Tihi moždani udar

master's thesis

• Title (english): Silent stroke
• Author: Ana Marija Jurić
• Mentor: Branko Malojčić (mentor)
• Committee member: Zdravka Poljaković (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Branko Malojčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Tihi moždani udar je čest nalaz na modernim radiološkim pretragama mozga. Čak do 30% osoba bez povijesti moždanog udara na slikovnim pretragama rađenim u sklopu brojnih epidemioloških studija ima znakove moždanog udara. Termin „tihi“ podrazumijeva nedostatak jasne kliničke slike uz slučajni pronalazak ishemijskih lezija metodama magnetske rezonancije ili CT-a. Ipak, danas je sve jasnije da ova vrsta moždanog udara uopće nije „tiha“, već u velikom broju slučajeva postoji pitanje slušamo li dovoljno pažljivo. Naime, niz je posljedica ovih lezija, koje su prije smatrane potpuno benignima: neurokognitivni te psihijatrijski poremećaji, povećan rizik klinički manifestnog moždanog udara, povećana smrtnost te smanjena kvaliteta života općenito. Rizični čimbenici su dijelom poznati te dijelom povezani sa klinički manifestnim moždanim udarom uz postojanje niza razlika. DWI pozitivnost (restrikcija difuzije) na magnetskoj rezonanciji je tipična za infarkte (obično manifestni MU) uz činjenicu da ih je idalje nemoguće potpuno odijeliti od lezija bijele tvari poznatijih kao leukoaraioza. Interes za ovu vrstu cerebrovaskularne bolesti se javio tek nedavno, a unatoč velikoj učestalosti idalje postoji niz problema vezanih uz nedovoljno definirane dijagnostičke kriterije, neosjetljivost postojećih kriterija na suptilne i kognitivne simptome, nejasni podatci o incidenciji te prevalenciji te patofiziološkim mehanizmima nastanka bolesti, a posljedično tome i prevencija nije adekvatna.

Abstract (english)

Silent brain infarction is a common finding by modern cerebral imaging methods. Up to 30% patients without a history of stroke shows radiological findings of infarction in different epidemiological studies. The term „silent“ refers to the lack of clear symptoms combined with accidentaly found ischemic lesions on MRI or CT. However, it becomes clearer today that this type of stroke is not „silent“ at all, and the question is are we listening careful enough. A series of consequences of these lesions, formaly considered benighn, such as: neurocognitive and psychiatric declines, heightened risk of clinically apparent stroke, heightened mortality and reduced quality of life in general. The risk factors are partialy known and associated with clinically apparent stroke but with many differences. DWI positivity (or diffusion restriction) on MRI is typical for infarct (especially clinically apparent) still admitting the fact that they are still incompletely separable from the white matter lesions better known as leucoaraiosis. Interest for this type of cerebrovascular disease appeared just recently and, despite its frequency, it still undergoes many problems related with poorly defined diagnostic criteria, insensitivity of commonly used diagnostic criteria, unclear incidence or prevalence data as well as relatively unknown pathophysiological mechanisms of silent brain infarction resulting in inadequate prevention possibilities.

• Keywords: moždani udar
• Keywords (english): brain infarction
• Language: croatian
• URN:NBN: urn:nbn:hr:105:825420
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-09 09:23:15