2011, nr. 1 - Academia de Ştiinţe a Moldovei

Ştiinţe Medicale
the making of a tragedy and leșșonș learned. Mayo.
Clin. Proc. 2005; 80: 1449–1460.
3. Nirav A. Steven J.; Shook H. Ch. Schumacher,
Andrew L. Tievsky, Greg W. Albers, Lawrence R.
Wechsler and Rishi Gupta. A 5-Item Scale to Predict
Stroke Outcome Aft er Cortical Middle Cerebral Artery
Territory Infarction: Validation From Results of the
Diff usion and Perfusion Imaging Evaluation for Understanding
Stroke Evolution (DEFUSE) Study. Stroke,
2011; 42:645-649.
4. Parsons M.W., Barber P.A., Desmond P.M., Baird
T.A., Darby D.G., Byrnes G, Tress BM, Davis SM.
Acute hyperglycemia adversely aff ects stroke outcome:
a magnetic resonance imaging and spectroscopy study.
Ann Neurol. 2002; 52:20–28.
5. Weimar C., Ziegler A., KoЁnig I.R., Diener
H.C. Predicting functional outcome and survival after
acute ischemic stroke. J Neurol. 2002; 249:888–
895.
6. Dziedzic T., Sl A. Sowik, Pera J. and A. Szczudlik.
Association between hyperglycemia, heart failure
and mortality in stroke patients. European Journal of
Neurology 2009, 16: 251–256.
7. Brett L. Cucchiara, Scott E. Kasner, David
A. Wolk, Patrick D. Lyden, Volker A. Knappertz, Tim
Așhwood, Tomaș Odergren, Anderș Nordlund, Early
impairment in conșciousness predicts mortality after
hemispheric ischemic stroke Crit. Care Med., 2004;
32:241–245.
8. Bousser M.G., Dubois B, Castaigne P: Transient
loss of consciousness in ișchaemic cerebral eventș: A
ștudy of 557 ischaemic strokes and transient ischaemic
attacks [author’s transl]. Ann. Med. Interne (Paris)
1981; 132:300–305.
9. Ferbert A., Bruckmann H., Drummen R. Clinical
features of proven basilar artery occlusion. Stroke
1990; 21:1135–1142.
10. Steiner T., Ringleb P., Hacke W. Treatment
options for large hemispheric stroke. Neurology, 2001;
57:s61–s68.
11. Ropper A. Lateral disșplacement of the brain
and level of consciousness in patients with an acute hemispheral
mass. N Engl J Med 1986; 314:953–958.
12. Kasner S.E., Demchuk A.M., Berrouschot J.,
et al: Predictors of fatal brain edema in massive hemispheric
ischemic stroke. Stroke 2001; 32:2117–2123.
13. Henon H., Godefroy O., Leys D. et al. Early
predictors of death and disability aft er acute cerebral
ischemic event. Stroke 1995; 26: 392–398.
14. Rordorf G., Koroșhetz W., Efi rd J.T. et al Predictors
of mortality in stroke patients admitted to an
intensive care unit. Crit. Care. Med. 2000; 28:1301–
1305.
15. James L. Bernat: Chronic disorders of consciousness
Lancet 2006; 367:1181–92.
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Rezumat
În Republica Moldova AVC sunt situate pe locul
II în structura mortalităţii populaţiei. Tulburările de
conștienţă sunt frecvent asociate în cadrul AVC, în majoritatea
cazurilor determinând o evoluţie severă și un
pronostic nefavorabil al maladiei. Mai multe modele de
predicţie au fost elaborate pentru pronosticarea stării
pacienţilor cu AVC. Recent (2011) Nirav A. și colegii
au implementat un model nou și unic pentru pronosticul
ictusului cerebral prin combinarea indicilor clinici,
de laborator și a parametrilor radiologici, pentru
a identifi ca factorii care au impact asupra recuperării.
Pacienţii de vârstă înaintată, nivel înalt la debut al scalei
NIHSS, focar ischemic masiv, hiperglicemie timpurie și
leucocitoză la spitalizare au un prognostic mai slab de
recuperare în cazul ictusurilor ischemice.
Summary
In the Republic of Moldova, cerebrovascular
accidents (stroke is ) are placed on the 2 nd place in
the structure of population mortality. Disorders
of consciousness are frequently associated within
strokes, in most cases causing a severe evolution
and an unfavorable prognosis of the disease. Most
of the accomplished studies, More predictive
methods were developed for predicting outcomes
of the patients with strokes. Recently, (2011) Nirav
A. and his colleagues have implemented a new and
unique method for the prediction of cerebral infarct
prognostic by combining clinical indexes, that of
laboratory and radiological parameters that have an
impact on recovery. Patients with advanced ages,
with high level at the onset of NIHSS scale, massive
ischemic focal, early hyperglycemia and leukocytosis
on hospitalization have a worse prognosis of recovery
in the ischemic strokes.
Резюме
В Республике Молдова в структуре смертности
населения ишемический инсульт (ИИ) занимает
II место. Нарушения сознания часто ассоциируются
с ИИ, в большинстве случаев определяя
тяжелое течение ИИ и неблагоприятный исход.
Были созданы несколько моделей для прогнозирования
результатов исхода у пациентов ИИ.
Недавно (2011) A. Nirav и его коллеги внедрили
новую и единственную модель прогноза исхода
ИИ, комбинируя клинические показатели, лабораторные
и радиологические параметры идентификации
факторов, влияющих на восстановление
пациентов. У пациентов в пожилом возрасте,
с массивным ишемическим очагом, с высоким
уровнем NIHSS в дебюте, гипергликемией и лейкоцитозом
при госпитализации прогноз для восстановления
при ИИ низкий.