S-3-06-04
CLINICALLY SYMPTOMATIC DEEP VENOUS THROMBOEMBOLISM IN A STROKE REHABILITATION POPULATION.
Marchuk Y, Teasell R, McRae M.
Department of Physical Medicine and Rehabilitation, London Health Sciences Centre and University of Western Ontario, London, Ontario, Canada, and Kiev Neurological Institute Kieve, Ukraine.
Deep venous thrombosis (DVT) and subsequent pulmonary embolism is a major source of morbidity and mortality among stroke patients. We studied 468 consecutive patients admitted to University Hospital, London, Ontario with a hemorrhagic and ischemic stroke severe enough to warrant admission to the hospital's in-patient rehabilitation unit. The study period was between July 1, 1986 and June 30, 1994. 27 patients were subsequently excluded because they had suffered a nonfocal subarachnoid hemorrhage or subdural hematoma leaving 441 patients with a focal stroke and localizing deficits. 21 of these patients had a clinically symptomatic DVT, all confirmed by venography (4.8%); 10 patients went on to develop a pulmonary embolus (2.3%). All were treated with anticoagulants; one patient subsequently suffered a large GI bleed secondary to a stomach carcinoma, could not tolerate the anticoagulants, and required an IVC filter. DVT incidence in patients following an acute ischemic strok is reported to range from 22% to 75% with similar rates among stroke patients admitted to rehabilitation units. The incidence of clinically significant DVTs was much lower than the high rates reported for DVTs in prospective studies where the incidence was determined even for asymptomatic patients.
S-3-06-05
STUDY OF THE DEPRESSION IN 112 PATIENTS WITH STROKE
Guanqing Ding (China-Japan Friendship Hospital, Beijing, China)
Abstract: The depression of 112 consecutive patients with stroke was studied. The purpose was to study the prevalence of post-stroke depression (PSD), influence factors and the efficacy of fluoxetine.
Method: There were 81 cases of cerebral infarction and hemorrhage 31 cases. All patients were diagnosed by CT and/or MRI. Depression was diagnosed by Geriatric Depression Scale Symptom Criteria. Fluoxetine was given after PSD was diagnosed. Follow-up was performed at 10 and 30 days.
Results: Four cases (22.2%) presented with depression in 18 out-patients (major depression 2). Of 94 in hospital patients, 31 (33%) presented with depression (major depression 9). Total prevalence of depression was 31.2% and major depression was 9.8%. This study showed that no significant difference was found of age, sex, occupation, nature and location of the lesion, course of the stroke between depressed and no-depressed patients respectively. The occurrence of depression after stroke with paralyses was higher significant than stroke with no-paralyses (p<0.05). Twenty three patients were treated with fluoxetine, including major depression 8 cases, 18 cases were followed-up. Complete recovery was 72.2% at one month and total effective rate was 88.9%. One patient presented with drup eruption, pruritus, then stopped drug immediately and recovery after three days.
Conclusion This study confirms the high prevalence of PSD. Physician should carefully discover low emotional problems in patients of the stroke. Fluoxetine is effective in treating PSD, side effects are rare.
