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Dypkrtk`sae` j`l joka`o rkfjtkl scjff jrtkry

laskjsks eg tdk brja` (^JLB)

Be @errva`o

Lkpjrtck`t eg @kurefeoy

Fu`l [`avkrsaty Despatjf

^wklk`

NJLJ^AF sycpesauc

Xjras, ^kpt :1-28, 28:>

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\dk 28:8 Ofebjf Burlk` eg Laskjsk ^tuly

Fj`nkt Lkn :;, 28:2

Dypkrtk`sae` tdk

cest acpertj`t

rasm gjnter ofebjffy

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Ofebjf rasm gjnter rj`ms :118 j`l 28:8

:118 28:8 % ndj`ok

Ndafldeel u`lkrwkaodt Daod bfeel prkssurk 2? %Deuskdefl jar peffutae` ^cema`o > %

^cema`o Deuskdefl jar peffutae` ->2 %

Daod bfeel prkssurk Few gruat 21 %

^ubeptacjf brkkst gkkla`o Jfnedef usk >2 %

Fj`nkt Lkn :;, 28:2

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Ndj`oks a` fagk kxpkntk`ny :1?8 te 28:8

Cjfks9 a`nrkjsk grec ;7.< ykjrs te 7?.; ykjrs

Gkcjfks9 a`nrkjsk grec 7:.2 ykjrs te ?>.> ykjrs

Fj`nkt Lkn :;, 28:2

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Rasm gjnter Xepufjtae`-jttrabutjbfk rasm, %(11% NA)

Dypkrtk`sae` >8.1.:)^cema`o :4.1 (:;.>2>.:)_jast-te-dap rjtae (tkrtafk 2 vs tkrtafk :) 27.; (:4.4>7.8)Laktjry rasm snerk (tkrtafk 2 vs tkrtafk :) :4.4 (::.221.?)Rkoufjr pdysanjf jntavaty 24.; (:

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A@\KR^\REMK9 cjier ga`la`os

:8 celagajbfk rasm gjnters kxpfja` 18 % eg stremk

\dk pepufjtae` jttrabutjbfk rasm ger dypkrtk`sae`

wjs jfcest twank daodkr tdj` ger nere`jry dkjrt

Laskjsk (A@\KRDKJR\)= >

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Fjnu`jr stremk

dew acpertj`t as dypkrtk`sae`5

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Fjvjles kt jf. Fj`nkt @kurefeoy 288?=79:

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% fjnu`jr_u kt jf. Nkrkbrevjsn Las 28:8=219:4:-4?

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Leks tdk rasm gjnter pregafk laggkr bktwkk`

fjnu`jr a`gjrnts j`l etdkr typks eg brja`

a`gjrnt5

Nfjssaganjtae` bajs ger fjnu`jr a`gjrnts5

\EJ^\-nfjssaganjtae`9 scjff vksskf laskjsk njtkoery9

- Fjnu`jr sy`lreck

- Brja` acjoa`o `ercjf er rkfkvj`t fksae` 6:.; nc

- J dastery eg dypkrtk`sae` j`l lajbktks supperts tdklajo`esas

- @e njrlajn seurnk eg kcbefasc

- @e fjrok jrtkry stk`esas 0;8 %

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Dypkrtk`sae` cerk necce` a` fjnu`jr stremk tdj` etdkr

subtypks a` stulaks watd nfjssaganjtae` bajs

Ijnmse` j`l ^ulfew. Jrk fjnu`jr stremks rkjffy laggkrk`t5

^tremk 288;.=>7941:-187941:-18? pjtak`ts watd j cafl nertanjf er fjnu`jr sy`lreck djl j`

jnutk asndkcan fksae` e` L_A.

2:/1> (2>%) watd j nertanjf sy`lreck djl

j` jnutk fjnu`jr a`gjrnt

?/1;

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Necpjrase` bktwkk` EN^X subtypks j`l

lw-CRA ga`la`os

Nfa`anjf gkjturks (j`l `kojtavk N\) vkry u`nkrtja` bjsas

ger lajo`esas eg fjnu`jr a`gjrnt.

Xesatavk prklantavk vjfuk ger fjnu`jr a`gjrnt grec FJNA

subtypk e`fy

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^kagkrt kt jf. I @kuref @kuresuro Xsyndajtry. 288; @ev=?7(::)9:;28- pjtak`ts watd subnertanjf er brja`stkc L_A fksae`s 6:.; nc

a` lajcktkr 6? ljys grec tdk e`skt eg stremk sycptecs.

E`fy

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Fj`nkt Juo :8 28:>

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^afk`t nkrkbrjf a`gjrnts

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Wkrckkr kt jf. Fj`nkt @kurefeoy 288?=797::-7:1

Xrkvjfk`nk eg safk`t nkrkbrjf a`gjrnts

a` tdk pepufjtae`9 evkrvakw eg stulaks

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:1 eut eg 28 safk`t a`gjrnts jrk subnertanjf

Wkrckkr kt jf. ^tremk 2882=>>92:-2;

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Wkrckkr kt jf. Fj`nkt @kurefeoy 288?=797::-7:1

^afk`t nkrkbrjf a`gjrnt9 rasm gjnters

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Cerkju kt jf. ^tremk 28:2=9:4>?-

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_jrlfjw I kt jf. Fj`nkt @kurefeoy 28:>=:29-1?

J laggkrk`tajf lajo`esas9 pkravjsnufjr (Warndew-Reba ) spjnks

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Rknk`t scjff

subnertanjf a`gjrnt

_datk cjttkr

dypkra`tk`satyFjnu`k

Xkravjsnufjr

spjnk

Nkrkbrjf

canrebfkkls

[sujf lajcktkr: 6 28 cc vjrajbfk > -:; cc 6 2cc 6 :8 cc

Necck`t bkst alk`tagakl e`

L_A

fenjtkl a` wdatk

cjttkr

usujffy djvk

dypkra`tk`sk

rac

usujffy

fa`kjr watdeut

dypkra`tk`sk rac

lktkntkl e` ORK

skq., reu`l er

eveal, bfeeca`o

L_A d : :/(a) : :

GFJAR d d a a a

\2 d d d d a

\: a :/(a) a a :

\2* / ORK : d :

(a ag dkcerrjok)

: aa

\dk Nk`tkrs eg Kxnkffknk a` @kurelkok`krjtae` Wjsnufjr Acjoa`o ^tj`ljrls

_erma`o Oreup. Fj`nkt @kurefeoy 28:>

Ndjrjntkrastans eg ^WL-rkfjtkl CR acjoa`o ga`la`os

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Xettkr kt jf. ^tremk 28:8=?-

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_jrlfjw I kt jf. Fj`nkt @kurefeoy 28:>=:29-1?

Necce` fjtk skqukfjk eg jnutk scjff lkkp a`gjrnts

Lasjppkjrkl

\ur`kl a`te _CD

Njvatjtkl (fjnu`k)

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scjff

subnertanjf a`gjrnt

fjrok

subnertanjf a`gjrnt

(k.o. strajtenjpsufjr)

etdkr fksae`

(k.o. scjff lkkp AND,

a`gfjccjtery fksae`)

jnutk

wdatk cjttkr

dypkra`tk`saty

`ercjf er

`kjrfy ercjf CRA

fjnu`kndre`an

tack

stremk sycptecs,

`e vasabfk fksae`

\dk Nk`tkrs eg Kxnkffknk a` @kurelkok`krjtae` Wjsnufjr Acjoa`o ^tj`ljrls_erma`o Oreup. Fj`nkt @kurefeoy 28:>

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^afk`t subnertanjf a`gjrnts j`l wdatk cjttkr laskjsk

egtk` nekxast

Muffkr kt jf. ^tremk 288;9:42:-2;

http://stroke.ahajournals.org/content/vol35/issue8/images/large/8FF1.jpeg

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Xjrt eg _CL as luk te efl a`gjrnts .

^afk`t nkrkbrjf a`gjrnts _datk Cjttkr Dypkra`tk`sataks

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Nfa`anjf njvkjts a` safk`t brja` a`gjrnts

Cjy djvk bkk` trufy safk`t a k lal `et njusk

jnutk `kurefeoanjf lysgu`ntae`

But

- sycptecs cjy djvk bkk` geroettk`

- a`gjrnt cjy djvk bkk` ca`acjffy sycptecjtan

- cjy djvk bkk` j \AJ

- asndkcan kvk`t lura`o sfkkp

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Fenjfazjtae` as tdk mky9 a`vefvkck`t eg ceter

j`l sk`sery fe`o trjnts subnertanjffy

_djt cjmks scjff lkkp a`gjrnts sycptecjtan5

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Brja` Xjtdefeoy 28:2=229;4>-1:

^ycptecjtan j`l safk`t scjff lkkp a`gjrnts= as at tdk sjck

laskjsk5

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ANL :: Nkrkbrevjsnufjr Laskjsks sa`ofk bfenm

A` tdk Laskjsks eg tdk @krveus ^ystkc ndjptkr

Nkrkbrevjsnufjr laskjsk watd `e jnutk nkrkbrjf sycptecs

^afk`t nkrkbrjf a`gjrnt

Lkga`atae`9 Nkrkbrjf a`gjrnt tdjt djs `et njuskl jnutk genjf lysgu`ntae` eg tdk brja`

^afk`t nkrkbrjf canrebfkklLkga`atae`9 ^cjff bfkkla`o a` tdk brja` pjrk`ndycj tdjt djs `et njuskl jnutk

genjf lysgu`ntae` eg tdk brja`

^afk`t wdatk cjttkr jb`ercjfataks jssenajtkl watd vjsnufjr laskjsk

Lkga`atae`9 Jb`ercjfataks a` tdk nkrkbrjf wdatk cjttkr eg prevk` er jssuckl

vjsnufjr eraoa`

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^afk`t nkrkbrjf canrebfkkls :(2)

< pepufjtae` bjskl stulaks

@ Ckj` jok Xrkvjfk`nk

Justraj` ^tremk Xrkvk`tae` ^tuly 248 78 7.< %

Grjca`odjc ^tuly

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^afk`t nkrkbrjf canrebfkkls 2(2)

Xjtak`ts watd fjnu`jr stremk:

^kvkrjf bfeel prkssurk a`lanks jssenajtkl watd canrebfkkls (a` pjrtanufjr

lkkp canrebfkkls)

Xjtak`ts watd NJLJ^AF2

Dbj:n, FLF, j`l systefan bfeel prkssurk jssenajtkl watd daodkr prebjbafaty eg

j`y canrebfkkl

^ystefan X j`l dypkrtk`sae` jssenajtkl watd cuftapfk NCBs

:

^tjjfs kt jf, ^tremk 2881=27?;-4>

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Ok`ktans rkfjtkl te

- stremk subtypk (scjff vksskf stremk)

- a`tkrcklajtk gk`etypk (dypkrtk`sae`)

C t t m

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\rjyfer kt jf. Fj`nkt @kuref 28:2=::91;:-172. ^kk jfse Bkffk`oukz kt jf. @jt Ok` 28:2=>>.

Cktjstremk

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Ndreceseck 7p2:.:

Deffaljy kt jf. @jturk Ok`ktans 28:2=

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Ok`eckwalk sao`aganj`nk, rkfjtkl tenejoufjtae`/gabra` pdk`etypks

Rs;8;122 (v_G a` JBE-ok`k), rkfjtkl te

^tremk, p38.82>

_affajcs kt jf.

J`` @kuref 28:>=?>9:7->:.

Rs;8;122, ndreceseck 1 rkfjtkl te9

Asndkcan stremk p38.88:

NK p38.8882

FJJ p38.88:

^WL p3`s

JB8 fenus e`ndreceseck 1

M`ew` tdjt `e`-8 bfeeloreups

jrk rkfjtkl te stremk rasm

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Celagakl, grec9 Bkvj` kt jf. Nurr Jtdkresnfkr Rkp 28:>,:;9>

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ON\J

Ok`eckwalk necpfkx trjat j`jfysasJffews kstacjtae` eg dkratjbafaty by jsskssa`o jff ^@Xs a` tdk celkf

Ger jff stremk >?.1% dkratjbafaty

Bkvj` kt jf. ^tremk 28:2==>:7:->:7?.

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A`tkrcklajtk pdk`etypk9

Dypkrtk`sae`

Rasm snerk eg 21 vjraj`ts rkfjtkl tedypkrtk`sae` wjs rkfjtkl te stremk

Kdrkt kt jf. @jturk 28::.

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Bfeel prkssurk vjrajbafaty

Retdwkff XC. Fj`nkt 28:8=>?;91>4-

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Leks fewkra`o bfeel prkssurk dkfp5

^ubstulaks eg XREORK^^

N\ substuly9 `e sao`aganj`t kggknt eg BX fewkra`o

e` rjtk eg safk`t nkrkbrjf a`gjrnts evkr >.1 ykjrsDjskojwj kt jf 288

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Fj`nkt Juo :8 28:>

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Fj`nkt Juo :8 28:>

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K`letdkfajf lysgu`ntae` a` scjff vksskf laskjsk

^y`kroasc watd dypkrtk`sae`5

_jrlfjw I, ^catd N, Landoj`s C. Fj`nkt @kurefeoy 28:>= :29-1?

NE@NF[^AE@^

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NE@NF[^AE@^

Dypkrtk`sae` j`l jok jrk nerk rasm gjnters ger jff necce` gercs

eg scjff vksskf laskjsk eg tdk brja`

^cjff vksskf asndkcan pdk`etypks jrk `kvkrpurk9 nfa`anjf

j`l acjoa`o njvkjts

Landetecazkl lkga`atae` eg dypkrtk`sae` evkrsacpfagakl9

bfeel prkssurk vjrajbafaty jppkjrs jt fkjst js acpertj`t

js bfeel prkssurk fkvkfs

Ok`ktan necpe`k`t eg fjnu`jr stremk jppkjrs scjffkr tdj`ger etdkr stremk subtypks

Dypkrtk`sae` pfjys j mky refk a` jff jspknts eg