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.

COMPREHENSIVE STUDY OF MANIFESTATIONS OF BRAIN TISSUE RESOLUTION IN CASE OF VARIOUS TYPES OF STROKE

OBJECTIVE

The aim: The study is to research the resolution of perifocal brain tissue at various type strokes using immunomorphology.

PATIENTS AND METHODS

Materials and methods: The immunohistochemical study of perifocal brain tissue in 21 cases of various strokes types was condacted.

RESULTS

Results: When comparing the GFAP + astrocytes detection area at IS, HS and IS with HT, no significant difference was found. At the 1st degree of GFAP + astrocytes were in the border around the necrosis nucleus at IS and IS with HT, and at HS GFAP + astrocytes accumulated along the hematoma edge. CD34 + cells were found in most cases of strokes. Over time, cases with a larger CD34 + cells detection area increased (Kendal's Tau = 0.512, p = 0.001) in all groups. The capillary network at HS was around the hematoma and formed a gliomesodermal capsule with microglia and inflammation. 1st degree τ-protein accumulation was detected in 2/3 of cases (66.7%) of all strokes without significant difference. If compared in different stroke periods, -protein detection frequency increased and accumulated in brain structures - Kendal's Tau = 0.359; p = 0.023.

CONCLUSION

Conclusions: With the development of the disease, the number of cases with a larger area of detection of GFAP + astrocytes and CD34 + cells increased in strokes of various types. τ-protein was detected in neurons in all variants of ACVA in the first period.

Investigation of the influence of thrombophilic genes polymorphism, including serpin 1 (pai-i), fii, prothrombin and itgb3-˩ integrin, on the frequency of stroke in association with controllable risk factors for its occurrence

OBJECTIVE

The aim is the analysis of the relationship between the polymorphism of thrombophilic genes, in particular Serpin 1 (PAI-1), F2-prothrombin and ITGB3-α integrin, and the incidence of stroke, as well as the study of factor effects of this polymorphism in association with controlled risk factors (hypertonic disease, smoking, alcohol consumption, diabetes mellitus, obesity, atrial fibrillation).

PATIENTS AND METHODS

Materials and methods: A total of 134 patients were examined (men accounted for 44.8%, women 55.2%, average age 62.5 ± 2.1). The statistical analysis was carried out using the following criteria: χ2-Pearson, Fisher's exact criterion (reversible), Chuprov's coefficient of conjugation and dispersion analysis (alternative complex).

RESULTS

Results: The relationship between the frequency of a specific allele of thrombophilia and the incidence of stroke is absent. The reason for such results can be a significant effect of random factors (hypertension, diabetes ...), a significant variability of risk factors, their different frequency in groups (inter- and intra-group differences), a significant (95%) total effect of these factors.

CONCLUSION

Conclusions:Identification of biochemical or genetic markers of thrombophilic conditions, including polymorphism of the hemostasis system genes, will significantly increase the possibility of adequate pathogenetic treatment and timely prevention of acute cerebrovascular disorders, especially persons of working age, which has great medical and social importance.