Author/Editor		Bucik Kajin, Irena; Goljar, Nika
Title		Zapleti in izidi rehabilitacijske obravnave bolnikov po možganski kapi zaradi disekcije vratne arterije
Translated title		Complications and outcomes of rehabilitations of patients after stroke caused by cervical artery dissection
Type		članek
Vol. and No.		Letnik 14, št. 1
Publication year		2015
Volume		str. 39-44
ISSN		1580-9315 - Rehabilitacija
Language		slv
Abstract		Izhodišča: Disekcija vratnih arterij (DVA) je najpogostejši vzrok za ishemično možgansko kap pri mlajših odraslih. Želeli smo ugotoviti, koliko bolnikov je bilo v zadnjih petih letih zaradi posledic možganske kapi po DVA vključenih v bolnišnične rehabilitacijske programe na Univerzitetnem rehabilitacijske inštitutu Republike Slovenije - Soča (URI - Soča), kakšni so bili izidi rehabilitacije teh bolnikov in ali so se v času rehabilitacije pojavljali zapleti, povezani z DVA. Metode: V retrospektivno raziskavo smo vključili bolnike po možganski kapi zaradi DVA, ki smo jih v obdobju od novembra 2008 do januarja 2014 prvič sprejeli na bolnišnično rehabilitacijsko obravnavo v URI - Soča. Zbrali smo podatke o bolnikovi starosti, spolu, času od nastopa možganske kapi do sprejema na URI - Soča, trajanju hospitalizacije na URI - Soča, o vrsti DVA, vrsti možganske kapi, strani okvare ter o prisotnosti arterijske hipertenzije. Iskali smo tudi podatke o drugih zdravstvenih zapletih ter podatek o zdravljenju z estrogeni. Funkcijsko stanje bolnikov smo ocenili ob sprejemu in ob odpustu z URI - Soča z Lestvico funkcijske neodvisnosti (FIM). Zbrali smo tudi podatke o morebitni rehabilitacijski obravnavi v Centru za poklicno rehabilitacijo in o vrnitvi na delo ali šolanje. Rezultati: Povprečna starost vključenih 20 bolnikov (15 moških in petih žensk) je bila 40 let. Pri osemnajstih bolnikih je bila ugotovljena spontana DVA, pri dveh travmatska DVA. Osemnajst bolnikov je zaradi DVA doživelo ishemično možgansko kap, dva znotraj možgansko krvavitev. Pred DVA se je zaradi arterijske hipertenzije zdravilo pet bolnikov. Trinajst bolnikov v času rehabilitacije na URI-Soča ni imelo dodatnih zdravstvenih zapletov. Pri nobenem bolniku ni prišlo do ponovnega ishemičnega dogodka ali ponovitve DVA. Izidi ob koncu rehabilitacijske obravnave, ocenjeni z lestvico FIM, so bili v povprečju dobri. Dvanajst bolnikov je bilo vključenih tudi v programe poklicne rehabilitacije, od teh se jih je pet vrnilo na delo in eden na šolanje. Zaključek: Disekcija vratnih arterij je zaradi razvoja slikovnih preiskovalnih metod vse pogosteje prepoznana kot pomemben vzrok za možgansko kap pri mlajših odraslih. V subakutnem obdobju, ko so bolniki vključeni v intenzivne rehabilitacijske obravnave, so zapleti redki, zaradi česar je rehabilitacijska obravnava teh bolnikov ob upoštevanju previdnostnih ukrepov varna, napoved izida zdravljena in okrevanja pa dobra, z ugodnim funkcijskim izidom.Background: Dissection of the cervical arteries (DCA) is a major cause of ischemic stroke in young adults. The aim of our study was to determine how many patients after stroke caused by DCA were admitted for the first time to the hospital rehabilitation programmes at the University Rehabilitation Institute in Ljubljana (URI) during the last five years, what were the results of the rehabilitation of these patients, and whether any complications occurred during the rehabilitation. Methods: Our retrospective research included all the patients with stroke due to DCA who were admitted for the first time to inpatient rehabilitation at the URI in the period from November 2008 to January 2014. We collected data on the patient's age, gender, time from stroke onset to admission to the URI, duration of hospitalisation at the URI, the type of DCA, type of stroke and the presence of arterial hypertension. We searched for information on complications due to DCA. The patients' functional status was assessed at admission and at discharge using the Functional Independence Measure (FIM). We also collected data about the eventual rehabilitation at our Centre for Vocational Rehabilitation, and return to work or school. Results: The average age of the 20 patients (15 men and 5 woman) was 40 years. Eighteen patients had spontaneous DCA, two traumatic DCA. Eighteen patients experienced ischemic stroke, two from intracerebral haemorrhage. Five patients had arterial hypertension before DCA. Thirteen patients did not have complications. No patients had any recurrences of ischemic events or DCA. Functional outcome was on average good. Twelve patients were enrolled in vocational rehabilitation during the medical rehabilitation, five of them have returned to work and one to school. Conclusion: Cervical artery dissection is increasingly recognised as an important cause of stroke in young adults thanks to the development of imaging investigation methods. Complications in the subacute period when patients are involved in intensive rehabilitation programs are rare. Rehabilitation treatment of these patients is safe when precautionary measures are regarded. Prognosis of recovery is good with a good functional outcome.
Descriptors		Stroke
Keywords		cervical artery dissection complication rehabilitation outcome možganska kap disekcija vratnih arterij zapleti izid rehabilitacije