gestione delle emergenze neurologiche stroke ... · and bleedings. also, data showed that the best...
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Dr. Andrea Zini
Responsabile S.S. Stroke Unit
Clinica Neurologica
Dipartimento di Neuroscienze
Nuovo Ospedale Civile � S.Agostino-Estense�
Azienda Ospedaliera Universitaria di Modena
GESTIONE DELLE EMERGENZE NEUROLOGICHE
STROKE: INQUADRAMENTO DIAGNOSTICO
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Ictus
Ischemico EmorragicoEmorragico
Cerebral lobesCerebral lobes
Basal gangliaBasal ganglia
ThalamusThalamus
PonsPonsCerebellumCerebellum
80%80% 20%20%
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Tipologie di ictus ischemico
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Aterotrombotico
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Pattern occlusivi
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ANGIO TC
vasi collo e intracranici
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AngioTC trifasica
-circoli collaterali.-
� PRoVe-IT Study
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CBVMTT
Neuroimmagini per la
selezione del paziente
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Uomo, 72 aa
Esordio di deficit VII inferiore nc sinistro, emiparesi
sx, parestesie emisoma sx.
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Lacunare
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Cardioembolico
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Fonti cardioemboliche
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Fonti cardioemboliche
Arboix, Current Cardiology Reviews 2010
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ESUS
Criteria for diagnosis of ESUS:
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Ecocardiogramma
ECG-Holter
AngioTC
Ecocardio + TCCD
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Molina, Stroke 2013
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Lesioni ischemiche emboliche
corticali
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Lesioni ischemiche emboliche
corticali
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Lesioni ischemiche emboliche multiple
(RMN DWI)
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Lesioni ischemiche emboliche multiple
(RMN DWI)
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Trial clinici
Rivaroxaban Versus Aspirin in Secondary Prevention
of Stroke and Prevention of Systemic Embolism in Patients
With Recent Embolic Stroke of Undetermined Source
(ESUS) (NAVIGATE ESUS)
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Grazie per l’attenzione