| 摘要 |
A method for the dynamic evaluation of the cognitive functions and the clinical state of the patients with the acute impairment of cerebral blood circulation comprises the additional examination on Day 7 of hospital stay. The findings are recorded and compared with those at admission. The neurological state is scored in points according to Scandinavian stroke scale SSS, psychical state is estimated according to MMSE scale. Then the dynamics of the additional examinations is assessed (changes in heart rate, arterial blood pressure in the morning and in the evening, the special neurological findings wit analysis of speech disorders, dynamics of meningeal symptoms, bulbar symptomocomplex, dynamics of the parameters of blood and urine analysis, analysis of cerebrospinal fluid, the state of eye-ground, ultrasonic Dopplerography of extracranial blood vessels, axial computed tomography. When the parameters of the additional examinations stated above do not correspond to the physiological standard values and may be considered as the causes of the negative dynamics in the SSS and MMSE assessments, the medicamentous therapy should be corrected. Prior to the discharge from the hospital, the patient is examined once again. The dynamics of the scores according to SSS and MMSE scales is compared with that assessed at admission and 7 days later. The results of the corrected treatment are analyzed by the clinical and paraclinical findings in total. The final conclusion as to the dynamic impairment of the cognitive functions is inferred. The final diagnosis is made, and the recommendations are proposed for further rehabilitation measures. |
