Clinical and neurological features of the vascular pathology of the brain in military personnel evacuated from the zone of Joint Forces Operation

Authors

  • O.V. Saiko Military Medical Clinical Center of the Western Region of Ukraine, Lviv, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.8.103.2019.192377

Keywords:

cerebral stroke, chronic cerebral ischemia, laboratory and instrumental studies, clinical and neurological characteristics, risk factors, armed conflict

Abstract

Stroke is one of the most important medical and social problems. More than 17 million strokes occur annually, about 6 million people die due to this disease. Over the past 25 years, the prevalence of cerebral stroke increased by 113 %, the incidence — by 70 %, mortality from stroke — by 36 %, disability — by 73 %, number of strokes in people aged 20–64 years — by 25 %, cerebral hemorrhages — by 16 %. The INTERSTROKE population study showed that most significant risk factors for ischemic stroke after arterial hypertension (35 %) are lack of regular physical activity, obesity (26 %), apolipoprotein B and I1 ratio (25 %), tobacco smoking (19 %), unhealthy diet (19 %), cardiologic factors (7 %), diabetes mellitus, depression, psychosocial stress (5 %). Recently, the concept of stress in the conditions of hostilities, which has a multi-valued interpretation, is of particular importance, and the introduction of the definition of “traumatic”, on the one hand, emphasizes the intensity of stress factors, and on the other, the potential risk of psychological trauma under their influence. However, the main risk factors for developing cerebral stroke in military personnel, who are on the front line in the military conflict zone, remain arterial hypertension, atherosclerotic lesions of blood vessels, lipid metabolism disorders, congenital and acquired heart defects, congenital and acquired pathology of intra- and extracranial vessels, cerebral strokes, diabetes mellitus and obesity. These factors play a special role against the background of constant psycho-emotional trauma and chronic combat stress, smoking and the periodic use of strong alcoholic beverages, which are also triggers of serious cardiovascular events. Depression and anxiety symptoms that occur in a significant number of sick military personnel can enhance the manifestations of acquired somatic pathologies and accelerate the occurrence of sudden acute cerebral catastrophes, the progression of chronic brain ischemia.

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References

Psihiatriya vojn i katastrof : Uchebnoe posobie pod redakciej VK. Shamreya. [ Psychiatry of wars and catastrophes: Textbook edited by V.K. Shamrey ]. SPb.: SpecLit, 2015. 22 s. (in Russian).

Alyapkin SF. Psihicheskie rasstrojstva i organizaciya psihiatricheskoj pomoshi voennosluzhashim v afganskoj vojne: avtoref. diss. kand. med. nauk. [ Psychiatric disorders and the organization of psychiatric care for servicemen in the Afghan war: author. diss. cand. honey. of science ]. SPb., 2005. S. 3-10. (in Russian).

Yakovlev GM., Novikov VS., Havinson VH. Rezistentnost'. Stress. Regulyaciya : monografiya. [ Resistance Stress. Regulation: monograph ]. Leningrad, «Nauka». Leningradskoe otdelenie, 1990. S. 89–90. (in Russian).

Sajko OV., Luchkevich MP. Osnovni pryncypy organizaciyi medychnoyi reabilitaciyi vijskovosluzhbovciv, yaki braly uchast u myrotvorchyx operaciyax (nadzvychajnyx sytuaciyax, zbrojnyx konfliktax) na bazi likuvalnyx zakladiv ministerstva oborony Ukrayiny. [ Basic principles of the organization of medical rehabilitation of servicemen who participated in peacekeeping operations (emergencies, armed conflicts) on the basis of medical institutions of the Ministry of Defense of Ukraine ]. Praktychna medycyna. 2012. 4 (tom XVIII). S. 82–90. (in Ukrainian).

Shamrej VK. Kliniko-diagnosticheskie aspekty boevyh posttravmaticheskih stressovyh rasstrojstv. [ Clinical and diagnostic aspects of combat post-traumatic stress disorders ]. Voenno-medicinskij zhurnal. 2011. T. 332, № 8. S. 28–35. (in Russian).

Rha J.H., Saver J.L. The impact of recanalization on ischemic stroke outcome: a meta-analysis. Stroke. 2007. Vol. 38(3). Р. 967–973.

Amarenco P., Bogousslavsky J., Caplan L.R. et al. Classification of stroke subtypes. Cerebrovasc. Dis. 2009. Vol. 27(5). Р. 493–501.

Mіshchenko TS. Epidemiologiya cerebrovaskulyarnyh zabolevanij i organizaciya pomoshchi bolnym s mozgovym insultom v Ukraine. [ Epidemiology of cerebrovascular diseases and organization of care for patients with cerebral stroke in Ukraine ]. Ukrayinskyj visnyk psyxonevrologiyi. 2017. T. 25, № 1(90). S. 22–24. (in Ukrainian).

Sapon NA., Nikiforova AN. Vliyanie faktorov dostupnosti medicinskoj pomoshchi na uroven smertnosti ot insulta. [ Influence of factors of accessibility of medical care on the mortality rate from stroke ]. Ukrayinskyj nejroxirurgichnyj zhurnal. 2016. № 2. S.78–81. (in Ukrainian).

Lee J.G., Lee K.B., Jang I.M. et al. Low glomerular filtration rate increases hemorrhagic transformation in acute ischemic stroke. Cerebrovasc. Dis. 2013. Vol. 35(1). Р. 53–59.

Mukheijee D., Patil C.G. Epidemiology and the global burden of stroke. World Neurosurg. 2011. Vol. 76, (Suppl.6). Р. 85–90.

Toyoda К. Epidemiology and registry studies of stroke in Japan. Stroke. 2013. Vol. 15 (1). Р. 21–26.

Stres i xvoroby systemy krovoobigu : posibnyk [ Stress and Diseases of the Circulatory System: A Guid ]. Za red.: V. M. Kovalenko, V. M. Kornacz`kogo. Kyyiv: Kolomishyn V. Yu., 2015. 352 s. (in Ukrainian).

Zinchenko OM., Mishhenko TS. Stan nevrologichnoyi sluzhby v Ukrayini v 2015 roci : statystychno-analitychnyj dovidnyk. [The state of the neurological service in Ukraine in 2015: a statistical and analytical guide ]. Xarkiv. 2016. 23 s. (in Ukrainian).

Coull A.J. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organization of services. BMJ. 2004. Vol. 328. 326 р.

WRITING GROUP MEMBERS, Lloyd-Jones D., Adams RJ, Brown TM, Carnethon M., Dai S, et al. Heart disease and stroke statistic: 2010 update: a report from the American Heart Association. Circulation. 2010. Vol. 121. Р. 46–215.

Golovach IYu. Dyscyrkulyatorna encefalopatiya: deyaki patogenetychni, klinichni ta likuvalni aspekty. [ Discirculatory encephalopathy: some pathogenetic, clinical and therapeutic aspects ].Liky Ukrayiny. 2011. №4 (150). S.60–67. (in Ukrainian).

Published

2019-12-27

How to Cite

Saiko, O. (2019). Clinical and neurological features of the vascular pathology of the brain in military personnel evacuated from the zone of Joint Forces Operation. EMERGENCY MEDICINE, (8.103), 85–90. https://doi.org/10.22141/2224-0586.8.103.2019.192377

Issue

Section

Original Researches