Retrospective analysis of brain structural changes in early terms of nontraumatic intracranial hemorrhage and prognosis of disease course

Abstract

Introduction. Nontraumatic intracranial hemorrhage (NIH) is not only medical but important social problem because of disease prevalence, it’s severity and high lethality rate. The hemorrhage centers as a rule arise in area of a. cerebri media, frequently at uncontrollable arterial hypertension, rupture of arterial aneurisms and arteriovenous malformations.Materials and methods. Structural features of NIH were estimated in 162 patients, died because of arterial aneurisms or arteriovenous malformations rupture, taking into consideration their structural features. The role of morphological changes in pathogenesis of secondary changes at NIH, depending on their centers localization and duration of treatment, was defined. Main pathogenetic chains links of a thanatogenesis were defined.Results. At hematomas in the zone of capsula interna and subcortical knots а cavity filled with liquid and blood parcels is formed. The area of hemorrhagic impregnation arises due to it’s small centers coalescence, it has no clear border and characterized by brain tissue flaccid consistence, impregnated with blood elements. In acute period of hemorrhagic NIH secondary diffuse and focal changes of brain tissue are observed, in their realization both pathogenetic, and sanogenic factors, referred to isolation of areas of necrosis by vascular reactions and an inflammation, play a significant role.However blood flow retardation owing to coagulation disturbances and brain edema at their inadequate expression and a long exposition can cause neurons’ death not only on border of primary damage, but also on a distance that can lead to fatal consequences.Conclusions. NIH, caused by arterial aneurysms or malformations rupture is accompanied by considerable secondary changes of brain tissue around the hemorrhage centers that breaks functions of many organs and systems, frequently with fatal consequences. In-timed diagnostics of secondary structural changes of brain tissue and prevention of their emergence are based on complex theoretical studying of this problem and are possible under use of complex of clinical, neurovisualizing and retrospective morphological researches. The obtained results allow to define certain links of cerebrovascular disease pathogenesis, show importance of in-timed neurosurgical help, and expand representations concerning thanatogenesis at NIH.