LATERAL MEDULLARY INFARCTION: A PROSPECTIVE HOSPITAL-BASED COHORT STUDY OF CLINICAL AND IMAGING FEATURES AND A CASE REPORT IN A WHITE ADULT.

OBJECTIVE: The aim: The purpose of this study is to determine clinical and imaging features of lateral medullary infarction in a prospective hospital-based cohort study, illustrated with a clinical case presentation in a white adult. PATIENTS AND METHODS: Materials and methods: We prospectively recruited 120 acute posterior circulation stroke patients, admitted to the Neurological Center of the University Hospital (Oleksandrivska Clinical Hospital) in Kyiv, Ukraine, within 6 to 24 hours from the onset of the stroke symptoms. Comprehensive neurological, clinical, laboratory, ultrasound, and imaging examination was performed on all patients. RESULTS: Results: Out of 120 adult patients (68 men, 52 women aged 28 to 89 years; average age 60.7 ± 12.1 years) with an acute ischemic MRI/CT-proven posterior circulation stroke, 22 (18.3%) patients have acute medulla oblongata infarctions.We provided a complex clinical, neurological, laboratory, and instrumental analysis of lateral medullary infarction illustrated with a clinical case presentation. CONCLUSION: Conclusions: Specific clinical and imaging features of lateral medullary infarction were determined, analyzed, compared, and described.

ASEPTIC MENINGITIS AS AN EXTRAHEPATIC MANIFESTATION OF HEPATITIS C: A CLINICAL CASE PRESENTATIONIN A WHITE YOUNG FEMALE EUROPEAN ADULT.

We aimed to provide a clinical case presentation of aseptic meningitis as an extrahepatic manifestation of hepatitis C. A 28-year-old lady has been admitted to the Regional Clinical Center of Neurosurgery and Neurology, Uzhhorod City, Ukraine, with mild meningeal signs and symptoms upon admission. Complex neurological, clinical, laboratory, and imaging examination was performed within 24 hours of admission. Mononuclear pleocytosis of the cerebrospinal fluid and positive express test on HCV were discovered. The patient was treated and showed full recovery. Specific neurological features of aseptic meningitis as an extrahepatic manifestation of hepatitis C in a young white adult were reported, described, and analyzed.

MULTIPLE ACUTE POSTERIOR CIRCULATION STROKE WITH LESIONS IN THE PONS AND BOTH HEMISPHERES OF THE CEREBELLUM ASSOCIATED WITH OVARIAN HYPERSTIMULATION SYNDROME: A CASE REPORT OF A WHITE EUROPEAN ADULT IN UKRAINE.

We have presented a brief literature overview of the disease, supported by a clinical case of multiple acute posterior circulation strokes with lesions in the pons and both hemispheres of the cerebellum associated with ovarian hyperstimulation syndrome in a white young European adult in Ukraine. Specific features of posterior circulation stroke associated with ovarian hyperstimulation syndrome were determined, analyzed, and described. Complex posterior circulation cerebral infarction in the pons and both hemispheres of the cerebellum associated with ovarian hyperstimulation syndrome has not been reported before but has devastating consequences for both mother and fetus. Strokes in patients with OHSS must be timely prevented, promptly diagnosed, and treated to avoid high morbidity and mortality associated with it.

CLINICAL AND IMAGING FEATURES OF MEDIAL MEDULLARY INFARCTION: RESULTS OF A PROSPECTIVE HOSPITAL-BASED COHORT STUDY ILLUSTRATED WITH A CASE REPORT IN A WHITE EUROPEAN ADULT.

OBJECTIVE: The aim: This study aims in a prospective hospital-based cohort study to determine clinical and imaging features of medial medullary infarction and report a relevant clinical case in a white European adult. PATIENTS AND METHODS: Materials and methods: We have prospectively enrolled one hundred twenty adult patients with acute posterior circulation stroke. All patients were admitted and enrolled in the study within 6 to 24 hours from the onset of the stroke symptoms. Study subjects were recruited from the hospital's wards and emergency departments from 2011 to 2020. Comprehensive clinical, MRI, ultrasound, and laboratory examinations were performed on all patients. RESULTS: Results: 68 men and 52 women aged 28 to 89 years (average age 60.7 ± 12.1 years) with an acute ischemic posterior circulation stroke were enrolled in the study. Out of these 120 patients, 22 (18.3%) had acute medulla oblongata infarctions. Clinical and imaging features of medial medullary infarction are analyzed and illustrated with a clinical case presentation in a white European adult. CONCLUSION: Conclusions: Specific features of medial medullary infarction were determined, analyzed, described, and illustrated with a clinical case.

CLINICAL AND IMAGING FEATURES OF LACUNAR AND NON-LACUNAR SUBTYPES OF ISCHEMIC POSTERIOR CIRCULATION STROKE.

OBJECTIVE: The aim: The purpose of this study is to determine clinical and imaging features of etiological subtypes of posterior circulation stroke in a prospective hospital-based cohort study. PATIENTS AND METHODS: Materials and methods: We prospectively recruited 120 acute posterior circulation stroke patients, admitted to the Neurological Center of the University Hospital (Oleksandrivska Clinical Hospital) in Kyiv, Ukraine, within 6 to 24 hours from the onset of the stroke symptoms. Comprehensive neurological, clinical, laboratory, ultrasound, and imaging examination was performed on all patients. RESULTS: Results: MRI/CT-proven etiological subtypes of ischemic posterior circulation stroke were defined - atherothrombotic (n = 59), cardioembolic (n = 24), lacunar (n = 27), and definitively indeterminate (n = 7). Two main study groups were formed - lacunar (n = 27) and non-lacunar (n = 90) subtypes of posterior circulation stroke. CONCLUSION: Conclusions: Specific clinical and imaging features of etiological subtypes of posterior circulation stroke were determined, analyzed, compared, and described.

PROSPECTIVE ANALYSIS OF THE EPIDEMIOLOGY OF CEREBROVASCULAR DISEASE AND STROKE AMONG THE ADULT POPULATION OF KYIV CITY, UKRAINE.

OBJECTIVE: The aim: We aimed to conduct a prospective analysis of the epidemiology of cerebrovascular disease and stroke among the adult population of Kyiv City, Ukraine the last 12 years. PATIENTS AND METHODS: Materials and methods: We analyzed sectoral statistical reports of cerebrovascular disease and stroke in Kyiv City for 2009-2020. The statistical method and the method of system approach were used in this study. RESULTS: Results: We established that during the last 12 years there was a decrease in the incidence of cerebrovascular disease and stroke among the adult population of Kyiv (reduction of 1.83 times (p <0.05) with t reliability criteria 26.89). However, the incidence remains high (476.62 per 100,000 population). At the same time, the prevalence of cerebrovascular isease remains stable, and among the working-age population tends to increase. The incidence of stroke indicates a positive trend (251.3 per 100,000 adult population of Kyiv in 2009 and 95.0 - in 2020, respectively). In particular, the number of primary registered strokes decreased 2.64 times (p ≤0.05) with a reliability criterion of 5.7 which is 1.94 (p≤0.05) times lower than in Ukraine generally. During the study period, 27,928 people died in Kyiv from a stroke. The mortality rate of stroke among the adult population in the city decreased from 96.14 per 100,000 in 2009 to 57.17 in 2020. This significant decline occurred over the past two years. CONCLUSION: Conclusions: A significant reduction in the incidence of cerebrovascular disease and stroke in the adult population of Kyiv during the last 12 years has been established. This might be caused by increased stroke prevention work, provided to the city population, and by a higher level of availability and quality of medical care in recent years.

Clinical syndromes of the thalamic stroke in the classical vascular territories: a prospective hospital-based cohort study.

OBJECTIVE: The aim: We aimed to determine, describe, and analyze the clinical and neuroimaging features of vascular syndromes of acute thalamic stroke in the classical vascular territories in a prospective hospital-based cohort study. PATIENTS AND METHODS: Materials and methods: We have prospectively recruited 319 acute stroke patients, admitted to the Neurological Center at an academic hospital (Oleksandrivska Clinical Hospital) in Kyiv, Ukraine. Complex neurological, clinical, laboratory, ultrasound, and neuroimaging examinations were performed to all study patients within 24 hours since the symptoms onset. RESULTS: Results: MRI/CT-proven thalamic stroke was diagnosed in 34 (10.6%) out of 319 patients, forming a study group. Twenty-two out of 34 patients (average age 61.9 ± 10.2 years) were diagnosed with an acute isolated ischemic thalamic stroke, and 12 patients (average age 59.0 ± 9.6 years) were diagnosed with an acute thalamic hemorrhage. CONCLUSION: Conclusions: Specific neurological features of clinical vascular syndromes of acute thalamic stroke in the classical vascular territories were analyzed, compared, and described.