Akut İnmeli Olguların Başvuru Anındaki Kan Basıncı ve Nabız Sayısı Değerlerinin Tutulan Beyin Yarıküresi ile İlişkisi‡

Abstract

Akut inmeli olguların neredeyse tamamına yakınında kan basıncı (KB) yükselmekte ve bu yükselmenin artmış sempatik aktivite ile ilişkili olduğu öne sürülmektedir. Kalp-damar ve baroreseptör sistemlerinin otonomik kontrolünde hemisferik lateralitenin (HL) önemli olduğu bildirilmektedir. Literatürde akut inmede sağ, sol veya her iki hemisfer tutulumunun kalp-damar sisteminin fonksiyonlarında değişikliğe yol açabileceği yönündeki HL ile ilgili sonuçlar çelişkilidir. Biz akut inmeli olgularda başvuru anındaki KB ve nabız sayısı (NS) değerlerinin tutulan beyin yarı küresi (BYK) ile ilişkisini araştırmak istedik. Bu çalışmada Acil servise inmenin ilk 24 saati içinde başvuran hastaların başvuru anındaki KB ve NS değerleri ile birlikte, tutulan BYK ile ilgili bilgiler geriye dönük olarak incelendi. Otuzyedi hastanın 19’unda sağ ve 18’inde sol BYK tutulumu vardı. Sağ hemisfer tutulumlu hastalarda ortalama sistolik KB 165,2±31, diyastolik KB 94,7±18 mmHg ve NS 87,4±16/dk iken sol hemisfer tutulumlu olanlarda sistolik KB 160,5±40, diyastolik KB 90,5±22 mmHg ve NS 83,2±19/dk olup fark anlamlı değildi (p>0.05). Her ne kadar biz akut inmenin erken dönemindeki otonomik aktivite değişikliğini yansıtabilen KB ve NS üzerindeki etkisi bakımından tutulan BYK’leri arasında anlamlı fark olmadığı sonucuna vardık ise de sağ hemisfer tutulumunun bu değerleri daha fazla etkileyeceği düşüncesindeyiz. The Relationship Between The Involved Hemisphere Of The Brain And Blood Pressure Level And Pulse Rate During Admission In Acute Stroke Patients In almost all of patients with acute stroke, blood pressure elevates and this status is associated with an increased sympathetic activity. It has been reported that in the autonomic control of the cardiovascular and baroreceptor systems, the hemispheric laterality (HL) is important. In the literature, in acute stroke, the results of, HL, the involvement of the right, left or both hemispheres causing cardiovascular dysfunction are contradictory. We would like to research the relationship between the involved hemisphere of the brain and blood pressure (BP) level and pulse rate (PR) during admission in acute stroke patients. In this study, we assessed retrospectively the data of involved hemisphere, with admission BP level and PR of patients presenting within the first 24 hours of acute stroke in emergency room. Of 37 patients, 19 had right hemispheric involvement, and 18 had left hemispheric involvement. While in the patients with right hemispheric involvement, main systolic BP was 165,2±31, diastolic BP was 94,7±18 mmHg and PR was 87,4±16/min, in those with left hemispheric involvement, 160,5±40, 90,5±22 mmHg and 83,2±19/min, respectively (p>0.05). Although, we did not detect a significant difference between involved cerebral hemispheres for increased BP and PR values pointing to an alteration in the autonomic activity in the early period of acute stroke, had an idea that the right hemispheric involvement affected these parameters more than other involvements.

Keywords

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