Journals / Akademik Acil Tıp Dergisi / 2009 / Cilt: 8 - Sayı: 4

Hemorajik ve iskemik inme ayırıcı tanısında D-dimer ve diğer koagülasyon belirteçlerinin değerliliği

Clinical value of D-dimer and other coagulation markers ın differantial diagnosis of hemorrhagic and ıschemic stroke

Pages
38–42
Publication Date
2022-10-12
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In our study, a difference between hemorrhagic stroke and TIA groups was observed, while no difference was found between ischemic and hemorrhagic stroke groups regarding coagulation markers.

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: This study aims to determine the clinical value of some laboratory markers(D- dimer, Fibrinogen, etc levels) as alternatives to expensive and sometimes unavailable advanced radiographic techniques, in differentiation and early diagnosis of hemorrhagic and ischemic stroke which require distinct diagnosis, monitoring and treatment methods.Materials and Methods: The study includes 100 adult patients who applied to Emergency Department of Uludag University with clinical symptoms of stroke.
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Key Findings & Data:CT and MRI detections were assessed by radiology specialists blindly.Findings: Of 100 patients included in the study, 53% were women and 47% were men.
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Conclusion & Impact:In our study, a difference between hemorrhagic stroke and TIA groups was observed, while no difference was found between ischemic and hemorrhagic stroke groups regarding coagulation markers.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Purpose: This study aims to determine the clinical value of some laboratory markers(D- dimer, Fibrinogen, etc levels) as alternatives to expensive and sometimes unavailable advanced radiographic techniques, in differentiation and early diagnosis of hemorrhagic and ischemic stroke which require distinct diagnosis, monitoring and treatment methods.Materials and Methods: The study includes 100 adult patients who applied to Emergency Department of Uludag University with clinical symptoms of stroke. At presentation on all of the patients and D-dimer, fibrinogen and other laboratory tests were studied. For differentiation of hemorrhagic and ischemic stroke, computerized tomography(CT) and magnetic resonance imaging(MRI) were taken. CT and MRI detections were assessed by radiology specialists blindly.Findings: Of 100 patients included in the study, 53% were women and 47% were men. In 28% of the patients, ischemic stroke, in 21%, hemorrhagic stroke and in 48%, transient ischemic attack (TIA) was detected, while remaining 3% were assessed as normal. Average age of patients with ischemic stroke was found higher than that of patients with hemorrhagic stroke. No significant difference was observed when patients were grouped by sexes. Coagulation markers, D-dimer and aPTT were significantly different between hemorrhagic stroke and TIA groups while no significant difference was observed between ischemic and hemorrhagic stroke groups.Results: Ischemic and hemorrhagic strokes cause homeostatic anomalies besides the brain damage accompanying. In our study, a difference between hemorrhagic stroke and TIA groups was observed, while no difference was found between ischemic and hemorrhagic stroke groups regarding coagulation markers.

Özet

Amaç: Bu çalışma tanı, takip ve tedavisi farklı olan iskemik ve hemorajik strokların ayrımında ve erken tanısında pahalı ve her zaman elde bulunmayan ileri radyolojik görüntüleme teknikleri yerine laboratuarda bakılabilen bazı belirteçlerin (D-dimer, Fibrinojen vb) değerlerliliğini tespit etmek amacıyla yapılmıştır.Yöntem-Gereçler: Uludağ Üniversitesi Acil Servisine strok kliniğiyle başvuran 18 yaş üstü 100 erişkin hasta çalışmaya dahil edilmiştir. Tüm hastalardan başvuru anında D-dimer, Fibrinojen ve diğer laboratuar tetkikleri istenmiştir. Çalışmaya alınan hastalarda hemorajik ve iskemik strok ayrımı için, kranial kompüterize Tomografi (CT) ve kranial Manyetik Rezonans Görüntüleme (MR) çekilmiştir. CT ve MR tetkikleri uzman radyologlar tarafından kör olarak değerlendirilmiştir.Bulgular: Çalışmaya alınan 100 hastanın %53’ü kadın ve %47’si erkekti. %28 olguda iskemik strok, %21 olguda hemorajik strok, %48 olguda geçici iskemik atak (GİA) saptanmış olup, kalan %3 olgu ise, normal olarak değerlendirildi. İskemik stroklu olguların yaş ortalaması anlamlı olarak kanamalı olgulardan daha yüksek saptandı. Cinsiyete göre bakıldığında ise, her iki grup arasında anlamlı fark saptanmadı. Koagülasyon belirteçlerine göre ise; hemorajik strok ve GİA grubu arasında D-dimer ve aPTT değerleri anlamlı farklılık gösterirken, iskemik ve hemorajik strok arasında istastistiksel olarak anlamlı farklılık saptanmadı.Sonuçlar: İskemik ve hemorajik stroklar beraberinde meydana gelen beyin hasarından hariç hemostatik anormalliklere de neden olmaktadırlar. Bizim çalışmamızda hemorajik strok ve GİA grubu arasında koagülasyon parametreleri açısından fark saptanırken, hemorajik ve iskemik stroklu olgular arasında ise fark saptanmamıştır.

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Cite This Article

ÖZÜÇELİK, D. N., AYDIN, Ş. A., BULUT, M., ÖZDEMİR, F., KÖKSAL, Ö. (2022). Hemorajik ve iskemik inme ayırıcı tanısında D-dimer ve diğer koagülasyon belirteçlerinin değerliliği. Akademik Acil Tıp Dergisi, Cilt: 8 - Sayı: 4, 38–42. https://ajindex.com/articles/431789

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References (15)

  1. M. Bulut, Ş.A.Aydın. Akut İnme. In: S. Satar, Ö. Karcıoğlu, editors. Kardiyak Aciller. 1st ed. İstanbul: Nobel Kitabevi; 2008. p.459
  2. Scott AP, Barsan WG. Stroke, Transient ischemic attack, and other central focal conditions. In: Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine: A Comprehensive Study Guide. 5th ed. North Carolina: McGraw-Hill; 1999. pp. 1430-1439
  3. Warlow C, Dennis MS, van Gijn J, et al. Stroke. A practical guide to management. Oxford: Blackwell; 1996
  4. Emre U, Durukan A, Tatlısumak T. İskemik İnmede Acil Tanı ve Tedavi Yaklaşımları. Turkiye Klinikleri J Surg Med Sci. 2007;3:6-12
  5. Mullins ME, Schaefer PW, Sorensen AG, Halpern EF, Ay H, He J, et al. CT and conventional and diffusion- weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology. 2002;224:353-60
  6. Wintermark M, Bogousslavsky J. Imaging of acute ischemic brain injury: the return of computed tomography. Curr Opin Neurol. 2003;16:59-63
  7. Grunwald I, Reith W. Non-traumatic neurological emergencies: imaging of cerebral ischemia. Eur Radiol. 2002;12:1632-47
  8. Campbell BG, Zimmerman RD. Emergency magnetic resonance of the brain. Top Magn Reson Imaging. 1998;9:208-27
  9. Landi G, D’Angelo A, Boccardi E, Candelise L, Mannucci PM, Nobile Orazio E, et al. Hypercoagulobility in acute stroke:prognostic signifcance. Neurology. 1987;37:1667-71
  10. Takano K, Yamaguchi T, Kato H, Omae T. Activation of coagulation in acute cardioembolic stroke. Stroke. 1991;22:12-6
  11. Yamazaki M, Uchiyama S, Maruyama S. Alterations of haemostatic markers in varios subtypes and phases of stroke. Blood Coagulations Fibrinolysis. 1993;4:707-12
  12. Antovic J, Bakic M, Zivkovic M, Ilic A, Blomback M. Blood coagulation and fbrinolysis in subarachnoid haemorhage compared to other types of stroke?. Scan J Clin Lab Invest. 2002;62:195-9. 13. de Moerloose P, Boehlen F. Should neurogists measure D-Dimer concentrations?. Lancet Neurol. 2003;2:77
  13. Li F, Zhang G, Zhao W. Coagulation and fbrinolytic activity in patients with acute cerebral infarction. Chin Med J (Engl). 2003;116:475-7
  14. Ageno W, Finazzi S, Steidl L, Biotti MG, Mera V, Melzi D’Eril G, et al. Plasma measurement of D-Dimer levels for the early diagnosis of ischemic stroke subtypes. Arch Intern Med. 2002;162:2589-93
  15. Koch HJ, Horn M, Bogdahn U, Ickenstein GW. The relationship between plasma D-dimer concentrations and acut ischemic stroke subtypes. J Stroke Cere