İnme Alt Gruplarında Diurnal Varyasyonun Değerlendirilmesi; Bir Üniversite Hastanesinin Deneyimleri

GİRİŞ ve AMAÇ: Bu çalışmada inme alt tiplerinde diurnalvaryasyonun uyku ve uyanıklık dönemi, aylık ve mevsimseldeğişimler ile korelasyonu olup olmadığını incelemeyi amaçladık. YÖNTEM ve GEREÇLER: İnme tanısı alarak takip vetedavisi yapılan 18 yaş üstü tüm hastalar çalışmamıza dahiledilmiştir ve retrospektif olarak değerlendirilmiştir. İnme alttipleri Oxfordshire Community Stroke Project (OCSP)sınıflandırmasına göre değerlendirilmiş ve hastalarınkliniklerine göre; total anterior sirkülasyon infarktı (TASİ),posterior sirkülasyon infarktı (POSİ), parsiyel anteriorsirkülasyon infarktı (PASİ), laküner infarkt (LAİ) gruplarıoluşturulmuştur. Ayrıca bu yapılan sınıflandırmaya göre hangianatomik bölgenin tutulumu olduğu difüzyon ağırlıklı beyinmanyetik rezonans görüntüleme sonuçlarından teyit edilmiştir.Hangi diurnal döngüde hangi grubun daha fazla etkilenimgösterdiği de tespit edilmiştir. BULGULAR: Uyku ve uyanıklık periyodları incelendiğinde;TASİ grubunda bulunan hastaların, POSİ ve LAİ gruplarındakihastalara göre uyku dönemde başvuru oranlarının daha sıkolduğu tespit edildi ve bu durum istatistiksel olarak anlamlıbulundu (p=0.045). Diğer grupların arasında herhangi biristatistiksel anlamlı farklılık bulunmadı (p˃0.05). Mevsimseldeğişkenler incelendiğinde ise yine gruplar arasındaistatistiksel olarak anlamlı bir fark tespit edilmedi (p˃0.05).Ancak sonbahar ve kış döneminde yüzde olarak başvurulardabir artış olduğu saptandı. TARTIŞMA ve SONUÇ: Genellikle daha ciddi bir tutulumunve daha ciddi morbiditenin gözlendiği TASİ grubunda, POSİ veLAİ guplarındaki hastalara göre inme gelişiminin uykudöneminde daha sık gerçekleştiği tespit edilmiştir..

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

INTRODUCTION: In this study, we aimed to investigatewhether the diurnal variation of stroke subtypes is correlatedwith the asleep and awake periods and monthly and seasonalchanges. METHODS: All patients over the age of 18 who werediagnosed with a stroke, treated, and followed up wereincluded in our study and evaluated retrospectively. Strokesubtypes were evaluated according to Oxfordshire CommunityStroke Project (OCSP) classification and grouped as totalanterior circulation infarction (TACI), posterior circulationinfarction (POCI), partial anterior circulation infarction(PACI), lacunar infarction (LACI) according to the patients'clinics. In addition, according to this classification, theanatomic location of the involvement was confirmed from theresults of diffusion-weighted brain magnetic resonanceimaging. It was also determined which group was moreaffected in which diurnal cycle. RESULTS: When asleep and awake periods were examined, it was found to be statistically significant that the patients in theTACI group had more frequent hospital admission rates in thesleep period than the patients in the POCI and LACI groups(p=0.045). There was no statistically significant differencebetween the other groups (p˃0.05). When the seasonalvariables were examined, no statistically significant differencewas found between the groups (p˃0.05). However, there wasan increase in the percentage of hospital admissions in theautumn and winter. DISCUSSION AND CONCLUSION: It was determined thatstroke development was more frequent during the asleepperiod in the patients in the TACI group, which usually hadmore serious involvement and more serious morbidity, than thepatients in the POCI and LACI groups.

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