Abstract:

Aim: was to identify and analyze key factors affecting the outcome of subarachnoid hemorrhage (SAH) in patients with ruptured cerebral aneurysms and endovascular embolization.

Materials and methods: as a material for this study, results of endovascular treatment of 150 patients with ruptured cerebral aneurysms operated in the acute period of subarachnoid hemorrhage were analyzed.

Results: statistically significant factors influencing the target indicator «Unfavorable outcome» on the Rankin scale (mRs 3-5) and the indicator «Fatal outcome» in patients with SAH who underwent endovascular method were identified. Among factors contributing to an unfavorable outcome are: severity of neurological status, prevalence of SAH according to computed tomography (CT), timing of surgical treatment from the moment of onset of SAH symptoms.

Conclusion: factors of severity of the condition on the Hunt-Hess scale (HH), severity of subarachnoid hemorrhage on the Fischer scale (F) and timing of the operation have the greatest influence on the outcome of subarachnoid hemorrhage of aneurysmal genesis.

Abstract

Article provides a literature review on problems of diagnosing of intracranial aneurysms (IA) rupture and its complications.

Aim: was to study relevant data on the use of computed tomography (CT), as well as other imaging methods, in patients with ruptured aneurysms in the acute period.

Materials and methods: a search was conducted for publications on this topic, dating up to December 2019, using main Internet resources: PubMed databases, scientific electronic library (Elibrary), Scopus, ScienceDirect, Google Scholar.

Results: we analyzed 45 literature sources, covering the period from 1993 to 2019, which include 3 meta-analyzes, 5 descriptions of studies evaluating the effectiveness of various visualization methods for ruptured IA. Both foreign and Russian publications were involved.

Conclusion: native CT is the leading visualization method to detect hemorrhages in nearest hours after the rupture of IA. CT angiography in combination with digital subtraction angiography (DSA), according to the vast majority of authors, allows to make thorough preoperative planning in the shortest time, as well as to identify unruptured aneurysms. Based on the obtained data, it is advisable to conduct a study to assess the role of CT in the acute period of IA rupture, as well as in the diagnosis of complications in the early postoperative period.

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Abstract:

Aim: was to submit a five-year experience in the treatment of vasospasm in patients after subarachnoid hemorrhage (SAH) due to rupture of a brain aneurysm.

Materials and methods: from 2007 to 2013 in clinic were operated 178 patients with acute SAH (87 patients underwent aneurysm clipping, 91 endovascular embolization).

Resavasospasm according to TCD was observed in 85% of patients. Mild vasospasm was observed in 55% , moderate in 31,8%, and 13,2% of patients had severe vasospasm. Chemical angioplasty was performed in 20 patients. Clinical manifestations of vasospasm in the form of ischemic neurological disorders observed in 8 patients. Five of them received balloon angioplasty of intracranial arteries. In 2 patients vasospasm was the cause of death. In 3 cases spasm was the cause of disability in the rough. In one case, when performing balloon angioplasty occurred fatal gap MCA.

Conclusion: treatment of vasospasm in patients with SAH remains a challenge and requires a comprehensive approach and multidisciplinary therapy.

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