79 -5 (91) 2026 - J. Nazarova, N. Alikulova - PREVIOUS TRANSIENT ISCHEMIC ATTACKS AS A FACTOR INFLUENCING THE SEVERITY OF NEUROLOGICAL DEFICIT IN HEMISPHERIC ISCHEMIC STROKE

PREVIOUS TRANSIENT ISCHEMIC ATTACKS AS A FACTOR INFLUENCING THE SEVERITY OF NEUROLOGICAL DEFICIT IN HEMISPHERIC ISCHEMIC STROKE

J. Nazarova - Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan

N. Alikulova - Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan

G.Urinova - Center for the Development of Professional Qualifications of Medical Workers under the Ministry of Health of the Republic of Uzbekistan

Resume

The effect of prior transient ischemic attacks (TIAs) on the dynamics of neurological recovery and the state of dynamic cerebral autoregulation (dCA) after ischemic stroke remains controversial. Objective. To compare changes in neurological status and dCA parameters in patients with a first-ever hemispheric ischemic stroke in the carotid territory, depending on the presence of a history of TIAs. A total of 74 patients were examined (40 with TIAs and 34 without TIAs), aged 40–65 years; the control group consisted of 20 healthy individuals. Neurological outcomes were assessed using the NIHSS, Rankin, and Rivermead scales. Dynamic cerebral autoregulation (dCA) was evaluated using the autoregulation coefficient (CA) and the reactivity coefficient (CR+) based on transcranial Doppler ultrasonography with functional tests. Statistical significance was determined using Student’s t-test at p < 0.05. As early as day 3, patients with TIAs showed a faster regression of neurological deficit (NIHSS 4.40 ± 1.1 vs 6.06 ± 1.1; p = 0.08) and more favorable Rankin dynamics (2.01 ± 0.28 vs 2.44 ± 0.30). The autoregulation coefficient (CA) remained stable (0.81 ± 0.05) by discharge, whereas patients without TIAs continued to exhibit more pronounced impairments in dCA (CA = 0.88 ± 0.08). A negative correlation was found between CA and stroke severity (r = –0.52), and a positive correlation between CR+ and the Rivermead index (r = 0.46). Prior transient ischemic attacks (TIAs) are associated with faster clinical improvement and relatively preserved cerebral blood flow autoregulation in the acute phase of ischemic stroke. Patients without TIAs require more intensive hemodynamic monitoring and personalized prevention, whereas patients with TIAs may begin rehabilitation interventions earlier.

Keywords: transient ischemic attack; ischemic stroke; dynamic cerebral autoregulation.

First page

467

Last page

471

For citation:J. Nazarova, N. Alikulova, G.Urinova - PREVIOUS TRANSIENT ISCHEMIC ATTACKS AS A FACTOR INFLUENCING THE SEVERITY OF NEUROLOGICAL DEFICIT IN HEMISPHERIC ISCHEMIC STROKE//New Day in Medicine 5(91)2026 467-471 https://newdayworldmedicine.com/en/new_day_medicine/5-91-2026

List of References

1. Caplan LR. Stroke: A Clinical Overview. 2nd ed. London: Springer; 2019.
2. Beishon L, Vasilopoulos T, Salinet ASM, Levis B, Barnes S, Hills E, et al. Individual patient data meta-analysis of dynamic cerebral autoregulation and functional outcome after ischemic stroke. Stroke. 2024;55(5):1235-1244. doi:10.1161/STROKEAHA.123.045700.
3. Johnson W, Feigin V. Global stroke facts and figures 2025. Lancet Neurol. 2025;24(1):5-6.
4. Tsivgoulis G, Sharma VK, Alexandrov AV. Impact of transient ischemic attack on stroke outcome. J Neurol Sci. 2023;456:117125.
5. World Stroke Organization. Global Stroke Fact Sheet 2025. Geneva: World Stroke Organization; 2025.
6. Zhao Y, Ma Y. Dynamic changes of cerebral hemodynamics after ischemic attacks. Neurol Res. 2022;44(2):122-130.

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