HOSPITAL REGISTER OF STROKE IN ANDIJAN CITY

Аннотация

Stroke is a clinical syndrome represented by focal and/or general cerebral disorders, developing suddenly as a result of stroke. Transient ischemic attack - transient episodes of neurological dysfunction caused by regional ischemia of the tissues of the brain, spinal cord or retina, but not leading to the development of infarction of the ischemic area [according to X-ray computed tomography (CT)ormagnetic resonance imaging (MRI)] Kеywоrds:Stroke, diagnosis, method, treatment. INTRОDUСTIОN Thus, regardless of the short duration (less than 24 hours) of clinically manifest symptoms, the presence of an infarction according to neuroimaging data allows us to make a diagnosis of cerebral infarction. At the same time, due to insufficient sensitivity of routine CT for early detection of an ischemic focus, especially in the posterior circulation system, a compromise diagnostic algorithm is used: if the neurological deficit lasts more than 24 hours, it is possible to make a diagnosis of ischemic strokeeven in theabsence ofradiological confirmation (based onclinical criteria). "Minor stroke" (reversible neurological deficit) is a clinical neurological syndrome that develops as a result of an acute disorder of cerebral circulation, in which the dysfunction is restored within the first 3weeks of thedisease. The first 5 days of stroke are defined as the most acute period. The acute period of stroke is considered for 28days.Up to6months –early recovery period, upto2years –laterecovery period. MАTЕRIАLSАNDMЕTHОDS Ischemic stroke is caused by a decrease in blood flow (usually due to occlusion of large or small arteries) in a certain area of ​ ​ impaired cerebral vascularization with the formation of a limited infarction. The following isincluded intheICD-10 section "Cerebrovascular diseases": I63. Cerebral infarction. The localization of cerebral infarctions is based on the vasotopic principle: dependence on the blood supply zone. Pathogenetic subtypes of ischemic stroke are distinguished [based on the TOAST criteria (Trial of Org 10172inAcute StrokeTreatment)]: I. Atherothrombotic stroke. II. Cardioembolicstroke. III. Lacunarstroke. IV. Strokeofotherestablished etiology. V. Strokeof unknown etiology (cryptogenic). I. Atherothrombotic stroke (includingarterio-arterial embolism) • Onset is usually intermittent, stepwise, with a gradual increase in symptoms over hours or days. Often debuts during sleep. The presence of atherosclerotic lesions of extra- and/or intracranial arteries (pronounced stenotic, occlusive process, atherosclerotic plaque with an uneven surface, with an adjacent thrombus) onthesidecorresponding to thefocal lesion ofthebrain. •Often preceded byTIA. •The sizeof thelesioncan vary from small to extensive. Features of clinical manifestations with occlusion at different levels of the carotid basin (anterior circulation system): •external carotid artery (ECA) -pain and numbness ofhalfof theface; 148 INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR RESEARCH & DEVELOPMENT SJIF2019:5.2222020:5.5522021:5.6372022:5.4792023:6.5632024:7,805 eISSN:2394-6334 https://www.ijmrd.in/index.php/imjrd Volume12,issue03(2025) • common carotid artery (CCA) — optic-pyramidal syndrome, oculopyramidal syndrome, decreased pulsation oftheinternal carotid artery (ICA) and temporal artery; •siphon oftheICA —hemisyndromes, blepharospasm, aphasia, other highercortical functions; • bilateral lesion of the carotid artery (CA) — tetraplegia, there may be alternation of symptoms of different hemispheres. RЕSULTSАNDDISСUSSIОN Features ofclinical manifestations incase of occlusion at different levels ofthevertebrobasilar basin (VBB) (posterior circulation system): • stenosis of the subclavian artery proximal to the beginning of the vertebral artery (VA) — numbness, pain in thearm. Physical activity on the left arm can lead to redistribution of blood flow from the VBB to the arteries of the upper limb, which is accompanied bysubclavian steal syndrome; • occlusion of the precranial part of the VA — clinical manifestation of severe alternating syndrome with bulbar disorders, cruciate hemiplegia. Forced position of the head — the head is tilted towards thethrombosis and turned to thesideoppositeto thethrombus; • occlusion of the intracranial part of the VA is characterized by severe clinical symptoms: sudden onset, rapid increase in syndromes, pronounced vegetative manifestations, often a disturbance in the rhythm ofbreathing; • occlusion of the basilar artery (BA) is characterized by impaired consciousness, development of the "locked-in" syndrome, vegetative disorders, hyperthermia, headache, systemic dizziness, mono- and tetraparesis, changes in muscle tone, hormetonia, pseudobulbar syndrome, alternating syndromes of thecerebral peduncle and pons. Hemodynamic variant ofan acute vascular event •Onset is suddenor stepwise, both in an active patient and in one at rest. •Localization ofthelesion is thezoneofadjacent blood supply. •Presence of extra- and/or