ACİL SERVİSE BAŞVURAN İSKEMİK İNMELİ GENÇ ERİŞKİN HASTALARIN KLİNİK OLARAK DEĞERLENDİRİLMESİ
Amaç: Genç erişkinlerde görülen iskemik inmeler, tüm inmelerin % 10-15’ini oluşturmaktadır. Bu genç erişkinleri hayatlarının en üretken oldukları dönemde engelli bıraktıından aynı zamanda ciddi bir sosyoekonomik yüktür. Bu nedenle hastalığı tanıma ve önleme için altt yatan nedenleri araştımak gerekmektedir. Çalışmamızın amacı, genç yaşlarda görülen iskemik inmelerin neden ve sonlanımlarını güncel literatür sonuçlarıyla karşılaştımaktı. Gereç ve Yöntem: Çalışma retrospekti olarak, 2014-2017 yılları arasında iskemik inme tanısı almış, 18-50 yaş arasındaki hastaları kapsamaktadır. Yaş, cinsiyet, acil servis şikayetleri, fiik muayenedeki nörolojik bulgular ve iskemik inme için birlikte bulunan hastalıklar her hasta için kayıt altıa alındı. İnme alt tilerini belirlemek için Trial of Org 10172 in Acute Stroke Treatment (TOAST) sınıflması kullanıldı. Hastane sonlanımları modifie Rankin Skalası (mRS) ile değerlendirildi. Grupların karşılaştımasında Pearson Ki-kare test kullanıldı. p
Clinical Evaluatin of Young Adult Patints With Ischemic Stroke Applying To Emergency Department
Objectie: Ischemic stroke in young adults constiutes about 10-15% of all strokes. It is also a serioussocioeconomic burden since it leaves these young adults disabled at their most productie years. For thisreason, it is necessary to investiate underlying causes in order to identiy and prevent the disease. Thepurpose of our study was to compare causes and outcomes of ischemic stroke at young age with the resultsavailable in the literature.Methods: The study retrospectiely covers patints aged 18 to 50 diagnosed with ischemic stroke between2014 and 2017 years. Age, gender, emergency department complaints, neurological fidings detected onphysical examinatin, and comorbid diseases which were risk factors for stroke were recorded for all patints.Trial of Org 10172 in Acute Stroke Treatment (TOAST) classifiatin was used for identiiatin of strokesubtypes. Hospital outcomes were assessed by the modifid Rankin Scale (mRS). Pearson Chi-square test wasused to compare the groups. p
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- 1. Singhal AB, Biller J, Elkind MS, Fullerton HJ, Jauch EC, Kitter SJ, et al. Recognitin and management of stroke in young adults and adolescents. Neurology. 2013;81:1089-97.
- 2. Hart R, Sherman D, Miller V, Easton JD. Diagnosis and management of ischemic stroke: Selected controversies. Curr Probl Cardiol. 1983;8:43-53.
- 3. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Register: Analysis of 1000 consecutie patints with fist stroke. Stroke. 1988;19:1083-92.
- 4. Dharmasaroja P. Baseline characteristis of patints with acute ischemic stroke in a suburban area of Thailand. J Stroke Cerebrovasc Dis. 2008;17:82-5.
- 5. Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E, et al. Analysis of 1008 consecutie patints aged 15 to 49 with fist-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke. 2009; 40:1195-203.
- 6. Ferro JM, Massaro AR, Mas JL. Aetilogical diagnosis of ischaemic stroke in young adults. Lancet Neurol. 2010;9:1085-96.
- 7. Lee TH, Hsu WC, Chen CJ, Chen ST. Etilogic study of young ischemic stroke in Taiwan. Stroke. 2002;33:1950-5.
- 8. Baptita MV, Ferreira S, Pinho-E-Melo T, Carvalho M, Cruz VT, Carmona C, et al. Mutatins of the GLA gene in young patints with stroke: the PORTYSTROKE study-screening geneti conditins in portuguese young stroke patints. Stroke. 2010; 41:431-6.
- 9. Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al; American Heart Associatin; American Stroke Associatin Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Interventin; Council on Cardiovascular Nursing; Interdisciplinary Council on Peripheral Vascular Disease. Defiitin and evaluatin of transient ischemic attck: a scientii statement for healthcare professionals from the American Heart Associatin/American Stroke Associatin Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Interventin; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affis the value of this statement as an educatinal tool for neurologists. Stroke. 2009; 40:2276-93.
- 10. Marini C, Russo T, Felzani G. Incidence of stroke in young adults: a review. Stroke. Res Treat. 2011;2011:535672.
- 11. Jacobs BS, Boden-Albala B, Lin IF, Sacco RL. Stroke in the young in the Northern Manhattn Stroke Study. Stroke. 2002;33: 2789-93.
- 12. Naess H, Nyland HI, Thomassen L, Aarseth J, Myhr KM. Etilogy of and risk factors for cerebral infarctin in young adults in western Norway: a populatin- based case–control study. Eur J Neurol. 2004; 11:25-30.
- 13. Dash D, Bhashin A, Pandit AK, Tripathi M, Bhati R, Prasad K, et al. Risk factors and etilogies of ischemic strokes in young patints: a tertiry hospital study in north India. Journal Stroke. 2014; 16:173-7.
- 14. Putaala J, Curtze S, Hiltunen S, Tolppanen H, Kaste M, Tatlisumak T. Causes of death and predictors of 5-year mortality in young adults aftr fist-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke. 2009;40: 2698-703.
- 15. Khan FY, Yasin M, Abu-Khattb M, El Hiday AH, Errayes M, Lot AK, et al. Stroke in Qatar; a fist prospectie hospital based study of acute stroke. J Stroke Cerebrovasc Dis. 2008;17:69-78.
- 16. Nayak SD, Nair M, Radhakrishnan K, Sarma PS. Ischemic stroke in the young adult: clinical features, risk factors and outcome. Natl Med J Indi.a 1997; 10:107-12.
- 17. Kwon SU, Kim JS, Lee JH, Lee MC. Ischemic stroke in Korean young adults. Acta Neurol Scand. 2000;101:19-24.
- 18. Carolei A, Marini C, Ferrant E, Frontoni M, Prencipe M, Fieschi C. A prospectie study of cerebral ischemia in the young. Analysis of pathogenic determinants. The Natinal Research Council Study Group. Stroke. 1993;24:362-7.
- 19. Spengos K, Vemmos K. Risk factors, etilogy, and outcome of fist-ever ischemic stroke in young adults aged 15 to 45-the Athens young stroke registry. Eur J Neurol. 2010;17:1358-64.
- 20. Zetola VH, Novak EM, Camargo CH, Carraro CH, Coral P, Muzzio JA, et al. Stroke in young adults: analysis of 164 patints. Arq Neuropsiquiatr. 2001. 59(3-B):740-5.
- 21. Lipska K, Sylaja PN, Sarma PS, Thankappan KR, Kutt VR, Vasan RS, et al. Risk factors for acute ischaemic stroke in young adults in South India. J Neurol Neurosurg Psychiatry. 2007;78: 959-63.
- 22. Nedeltchev K, Der Maur TA, Georgiadis D, Arnold M, Caso V, Matte HP, et al. Ischemic stroke in young adults: predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry. 2005;76:191-5.
- 23. Rasura M, Spalloni A, Ferrari M, De Castro S, Patella R, Lisi F, et al. A case series of young stroke in Rome. Eur J Neurol. 2006;13:146-52.
- 24. Jovanovic DR, Beslac-Bumbasirevic L, Raicevic R, ZidvercTrajkovic J, Ercegovac MD. Etilogy of ischemic stroke among young adults of Serbia. Vojnosanit Pregl. 2008;65:803-9.
- 25. Ji R, Schwamm LH, Pervez MA, Singhal AB. Ischemic stroke and transient ischemic attck in young adults: risk factors, diagnosti yield, neuroimaging, and thrombolysis. JAMA Neurol. 2013;70:51-7.
- 26. Chan MT, Nadareishvili ZG, Norris JW. Diagnosti strategies in young patints with ischemic stroke in Canada. Can J Neurol Sci. 2000;27:120-4.
- 27. Yesilot Barlas N, Putaala J, Waje-Andreassen U, Vassilopoulou S, Nardi K, Odier C, et al. Etilogy of fist-ever ischaemic stroke in European young adults: the 15 citis young stroke study. Eur J Neurol. 2013;20:1431-9.
- 28. Özer İŞ, Sorgun MH, Rzayev S, Kuzu M, Tezcan S, Yılmaz V, et al. Etilogic Subtypes, Risk Factors And Outcome Of Acute Ischemic Stroke With Young Patints. Turk J Neurol. 2015;21:159-64
- 29. Smajlović Dž Salihović D, Ibrahimagić OĆ Sinanović O, Burina A. Stroke in patints with diabetes mellitus: a hospital based study. Med Arh. 2006;60 (6 Suppl 2):63-5.
- 30. Cerrato P, Grasso M, Imperiale D, Priano L, Baima C, Giraudo M, et al. Stroke in young patints: etipathogenesis and risk factors in diffrent age classes. Cerebrovasc Dis. 2004,18:154-9.
- 31. Tancredi L, Martielli Boneschi F, Braga M, Santili I, Scaccabarozzi C, Lattada P, et al. Stroke care in young patints. Stroke Res Treat. 2013;2013:715380.
- 32. Varona JF, Bermejo F, Guerra JM, Molina JA. Long-term prognosis of ischemic stroke in young adults. Study of 272 cases. J Neurol. 2004;251:1507-14.