Гиперсомния и избыточная дневная сонливость при ишемическом инсульте

В ряде исследований продемонстрирована высокая частота нарушений сна у пациентов с инсультом. В настоящем обзоре обсуждаются варианты расстройств бодрствования, наблюдаемые при ишемическом инсульте, с учетом актуальной терминологии, а также методы их диагностики. Предметом дискуссий остается происхождение постинсультной гиперсомноленции, отсутствует однозначное мнение о патофизиологии этого синдрома в раннем постинсультном периоде. Несмотря на то, что в качестве звеньев патогенеза гиперсомноленции, вызванной ишемическим инсультом, предлагаются механизмы орексин-лигандной недостаточности, дегенерации орексиновых нейронов, а также нарушения связей гистаминергической и орексинергической систем, конкретных и четких представлений о ее генезе до сих пор не сформировано. В статье рассмотрены вопросы патофизиологии гиперсомнии и избыточной дневной сонливости у пациентов с ишемическим инсультом, продемонстрированы различные точки зрения о взаимосвязи этих патологических феноменов с инсультом. На основании данных литературы рассмотрена гипотеза о компенсаторном характере гиперсомнии и избыточной дневной сонливости при остром ишемическом инсульте и их возможном нейропротективном воздействии на головной мозг у пациентов с инсультом.

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