Læknablaðið - 15.12.1998, Blaðsíða 19

LÆKNABLAÐIÐ 1998; 84
921
Orsakagreining heilablóðþurrðar á
endurhæfinga- og taugadeild
Borgarspítalans 1994
Einar M. Valdimarsson, Garðar Sigurðsson, Finnbogi Jakobsson
Valdimarsson EM, Sigurðsson G, Jakobsson F
Etiology and treatment of cerebral ischemia at the
Department of Neurology and Rehabilitation
Medicine at Reykjavík City Hospital
Læknablaðið 1998; 84: 921-7
Objectives: This is the first Icelandic study in which
the etiology of cerebral ischemia is examined. The
goal of the study was to examine how the etiology of
cerebral infarcts and transient ischemic attacks was
determined at the Department of Neurology and
Rehabilitation Medicine at Reykjavík City Hospital
and how the patients were treated.
Material and methods: The study was retrospective
and included 102 patients with cerebral infarcts and
transient ischemic attacks that were admitted to the
Department of Neurology and Rehabilitation Medi-
cine at Reykjavík City Hospital in 1994. Patients
with cerebral hemorrhage were excluded. The
patients' mean age was 68.5 years (range 25-89) and
the male:female ratio was 59:43. Cerebral compu-
terized tomography was obtained from 98 (98%)
patients. Carotid ultrasonography was done in 72
(72%) cases and carotid angiogram in 14 (14%)
patients. Transthoracic echocardiography was done
in 69 (69%) cases and transesophagal echocardio-
graphy in the 11 (11%) youngest patients.
Results: Of the 102 patients, 79 (79%) had cerebral
infarctions and 23 (23%) transient ischemic attacks.
Frá taugadeild Sjúkrahúss Reykjavíkur. Bréfaskipti, fyrir-
spurnir: Einar M. Valdimarsson, taugadeild Sjúkrahúss
Reykjavíkur, 108 Reykjavík. Bréfsími: 525 1662.
Lykilorð: heilablóðþurrö, heiladrep, skamvinn heilablóð-
þurrð, þrenging í hálsæðum, heiladrep vegna smáæða-
sjúkdóms, segalindirí hjarta, ómun afhálsi, ómun afhjarta,
hálsæðaaögerð.
The probable cause of cerebral infarction was cardio-
embolic in 21 patients (27%), lacunar infarction in
16 patients (20%) and carotid artery disease in 13
patients (16%). In 37% of the cases the cause was
unspecific. The etiology of transient ischemic attacks
was carotid artery disease in four patients (17%),
cardioembolic in two patients (9%) and lacunar in
one patient (4%). In 70% of the cases the cause of
transient ischemic attacks was undetermined. Nine
of the 102 patients (9%) underwent carotid endarte-
rectomy and 15 (15%) were treated with warfarin.
Conclusion: A specific etiology was found in % of
those with cerebral infarcts and in / of those with
transient ischemic attacks. Determination of etiology
led to specific preventive treatment in 'A of the
patients.
Key words: cerebral ischemia, cerebral infarction, tran-
sient cerebral ischemia, carotid artery stenosis, lacunar
infarction, cardioembolic sources, carotid ultrasonography,
echocardiography, carotid endarterectomy.
Ágrip
Inngangur: Ekki hafa áður verið birtar nið-
urstöður rannsókna á Islandi sem lýsa orsökum
heilablóðþurrðar. Tilgangur rannsóknarinnar
var að athuga hvernig orsakir heiladreps og
skammvinnrar heilablóðþurrðar voru greindar
á endurhæfinga- og taugadeild Borgarspítalans
árið 1994, hverjar þær voru og hvernig brugð-
ist var við þeim.
Efniviður og aðferðir: Litið var afturskyggnt
á sjúkraskrár allra sjúklinga sem lögðust inn á
endurhæfinga- og taugadeild Borgarspítalans
árið 1994 með greininguna heiladrep og skamm-
vinn heilablóðþurrð, en heilablæðingar voru
undanskildar. Meðalaldur hópsins var 68,5 ár
(25-89 ára) og hlutfall karla og kvenna 59:43.
Tölvusneiðmynd af höfði var framkvæmd hjá
98 (98%) einstaklingum. Ómun af hálsslagæð-