DOI: https://doi.org/10.22141/2224-0586.8.87.2017.121334

Is it time to create stroke units in the system of specialized medical care for vascular diseases of the brain?

I.S. Zozulya, A.I. Zozulya, A.O. Volosovets

Abstract


Background. Despite the fact that stroke is the most common disease that can lead to irreversible consequences, only a small part of stroke patients are under constant observation by well-qualified neurologists, neurosurgeons, family doctors, cardiologists, pediatricians and resuscitation surgeons. The purpose of the study: to conduct an analysis of scientific li­terature on the identification of current world trends in the organization and assistance to patients with cerebrovascular diseases and to identify the main directions for the present. Materials and methods. The accomplishment of the task was carried out by using the structural-logical analysis, bibliosemantic method and the study of 242 literature sources. Results. In the 1960s, when specialized neurosurgical and intensive care units were opened, neurological teams of the ambulance service and rehabilitation clinics in hospitals were also created. In 1974, such system was implemented in all countries of the world. Howe­ver, this system has been destroyed in the former Soviet Union, and now it doesn’t exist in Ukraine. During the past 25 years, a “quiet revolution” occurred in providing care to the patients with stroke with the help of effective treatments (antiplatelet drugs: acetylsalicylic acid preparations (1978), warfarin (1993), clopidogrel (1996), carotid endarterectomy (1991), the injection of a tissue plasminogen activator (2003)). Current data suggest that the treatment of all stroke patients should be carried out in organized stroke centers. Such centers were created in England, Northern Ireland, Sweden, Austria, Japan, USA, France. Conclusions. Today, it is important to create stroke centers (units), which will provide assistance to stroke patients, starting with an acute period. Multidisciplinary brigades should be included in intensive care units, neurological and neurosurgical departments and have to work in centers round-the-clock.


Keywords


stroke; treatment; stroke centers (units)

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