Epidemiology of stroke in the Left bank area of Kyiv region on the eve of the 38th anniversary of the man-made Chernobyl disaster: implementing international experience into practice (modern view of the problem and own research)

Abstract

The article highlights the global problems of stroke. Most of them are associated with three groups of risk factors for stroke: well-known pathogenetic, psychogenic, and ecological factors of environmental pollution. The authors draw attention to this on the eve of 38th anniversary of the man-made Chernobyl disaster (April 26, 1986) comparing data on the stroke in Japan after the Fukushima nuclear accident (March 11–12, 2011) due to the earthquake, which led to the reactor core melting at three power units. Issues of improving the provision of specialized medical care to patients with stroke, risk factors for stroke are considered to minimize the consequences, optimize treatment, prevention of risk factors, especially in areas where the population is exposed to incorporated radiation damage through food, water, milk, fish, meat, berries, mushrooms, as well as the issues of improving the specialized stroke care, creation of stroke centers in regions of Ukraine. Studies conducted show that there are many causes of strokes, and they are not yet fully understood. The features of the clinical course of strokes in the Chernobyl liquidators are their development in the middle (40–49 years) and advanced age, long vascular history characterized by vascular dystonia transformation into dyscirculatory (postradiation) encephalopathy during the onset, the predominance of ischemic stroke over hemorrhagic one, lesions mainly of the carotid system, the relative benignity of clinical course, progressive nature of mental disorders, concomitant somatic pathology, the presence of stable pathomorphological substrate from both vascular endothelial dysfunction and cerebral liquor system. The obtained information complements the data on the pathogenesis, clinical picture, diagnosis of cerebral strokes in Chernobyl liquidators and is of practical interest. Raised issues of optimizing the provision of specialized care in stroke units, centers and further rehabilitation, their sufficient supply, both in terms of staffing and equipment, are becoming a cornerstone in overcoming the stroke epidemic. Based on the above, there is still a need to continue substantial research in this area, promptly develop and implement a scientific concept on the prevention, early detection of major modifiable risk factors for stroke together with family medicine doctors, specialist physicians, proper stroke treatment, which will undoubtedly improve quality of life of patients and their relatives.