[Predictors of lethal outcome in young patients with hemorrhagic stroke]. / Prediktory letal'nogo iskhoda gemorragicheskogo insul'ta u patsientov molodogo vozrasta.

OBJECTIVE: To evaluate the predictors of the lethal outcome of hemorrhagic stroke in young people. MATERIAL AND METHODS: A retrospective analysis of cases of non-traumatic hemorrhagic stroke was carried out in 60 young patients hospitalized in the neurosurgical department in the Ufa Clinical Emergency Hospital. By gender, the male predominated. The mean age of the patients was 37.4±5.1 years. Lethal outcome was in 18 (30%) patients. RESULTS: Data analysis revealed a relationship between the lethal outcome of hemorrhagic stroke and certain clinical, somatic, laboratory and instrumental factors. As a result, a significant model (p<0.001) of the probability of a lethal outcome in young patients was developed. CONCLUSION: The identified predictors of the probability of death from stroke can serve as the basis for adequate management of young patients with hemorrhagic stroke.

[Ethiopathogenetic features and course of ischemic stroke associated with COVID-19]. / Etiopatogeneticheskie osobennosti i techenie ishemicheskogo insul'ta, assotsiirovannogo s COVID-19.

OBJECTIVE: To analyze etiopathogenetic factors and course of ischemic stroke associated with new coronavirus infection (COVID-19). MATERIAL AND METHODS: A retrospective clinical study of 173 patients with ischemic stroke and COVID-19 (main group) and 86 patients with ischemic stroke without COVID-19 (comparison group) was carried out. There were no statistically significant differences in age and gender. All patients underwent standard clinical-instrumental, laboratory and neuroimaging assessments. RESULTS: Compared with the comparison group, patients with COVID-19 were less likely to have cardiovascular risk factors, the difference being statistically significant. Stroke in the main group was more severe than in the comparison group. According to the TOAST classification, an unknown stroke subtype significantly predominated in the main group. Laboratory data in the main group indicated the significance of an increase in renal-hepatic markers (creatinine, aspartate aminotransferase) and systemic inflammatory response syndrome (C-reactive protein). CONCLUSION: The development of cardiovascular diseases in patients with COVID-19 is an important negative prognostic factor that requires further study to determine the optimal management strategy.

[Dissection of cerebral arteries as a cause of ischemic stroke]. / Dissektsiya tserebral'nykh arterii kak prichina ishemicheskogo insul'ta.

Dissection of cerebral arteries is a rare cause of stroke in the general population. The article describes 5 clinical cases of patients with ischemic stroke after dissection, discusses the issues of etiology, diagnosis and treatment tactics. The possibility of using high-tech methods of treatment for this subtype of stroke is emphasized. The diagnostic method of choice is neuroimaging, including cerebral angiography.

[Predictors of unfavorable outcomes of ischemic stroke associated with COVID-19]. / Prediktory neblagopriyatnogo iskhoda ishemicheskogo insul'ta, assotsiirovannogo s COVID-19.

OBJECTIVE: To study predictors of unfavorable outcomes in ischemic stroke associated with COVID-19. MATERIAL AND METHODS: A retrospective analysis of 173 case histories of patients with ischemic stroke and COVID-19 was carried out. The average age was 68.64±11.39 (95% CI 66.93-70.35; median 92, mean 34) years. By gender, women predominated (64.16%). Fatal outcome was observed in 62 (35.84%) patients. Risk factors were studied using binary logistic regression. RESULTS: The risk of a fatal stroke in a univariate analysis was established in the presence of a general severe condition of the patient and a number of other factors, which included the severity of COVID-19, acute coronary syndrome, multiple organ failure, the need for a ventilator, a history of kidney disease, pneumonia, high NIHSS score, oxygen partial pressure level, respiratory rate, number of hospitalizations, complete blood count (erythrocytes, hemoglobin, hematocrit, leukocytes, neutrophils), coagulogram, glucose, liver and kidney markers (bilirubin, aspartate aminotransferase, alanine aminotransferase, creatinine, urea), levels of creatine phosphokinase, lactate dehydrogenase and C-reactive protein. A model based on multivariate analysis was used, which makes it possible to predict the probability of a fatal outcome. A regression function was obtained, which included the content of C-reactive protein, urea and NIHSS score. In patients with a value of 35% and above, there was an increased risk of death, in the case of a value below 35%, a favorable outcome was assumed. The model was statistically significant (p<0.001). The sensitivity and specificity of the model were 88.9% and 97.9%, respectively. CONCLUSION: The revealed predictors of the probability of a fatal stroke outcome can be guidelines for a Coctor in choosing a patient management strategy at different stages of patient care.

[Etiopathogenetic features, course and outcome of hemorrhagic stroke in young people]. / Etiopatogeneticheskie osobennosti, techenie i iskhod gemorragicheskogo insul'ta u lits molodogo vozrasta.

OBJECTIVE: Analysis of etiopathogenetic factors and features of the course of hemorrhagic stroke in young people. MATERIAL AND METHODS: A retrospective analysis of 402 case histories with non-traumatic hemorrhagic stroke was carried out, of which 60 (14.93%) patients were young. The average age was 37.37±5.09 years. There were 19 (31.7%) females and 41 (68.3%) males. Statistical data processing was carried out using Microsoft Office 2010 and SPSS v.26. RESULTS: The main causes of hemorrhagic stroke in young people were changes in cerebral vessels by the type of aneurysmal deformation of the vascular wall, including Moya-Moya disease, and arteriovenous malformations (60%). The second etiological factor of hemorrhagic stroke was arterial hypertension (40%). Intracerebral hematoma was the most common type of hemorrhagic stroke. The functional outcome was influenced by: the severity of the patient's general condition, the severity of the neurological deficit, the degree of consciousness, the presence of concomitant pathology, convulsive, dislocation syndrome, leukocytosis, hyperglycemia, high creatinine levels. CONCLUSION: The problem of hemorrhagic stroke at a young age is complex and relevant, since the etiological factor of the disease at this age differs significantly from that in older age groups, requires adequate diagnostic searches to identify the etiopathogenetic factor and subsequent secondary prevention.