Cerebral hemispheres – cerebellum – kidney interaction in patients with acute cerebral ischemia

O.M. Kononets; O.V.  Tkachenko; O.O.  Kamenetska

doi:10.26641/2307-0404.2021.1.227941

Authors

O.M. Kononets Shupyk National Medical Academy of Postgraduate Education, Department of Neurology N 2, Dorohozhytska str., 9, Kyiv, 04112, Ukraine, Ukraine https://orcid.org/0000-0002-3060-5911
O.V. Tkachenko Shupyk National Medical Academy of Postgraduate Education, Department of Neurology N 2, Dorohozhytska str., 9, Kyiv, 04112, Ukraine, Ukraine https://orcid.org/0000-0001-5486-4996
O.O. Kamenetska Shupyk National Medical Academy of Postgraduate Education, Department of Neurology N 2, Dorohozhytska str., 9, Kyiv, 04112, Ukraine, Ukraine https://orcid.org/0000-0001-6098-4740

DOI:

https://doi.org/10.26641/2307-0404.2021.1.227941

Keywords:

acute ischemic stroke, lateralization of brain function, cerebellum, renal concentration-filtration function

Abstract

The nervous system, in particular the autonomic one, is well known to constantly regulate the internal functioning of the body, adapting it to changeable external and internal environmental parameters. In particular, there is a close multiple-vector correlation between the nervous system and the kidneys. The aim of this study was to specify the mechanisms, clinical and paraclinical characteristics of the concomitant lesions of the nervous system and the kidneys in patients with acute stroke. This paper presents the case report of 215 patients, aged 70 ± 8.44, who suffered from ischemic stroke. Among them, we examined 144 women and 71 men. The patients underwent a comprehensive examination, including a detailed clinical and neurological check-up (evaluating the patients’ condition severity with the National Institutes of Health Stroke Scale (NIHSS) and the Barthel index on admission and on the 21^st day of the disease), laboratory analysis (electrolyte balance, nitrogen metabolism (on admission and on the 21^st day of the disease) and instrumental examination (CT scan of the brain, the follow-up brain magnetic resonance imaging). The statistical methods were used to analyze the data. In the 1^st day of the disease, all the surveyed patients with right hemispheric carotid stroke and the overwhelming majority of the patients with left hemispheric carotid stroke and ischemic stroke in the vertebrobasilar system had cerebral renal syndrome, represented by renal concentration-filtration dysfunction, accompanied by the reduced glomerular filtration rate. A reliable relationship was found between the renal concentration and filtration function and the right hemispheric ischemic focus in patients with ischemic stroke, the characteristics are to be specified.

References

El Husseini N, Fonarow G, Smith E, Ju C, Sheng S, Schwamm L, et al. Association of Kidney Function With 30-Day and 1-Year Poststroke Mortality and Hospital Readmission. Stroke. 2018;49(12):2896-903. doi: http://doi.org/10.1161/STROKEAHA.118.022011

Freeman W, Wadei H. A Brain–Kidney Connection: The Delicate Interplay of Brain and Kidney Physiology. Neurocritical Care. 2015;22(2):173-5. doi: http://doi.org/10.1007/s12028-015-0119-8

Kelly D, Rothwell P. Disentangling the multiple links between renal dysfunction and cerebrovascular disease. Journal of Neurology, Neurosurgery & Psychiatry. 2019;91(1):88-97. doi: http://doi.org/10.1136/jnnp-2019-320526

Legrand M, Sonneville R. Understanding the renal response to brain injury. Intensive Care Medicine. 2019;45(8):1112-5.

doi: http://doi.org/10.1007/s00134-019-05685-z

Nishi E, Bergamaschi C, Campos R. The crosstalk between the kidney and the central nervous system: the role of renal nerves in blood pressure regulation. Experimental Physiology. 2015;100(5):479-84. doi: http://doi.org/10.1113/expphysiol.2014.079889

Peacock J, Peacock P. Oxford handbook of medical statistics. 2nd ed. Oxford University Press; 2020.

Rowat A, Graham C, Dennis M. Renal Dysfunction in Stroke Patients: A Hospital-Based Cohort Study and Systematic Review. International Journal of Stroke. 2014;9(5):633-9. doi: http://doi.org/10.1111/ijs.12264

Sakakibara R. The cerebellum seems not a ‘little brain’ for the autonomic nervous system. Clinical Neurophysiology. 2019;130(1):160. doi: http://doi.org/10.1016/j.clinph.2018.08.021

Snarska K, Kapica-Topczewska K, Bachórzewska-Gajewska H, Małyszko J. Renal Function Predicts Outcomes in Patients with Ischaemic Stroke and Haemorrhagic Stroke. Kidney and Blood Pressure Research. 2016;41(4):424-33. doi: http://doi.org/10.1159/000443444

Chen S, Li Q, Wu H, Krafft P, Wang Z, Zhang J. The Harmful Effects of Subarachnoid Hemorrhage on Extracerebral Organs. Biomed Res Int. 2014;2014:858496. doi: http://doi.org/10.1155/2014/858496

Lawrenson C, Bares M, Kamondi A, Kovács A, Lumb B, Apps R, et al. The mystery of the cerebellum: clues from experimental and clinical observations. Cerebellum & Ataxias. 2018;5(1). doi: https://doi.org/10.1186/s40673-018-0087-9

Wiebers D, Feigin V, Brown R. Handbook of stroke. 3rd ed. Philadelphia: Wolters Kluwer; 2019. p. 500.