Akut iskemik inme �ncesinde g�r�len fokal ve non-fokal n�rolojik belirtiler

Nadirova, Aygul; Sorgun, Mine Hayriye; Bah�i, Remzi; Togay Is�kay, Canan

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Akut iskemik inme �ncesinde g�r�len fokal ve non-fokal n�rolojik belirtiler [T�rk Beyin Damar Hast Derg]

T�rk Beyin Damar Hast Derg. 2021; 27(2): 145-152 | DOI: 10.5505/tbdhd.2021.26928

Akut iskemik inme �ncesinde g�r�len fokal ve non-fokal n�rolojik belirtiler

Aygul Nadirova¹, Mine Hayriye Sorgun¹, Remzi Bah�i², Canan Togay Is�kay¹
¹Ankara �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Ankara
²Ankara �niversitesi T�p Fak�ltesi, Geriatri Anabilim Dal�, Ankara

G�R�� ve AMA�: Ge�ici iskemik atak (G�A) inme habercisi olup, yakla��k 10 kat artm�� inme riski ta��r. Tek ba��na G�A belirtisi olup olmad�� tart��mal� olan belirtileri i�eren ge�ici n�rolojik ataklar�n (GNA) da inme riskini art�rd��na dair veriler vard�r. Bu �al��mada akut iskemik inme �ncesinde son bir ayda g�r�len fokal ve non-fokal n�rolojik belirtilerin varl��n� herhangi bir n�rolojik hastal�� bulunmayan benzer ya� grubundaki ki�ilerle kar��la�t�rmay� ama�lad�k.
Y�NTEM ve GERE�LER: Ocak 2018 ve Nisan 2020 tarihleri aras�nda akut iskemik inme veya G�A tan�s�yla yatan hastalar �al��maya al�nm��t�r. Kontrol grubunu ise ayn� d�nemde geriatri klini�inde yatan veya ayaktan ba�vuran ve herhangi bir n�rolojik hastal�� bulunmayan benzer ya� grubundaki ki�iler olu�turmu�tur. Akut iskemik inme/G�A �ncesinde ve herhangi bir n�rolojik hastal�� bulunmayan benzer ya� grubundaki ki�ilerde son 1 ayda g�r�len fokal ve non-fokal n�rolojik belirtiler sorgulanm��t�r.
BULGULAR: Bu �al��mada toplam 65 akut iskemik inme veya G�A hastas� ve 68 kontrol grubu prospektif olarak incelenmi�tir. Ba� d�nmesi, dengesizlik, bulan�k g�rme, g�rsel fenomenler, uyu�ukluk, sarho�vari y�r�me ve �oklu belirtiler akut iskemik inme/G�A grubunda, kontrol grubuna g�re istatistiksel olarak daha fazla idi (p<0,05). Ba� d�nmesi posterior dola��m inmelerinde anlaml� olarak daha s�kt� (p=0,015). �oklu regresyon analizi yap�ld��nda akut iskemik inme ile ba� d�nmesi, dengesizlik, g�rsel fenomenler ve �oklu belirtiler aras�nda ve posterior sulama alan�ndaki iskemik inme ile ba� d�nmesi aras�nda anlaml� ili�kili bulunmu�tur (p<0,05).
TARTI�MA ve SONU�: Klinisyenler, izole ba� d�nmesi, dengesizlik, nonspesifik g�rsel belirtiler �eklinde GNA veya �oklu ge�ici n�rolojik belirtiler ile ba�vuran hastalarda inme riski a��s�ndan dikkatli olmal�d�r. Ancak bu konuda daha fazla hastan�n dahil edildi�i prospektif �al��malara ihtiya� oldu�u kanaatindeyiz.

Anahtar Kelimeler: Akut iskemik inme, ge�ici iskemik atak, ge�ici n�rolojik atak.

Focal and non-focal neurological symptoms before acute ischemic stroke

Aygul Nadirova¹, Mine Hayriye Sorgun¹, Remzi Bah�i², Canan Togay Is�kay¹
¹Department of Neurology, Ankara University School of Medicine, Ankara, Turkey
²Department of Geriatrics, Ankara University School of Medicine, Ankara, Turkey

INTRODUCTION: Transient ischemic attack (TIA) is a precursor to stroke, and a person who experiences TIA has a 10-fold increased risk of stroke. There are previous studies showing transient neurological attacks (TNA) that include symptoms not certainly accepted for TIA also increase the risk of stroke. In this study, the presence of focal and non-focal neurological symptoms before acute ischemic stroke (AIS) or TIA was compared with the control group of similar age without any neurological diseases.
METHODS: Between January 2018 and April 2020, all patients who were admitted to the neurology clinic with diagnosis of AIS or TIA were included in the studyThe control group consisted of the patients with similar age who were admitted to the geriatric clinic or applied to the their outpatient clinics, and did not have any neurological disease. The focal and non-focal neurological symptoms in the last month were questioned in patients with AIS or TIA and patients without any neurological disease.
RESULTS: In this study, a total of 65 AIS or TIA patients and 68 control patients were prospectively evaluated. Vertigo, imbalance, blurred vision, visual phenomena, numbness, unsteady gait, and multiple symptoms were significantly more frequent in the patient group than in the control group (p<0,05). Vertigo was significantly more common in the PCS (p=0,015). In multiple regression analysis, there was a significant correlation between vertigo, imbalance, visual phenomena, multiple symptoms and AIS/TIA. A significant correlation also existed between the PCS and dizziness (p<0,05).
DISCUSSION AND CONCLUSION: Clinicians should be careful about the risk of stroke in patients presented with TNA such as isolated vertigo, imbalance, nonspecific visual symptoms or with a combination of transients neurological symptoms. However, we believe that further prospective studies including more patients is needed.

Keywords: Acute ischemic stroke, transient ischemic attack, transient neurological attacks.

Sorumlu Yazar: Mine Hayriye Sorgun, T�rkiye
Makale Dili: T�rk�e

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Akut iskemik inme �ncesinde g�r�len fokal ve non-fokal n�rolojik belirtiler

Focal and non-focal neurological symptoms before acute ischemic stroke