Dopplerographic features of patients with onset of acute cerebral stroke in different periods of the day
Background. The question of a connection of pathological changes in the hemodynamic parameters of cerebral circulation with a time of a stroke onset in the literature is not considered well, that determines the relevance of the study of this problem. The purpose of our study was to evaluate the state of cerebral hemodynamics and the nature of hemodynamic disorders in patients depending on the period of an ischemic cerebral stroke onset. Materials and methods. For achieving our goals we have performed clinical and magnetic resonance tomography examination for 300 patients who suffered from an acute ischemic stroke (men — 196, women — 104) aged 42 to 84 years (average age 65.2 ± 8.7 years). To optimize the analysis of the obtained data, all patients were divided into 4 groups according to the period of the day when an ischemic stroke occurred: group 1 — patients suffering from cerebral ischemia in the afternoon (8.00–14.59); group 2 — patients with stroke occured in the evening (15.00–21.59); group 3 — patients which had an ischemic stroke at night (22.00–7.59). Results. Indicators of cerebral hemodynamics in patients after a «daytime» cerebral stroke had a higher incidence of pronounced vascular stenosis (18.4 %). However, after the «evening stroke», patients had a higher incidence of all hemodynamically significant stenosis in general (90.7 %) and a more pronounced pathological pattern than among patients in the group of «nocturnal stroke» (29.7 %), that may be explained by the prevalence among the patients in the second groups of such risk factors as obesity, hypercholesterolemia and decreased physical activity, that contributed to the increased systemic narrowing of vascular lumen due to chronic progressive atherosclerosis and, as a consequence, the formation of chronic cerebral ischemia. Conclusions. The study of cerebral hemodynamic disorders in patients with different time of stroke onset has revealed that parameters of cerebral hemodynamics in patients after a «daytime» and «night» stroke had a less pathological character than among the patients after an «evening stroke».
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