mozgovoy insult: sovremenniy vzglyad na problemu

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zagolovok slayda otsutstvuet mozgovoy insult: sovremenniy vzglyad na problemu insultus — pristup insulto — skachu, vprigivayu (drevnelatinskiy yazik) pervim upominaniem ob insulte slujat opisaniya, sdelannie gippokratom v 460-x godax do n. e., v kotorix govoritsya o sluchae poteri soznaniya v rezultate zabolevaniya golovnogo mozga v dalneyshem galen opisal simptomi, kotorie nachinayutsya s vnezapnoy poteri soznaniya, i oboznachil ix terminom «apopleksiya», to est paralich uilyam garvey v 1628 godu izuchil, kak dvijetsya krov v organizme, i opredelil funktsiyu serdtsa kak nasosnuyu, opisav protsess tsirkulyatsii krovi. eti znaniya zalojili osnovu izucheniya prichin vozniknoveniya insulta i roli sosudov v etom protsesse. insult: statistika voz ejegodno v mire registriruetsya okolo 18 - 20 millionov bolnix insultom kajdiy god v mire ot insulta umiraet 8 - 10 millionov chelovek srednegodichnaya chislennost bolnix ostrim insultom i perenesshix insult bolee 80 - 90 millionov chelovek insult zanimaet vtoroe mesto sredi prichin smertnosti naseleniya zabolevaemost insultom v mire …

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ident ssha. 12 aprelya 1945 goda umer ot insulta. • iosif vissarionovich stalin — sovetskiy gosudarstvenniy, politicheskiy i voenniy deyatel. 5 marta v 1953 godu umer ot insulta. • andrey mironov — vidayushiysya sovetskiy akter. umer v rige v 1987 godu ot insulta. • federiko fellini — vidayushiysya italyanskiy rejissyor. rodilsya i viros v rimini. umer v rime v vozraste 73 let ot insulta. • vitaliy solomin — sovetskiy i rossiyskiy akter teatra i kino. umer v vozraste 60 let ot razriva anevrizmi. • igor starigin - sovetskiy i rossiyskiy aktyor kino. umer 8 noyabrya 2009 goda ot insulta. insult v uzbekistane (metaanaliz 2 200 sluchaev – sobstvennie dannie)* ejegodno do 40 000 novix sluchaev insulta sredi jiteley sela chashe (54%), chem sredi gorodskix jiteley (46%) sootnoshenie ishemicheskix i gemorragicheskix form 4 : 1 omolojenie insulta: 55% bolnix – litsa moloje 65 let visokaya chastota sredi jenshin fertilnogo vozrasta, osobenno …

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ost sopostavima s gemorragicheskim insultom: faktori riska sad vishe 160 mm rt st sudorojniy sindrom temperatura vishe 40 gradusov obshirniy ochag (bolee 2/3 ploshadi polushariya po dannim kt) naznachenie geparina pri visheuka-zannix situatsiyax protivopokazano patogenez klassifikatsiya po patogenezu toast – (trail of org in acute stroke treatment) aterotromboticheskiy kardioembolicheskiy lakunarniy gemodinamicheskiy, gemoreologicheskiy insult neutochnyonnogo geneza osnovnie patogeneticheskie podtipi ishemicheskogo insulta (struktura po dannim nii nevrologii amn rossii) aterotromboticheskiy - 25% kardioembolicheskiy - 25% lakunarniy - 20% gemodinamicheskiy - 15% arterio-arterialnaya emboliya - 8% gemoreologicheskiy - 7% * struktura patogeneticheskix variantov ishemicheskogo insulta po dannim rntsemp (380 bolnix)* aterotromboticheskiy – 125 (32,9%) kardioembolicheskiy – 110 (28,9%) lakunarniy – 76 (20%) gemodinamicheskiy – 52 (13,7%) gemoreologicheskiy – 17 (4,5%) * klinicheskaya i paraklinicheskaya verifikatsiya: kt, uzdg, angiografiya, ekg,exo-kg, laboratornie dannie, dannie autopsiy aterotrombo-ticheskiy insult * sredi ishemicheskix insultov videlyayut aterotromboticheskiy, embolicheskiy, gemodinamicheskiy i lakunarniy insulti. aterotromboticheskiy insult sostavlyaet primerno 30-40% ishemicheskix insultov …

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jnogo krovosnabjeniya peredney, sredney i zadney mozgovoy arterii vsledstvie gipoperfuzii mozga, obuslovlennoy ostroy serdechnoy nedostatochnostyu, aritmiey, ortostaticheskoy gipotenziey, shokom ili gipovolemiey. lakunarniy insult gipertoniya arterioskleroz melkix penetriruyushix arteriy * lakunarniy insult sostavlyaet 15-30% ishemicheskix insultov i vizvan arteriosklerozom melkix penetriruyushix vetvey mozgovix arteriy, razvivayushimsya vsledstvie arterialnoy gipertonii, saxarnogo diabeta. klinika aterotrombotiches-kiy insult kardioemboliches-kiy insult gemodinamicheskiy insult lakunarniy insult gemoreologi-cheskiy insult ostroe (ostrey- shee) nachalo - +++ ++ - - podostroe nachalo ++ - + + ± psevdotumoroz-noe techenie ++ - ± - ± infarkt miokarda - +++ - - - aritmiya - +++ - - - serd. ned., nk - ++ +++ - - revmatizm, porok serdtsa - ++ - - - visokoe ad - - - +++ - ponijennoe ad ± - +++ - ± giperkoagu-lyatsiya ++ ± ± - ± povishenie gematokrita ± - ± - +++ otnositelno molodoy vozrast - ++ - ± - sudorojniy sindrom - …

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stupeneobraznoe, kak u aktivno deystvuyushego patsienta, tak i vo sne, lokalizatsiya ochaga - zona smejnogo krovosnabjeniya, v tom chisle korkovie infarkti, ochagi v periventrikulyarnom i belom veshestve nalichie patologii ekstra- i/ili intrakranialnix arteriy: ateroskleroticheskoe porajenie, anomalii sosudistoy sistemi mozga (razobshenie villizieva kruga, gipoplazii arteriy) gemodinamicheskiy faktor: snijenie ad (ortostaz, yatrogennaya gipotenziya), padenie minutnogo ob'ema serdtsa (umenshenie udarnogo ob'ema serdtsa vsledstvie ishemii miokarda, znachitelnoe urejenie chss), gipovolemiya lakunarniy insult predshestvuet arterialnaya gipertoniya, nachalo - chashe intermittiruyushee, simptomatika narastaet v techenie chasov, do sutok, inogda i dolshe, ad obichno povisheno lokalizatsiya infarkta - podkorkovie yadra, prilejashee beloe veshestvo, vnutrennyaya kapsula, osnovanie mosta, razmer ochaga - maliy, do 1 -1,5 sm v diametre, mojet ne vizualizirovatsya pri kt, nalichie xarakternix nevrologicheskix sindromov (chisto dvigatelniy, chisto chuvstvitelniy lakunarniy sindrom, atakticheskiy gemiparez, dizartriya i monoparez; izolirovanniy monoparez ruki, nogi, litsevoy i dr. sindromi) otsutstvie obshemozgovix i meningealnix simptomov, a takje narusheniy visshix korkovix funktsiy, techenie …

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"mozgovoy insult: sovremenniy vzglyad na problemu" haqida

zagolovok slayda otsutstvuet mozgovoy insult: sovremenniy vzglyad na problemu insultus — pristup insulto — skachu, vprigivayu (drevnelatinskiy yazik) pervim upominaniem ob insulte slujat opisaniya, sdelannie gippokratom v 460-x godax do n. e., v kotorix govoritsya o sluchae poteri soznaniya v rezultate zabolevaniya golovnogo mozga v dalneyshem galen opisal simptomi, kotorie nachinayutsya s vnezapnoy poteri soznaniya, i oboznachil ix terminom «apopleksiya», to est paralich uilyam garvey v 1628 godu izuchil, kak dvijetsya krov v organizme, i opredelil funktsiyu serdtsa kak nasosnuyu, opisav protsess tsirkulyatsii krovi. eti znaniya zalojili osnovu izucheniya prichin vozniknoveniya insulta i roli sosudov v etom protsesse. insult: statistika voz ejegodno v mire registriruetsya okolo 18 - 20 mi...

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