SU1686358A1 - Method for differential diagnosis of the types of cerebrovascular accidents - Google Patents

Abstract

The invention relates to the field of medicine, in particular to neurology, and can be used for differential diagnosis of strokes. The goal is to improve the accuracy of the method. The essence of the method is that the cerebrospinal fluid, diluted with saline at a ratio of 15, is photometrical, and on the curve of optical density (D) as a function of wavelength 0.) the values are determined and the value is D (Omax-Omin) / Omax-10, where And OM values of optical density. CID with 265.5 ± 3.0 nm and D- 3-16% is diagnosed with ischemic stroke, with Yamax 275.0 ± 2.0 nm and D-31-40% - Parenchymatous headband, with Yamash. 278.8 ± 2, Onmid 17-30% -suberahnoidal hemorrhage. The method allows, with an accuracy of 95%, to carry out a differential diagnosis of strokes with t

Description

The invention relates to the field of medicine, namely, neurology, and can be used in the differential diagnosis of strokes.

The purpose of the invention is to improve the accuracy of the method.

The method is carried out as follows.

The cerebrospinal fluid obtained as a result of lumbar puncture is centrifuged for 10 minutes at 1500 rpm, the supernatant is mixed with a physiological solution in a 1: 5 ratio and photometrized in a 1 cm thick quartz cell. on the wavelength (I). The position of Yamax and Amin is determined by the curve, and the value is D 1 "lmin. 1 00 g de Omaks and UMBKC

Omin are the corresponding values (max and min) of optical density. If yamaks

265.5 ± 3.0 nm and D 3-16% - diagnose ischemic stroke: if Yam scg 275.0 ± 2.0 nm and D 31-40% - diagnose parenchymal hemorrhage, if Yamax 278.8 ± 2.0 nm D 17-30% - diagnose subarachnoid hemorrhage.

Example 1. Patient G. 67 years. Diagnosis: subarachnoid hemorrhage. Over the course of years, he suffered from hypertension. The day before admission to the hospital, a severe headache suddenly appeared, was disoriented, the next day, psychomotor agitation, inadequate behavior was joined. During the examination, the state of severe stunned. instructions executes e. BP-200/100 mm Hg Pulse - 74 per minute. From the side of the cranial nerves, a slight central paresis of the VII and XII pairs on the right was revealed. Tendon reflexes are symmetrical. Paresis of the extremities is not detected. Muscle tone is not changed. Ria

"

with

01

with

the hydration of the neck and occipital muscles is 5-6 cm. The symptom Kernig is not pronounced. The fundus of the eye: angiosclerosis. ECG: sinus bradycardi with heart rate 60 in 1 min. Deviation of the electrical axis of the heart to the left. Diffuse changes in myocardium. In the CSF - blood. The absorption spectrum of the CSF of the patient J. has the form of a curve with a pronounced maximum absorption at I 277 nm. depth of absorption peak

13max Omin ,, - ,, -,

 100 SOLJviaKC

determined by

puts, 7% According to the developed criteria for the spectrum - subarachnoid hemorrhage.

Example 2. Ill F., 57 years old Diagnosis: ischemic stroke Received complaints of headache, weakness in the left extremities. Got sick acutely the day before hospitalization: woke up late at night and noticed a lack of movement in the left extremities. In an objective study of the state of moderate severity. Consciousness is clear, from the side of the cranial nerves, central paresis of the VII and XII nerves on the right, paresis of the eye to the left. Left-sided hemiplegi and hemihypesthesia. AD-130/80 mmHg Pulse - 100 per 1 min. Eye fundus: angiosclerosis. ECG; diffuse changes in the myocardium. Lumbar cerebrospinal fluid colorless transparent, protein - 0.165 g / l, cytosis-4 cells. The Dmax value is 266 nm, the peak depth is L - 7%. The diagnosis of the spectrum - ischemic stroke.

Example 3 Ill R., 49 years old Diagnosis: hemorrhagic stroke in inny parenchymal hemorrhage or 1 in the right hemisphere of the brain

Received complaints of severe headache. For 10 years, she suffered from hypertension. In the evening, after work, sudden spasms of the muscles of the left half of her face and left extremities appeared. After the attack, the hand hung like a whip. An hour later, hospitalized

five

0

five

0

objectively: the state is heavy. Consciousness soporous AD-240/140 mm Hg Pulse - 62 in 1 min., In the neurological status: there are no meningal signs. Left hemiplegic. Oppenheim's symptom on the left. The lumbar liquor is bloody, after centrifugation xanthochrome, protein - 3.3 g / l. completely red blood cells. The condition progressively worsened and by the end of the second day the patient died. Pathological examination confirmed the clinical diagnosis. The value of Amax is 277 nm, D 38%. The diagnosis of the spectrum - hemorrhagic stroke.

Claims (1)

A total of 74 patients with stroke were examined, with a differential diagnosis of ischemic stroke, parenchymal or subarachnoid hemorrhage with an accuracy of 95%. DETAILED DESCRIPTION OF THE INVENTION A method for differential diagnosis of stroke types, consisting in a spectrophotometric study of cerebrospinal fluid characterized in that, in order to improve the accuracy of the method, the entire absorption spectrum is studied, the value of the wavelength corresponding to the maximum absorption (first indicator) and absorption peak (second indicator) according to the formula five 0  .100% where L is the depth Omax absorption peak, Omaxg - maximum optical density, Omin - minimum optical density, and with the value of the first indicator equal to 265.5 ± 3.0 nm, and the second 3-16% is diagnosed with ischemic stroke, with the value of the first 275.0 ± 2.0 nm and the second 31-40% diagnose parenchymal hemorrhage, with the value of the first 278.8 ± 2.0 nm and the second 17-30% diagnose subarachnoid hemorrhage.