrombotic and cardioembolic strokes. Patients treated with PK-Merz exhibited the more significant restoration of consciousness and better dynamics (regress) of neurological deficit with the most intensive restoration of neurological deficit in the first day that allows to recommend the use of amantadine sulfate in the first hours of ischemic stroke and for the prevention of reperfusion damage in recanalisation therapy of ischemic stroke.
Subject(s)
Amantadine/therapeutic use , HSP70 Heat-Shock Proteins/biosynthesis , Infarction, Middle Cerebral Artery/drug therapy , Aged , Aged, 80 and over , Amantadine/administration & dosage , Animals , Blotting, Western , Calcium Channel Blockers/administration & dosage , Calcium Channel Blockers/therapeutic use , Consciousness/drug effects , Disease Models, Animal , Dopamine Agents/administration & dosage , Dopamine Agents/therapeutic use , Dose-Response Relationship, Drug , Female , Follow-Up Studies , HSP70 Heat-Shock Proteins/drug effects , Humans , Immunohistochemistry , Infarction, Middle Cerebral Artery/genetics , Infarction, Middle Cerebral Artery/metabolism , Magnesium Sulfate/administration & dosage , Magnesium Sulfate/therapeutic use , Male , Middle Aged , Rats , Rats, Wistar , Recovery of Function , Treatment OutcomeABSTRACT
The high-tech methods of diagnostics and treatment of patients with ischemic stroke during the therapeutic window have been introduced in the Inter regional clinical-diagnostic center of Kasan. These are systemic intravenous pharmacological thrombolysis, intra-arterial selective pharmacological thrombolysis, balloon angioplasty with simultaneous stenting of an occlusive vessel. The results obtained indicate that the implication of these techniques allows to increase the effectiveness of treatment of patients with acute cerebral ischemia provided minimization of the preperfusion period, individual approach in the choice of a method of thrombolysis, assessment of the character of occlusive process and specifics of the lesion on MRI, use of neuroprotection.