Abstract
Introduction: Tremor can occur as a part of the clinical picture of cerebrovascular diseases. Many patients with cerebral stroke have cardiovascu- lar diseases as a comorbidity or complication of stroke; sometimes cardiovascular events can lead to embolic stroke. Aim: To present types of tremor in patients with cerebrovascular diseases and cardiovascular events and diabetes mellitus type 2, clinical characteristics of tremor and investigations used. Material and methods: In our study we included 36 patients, 24 men and 12 women, that were exami- ned and followed for 3 years, from 2012-2015. All pa- tients were subjected to the following investigations: neurological examination, laboratory analysis, compu- terized tomography of brain, magnetic resonance ima- ging and electroencephalography. In cardiovascular patients we also performed Doppler sonography of ca- rotid arteries, electrocardiography, cardiac ultrasound. The patients were examined and treated by cardiolo- gists. Results: Of all patients 22% had cerebral infarc- tion, 41% atherosclerosis, 36% multiple lacunar in- farctions and 28% diabetes mellitus type 2. Three pati- ents with cerebral infarction had chorea, hemiballi- smus, dystonia and dystonic tremor, three had postural tremor and two cerebellar intention tremor. Athero- sclerotic patients had atherosclerotic action tremor, while diabetic patients predominantly had with ac- tion-type tremor. Electroencephalography showed irri- tative basic brain activity with slow waves, while caro- tid arteries stenosis was diagnosed by Doppler sono- graphy. Computerized tomography of the brain and magnetic resonance imaging revealed cerebrovascular diseases in certain areas. Patients with cardiomyo- pathy, rhythm disorders, high blood pressure, hyperli- pidemia was investigated and medically treated by a cardiologist. Conclusion: In cerebrovascular diseases different types of tremor can occur as a result of damage of the extrapyramidal system.
Highlights
Tremor can occur as a part of the clinical picture of cerebrovascular diseases
In cerebrovascular diseases different types of tremor can occur as a result of damage of the extrapyramidal system
Tremor is present in Petrov Igor, Mulic Mersudin, Antonio Georgiev patients with diabetes mellitus associated with diabetic neuropathy that is the complication of diabetes
Summary
Tremor can occur as a part of the clinical picture of cerebrovascular diseases. Many patients with cerebral stroke have cardiovascular diseases as a comorbidity or complication of stroke; sometimes cardiovascular events can lead to embolic stroke. Tremor can occur as a symptom of cerebrovascular insult, such as brain infarction predominantly or hemorrhagic stroke. Many patients with cerebral strokes have cardiovascular diseases as a comorbidity or a complication of the cerebrovascular brain stroke. In these patients, in the acute period, many metabolic disorders and electrolyte disbalance can occur which causes the occurrence of tremor. Vascular Parkinsonism is a special clinical entity which can occur in cerebrovascular diseases and post stroke patients; sometimes it is called atherosclerotic Parkinsonism when atherosclerosis is present mainly in the small and medium brain blood vessels and is manifested with parkinsonian symptoms predominantly on the lower extremities and postural tremor. Atherosclerotic Parkinsonism is typically presented in patients with long term hypertension and cardiomyopathy and diabetic patients when the tremor is more often present symptom [3, 4]
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