Evaluation of Diurnal Variation in Stroke Subtypes; Experiences of a University Hospital

INTRODUCTION: In this study, we aimed to investigate whether the diurnal variation of stroke subtypes is correlated with the asleep and awake periods and monthly and seasonal changes. METHODS: All patients over the age of 18 who were diagnosed with a stroke, treated, and followed up were included in our study and evaluated retrospectively. Stroke subtypes were evaluated according to Oxfordshire Community Stroke Project (OCSP) classification and grouped as total anterior circulation infarction (TACI), posterior circulation infarction (POCI), partial anterior circulation infarction (PACI), lacunar infarction (LACI) according to the patients' clinics. In addition, according to this classification, the anatomic location of the involvement was confirmed from the results of diffusion-weighted brain magnetic resonance imaging. It was also determined which group was more affected in which diurnal cycle. RESULTS: When asleep and awake periods were examined, it was found to be statistically significant that the patients in the TACI group had more frequent hospital admission rates in the sleep period than the patients in the POCI and LACI groups (p=0.045). There was no statistically significant difference between the other groups (p˃0.05). When the seasonal variables were examined, no statistically significant difference was found between the groups (p˃0.05). However, there was an increase in the percentage of hospital admissions in the autumn and winter. DISCUSSION AND CONCLUSION: It was determined that stroke development was more frequent during the asleep period in the patients in the TACI group, which usually had more serious involvement and more serious morbidity, than the patients in the POCI and LACI groups.

İnme Alt Gruplarında Diurnal Varyasyonun Değerlendirilmesi; Bir Üniversite Hastanesinin Deneyimleri

GİRİŞ ve AMAÇ: Bu çalışmada inme alt tiplerinde diurnal varyasyonun uyku ve uyanıklık dönemi, aylık ve mevsimsel değişimler ile korelasyonu olup olmadığını incelemeyi amaçladık. YÖNTEM ve GEREÇLER: İnme tanısı alarak takip ve tedavisi yapılan 18 yaş üstü tüm hastalar çalışmamıza dahil edilmiştir ve retrospektif olarak değerlendirilmiştir. İnme alt tipleri Oxfordshire Community Stroke Project (OCSP) sınıflandırmasına göre değerlendirilmiş ve hastaların kliniklerine göre; total anterior sirkülasyon infarktı (TASİ), posterior sirkülasyon infarktı (POSİ), parsiyel anterior sirkülasyon infarktı (PASİ), laküner infarkt (LAİ) grupları oluşturulmuştur. Ayrıca bu yapılan sınıflandırmaya göre hangi anatomik bölgenin tutulumu olduğu difüzyon ağırlıklı beyin manyetik rezonans görüntüleme sonuçlarından teyit edilmiştir. Hangi diurnal döngüde hangi grubun daha fazla etkilenim gösterdiği de tespit edilmiştir. BULGULAR: Uyku ve uyanıklık periyodları incelendiğinde; TASİ grubunda bulunan hastaların, POSİ ve LAİ gruplarındaki hastalara göre uyku dönemde başvuru oranlarının daha sık olduğu tespit edildi ve bu durum istatistiksel olarak anlamlı bulundu (p=0.045). Diğer grupların arasında herhangi bir istatistiksel anlamlı farklılık bulunmadı (p˃0.05). Mevsimsel değişkenler incelendiğinde ise yine gruplar arasında istatistiksel olarak anlamlı bir fark tespit edilmedi (p˃0.05). Ancak sonbahar ve kış döneminde yüzde olarak başvurularda bir artış olduğu saptandı. TARTIŞMA ve SONUÇ: Genellikle daha ciddi bir tutulumun ve daha ciddi morbiditenin gözlendiği TASİ grubunda, POSİ ve LAİ guplarındaki hastalara göre inme gelişiminin uyku döneminde daha sık gerçekleştiği tespit edilmiştir..

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