Abstract
The angio- and neurovisualization methods vigorously developing in recent decades determine the relevance of improvement of etiopathogenetic ischemic stroke classification used for the treatment tactics selection and for secondary prevention of the disorder. The study was aimed to clarify the capabilities of clinical diagnosis for pathogenetic variants of ischemic stroke. For that, in 125 postmortem cases, the macro and microscopic examination of brain and cardiovascular system was carried out in order to verify the stroke pathogenesis established as a result of the previous patients’ examination. The study demonstrates the great potential of the major pathogenetic stroke subtypes (large-artery atherosclerosis, cardioembolism, small-artery occlusion) diagnosis using the complex of contemporary clinical and instrumental methods and the main morphological criteria of these subtypes in accordance with the TOAST classification. Moreover, the clinical and pathomorphological assessment allowed us to differentiate stroke resulting from various alterations of single cerebral artery, the atherothrombotic occlusion (44% of cases for the subtype), arterio-arterial embolism (13%) and critical stenosis (10%), as well as stroke resulting from cerebrovascular insufficiency (33%), within the “large-artery atherosclerosis” subtype. Thus, the high informativity of the existing examination methods allows for a more differentiated understanding of the cause of ischemic stroke, which is fully in line with modern personalized medicine.
Highlights
The angio- and neurovisualization methods vigorously developing in recent decades determine the relevance of improvement of etiopathogenetic ischemic stroke classification used for the treatment tactics selection and for secondary prevention of the disorder
In most cases death was caused by cerebral edema in the presence of infarctions or hemorrhages, and in the absence of such the death was due to pulmonary embolism, heart failure associated with coronary heart disease (CHD), as well as renal or multiple organ dysfunction upon severe infectious disease
In accordance with Stop Stroke Study (SSS)-TOAST, 76 stroke cases were classified as large-artery atherosclerosis based on the arterial alterations in the form of occlusion or atherostenosis, both severe (≥ 50%) and moderate (30–49%), ipsilateral to the infarction in the absence of cardiac pathology and aorta with high risk of embolism
Summary
The angio- and neurovisualization methods vigorously developing in recent decades determine the relevance of improvement of etiopathogenetic ischemic stroke classification used for the treatment tactics selection and for secondary prevention of the disorder. The study was aimed to clarify the capabilities of clinical diagnosis for pathogenetic variants of ischemic stroke. The study demonstrates the great potential of the major pathogenetic stroke subtypes (large-artery atherosclerosis, cardioembolism, small-artery occlusion) diagnosis using the complex of contemporary clinical and instrumental methods and the main morphological criteria of these subtypes in accordance with the TOAST classification. Активное развитие в последние десятилетия методов ангио- и нейровизуализации определяет актуальность совершенствования этиопатогенетической классификации ишемического инсульта, используемой для выбора целенаправленной тактики лечения и вторичной профилактики этого заболевания. Показаны широкие возможности диагностики ведущих патогенетических подтипов инсульта (атеросклероз крупной артерии, кардиоаортальная эмболия, окклюзия мелкой артерии) при использовании комплекса современных клинико-инструментальных методов и основных морфологических критериев этих подтипов, отмеченных в общепризнанной классификации TOAST. Высокая информативность существующих методов исследования позволяет более дифференцированно подходить к установлению причины ишемического инсульта, что в полной мере отвечает персонализированной направленности современной медицины
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
