Clinical features of the acute period of primary aneurysmal hemorrhage due to rupture of arterial aneurysms of the posterior circulation

Abstract

Objective — to determine the clinical features of the hemorrhagic course of the primary aneurysmal hemorrhage in the acute period of the disease due to rupture of the arterial aneurysms of the posterior circulation.
Materials and methods. Arterial aneurysms of the posterior circulation with a hemorrhagic type of flow were observed in 338 patients. According to the results of the study, patients who had single aneurysmatic hemorrhages prevailed. There were 295 such patients (87.3 %) in the structure of the group of patients with hemorrhagic course of the disease. In other patients, the relapse course of the disease was observed. Single aneurysmal hemorrhages occurred in 295 cases. This group is represented by patients with acute and cold periods of aneurysmal hemorrhage. In the acute period of the disease 208 patients were treated with a single transferred aneurysmal hemorrhage due to rupture of arterial aneurysms of the posterior circulation. This study presents the characteristics of the main clinical manifestations of an acute period of aneurysmal hemorrhage due to rupture of posterior circulation arterial aneurysms.
Results. The analysis of the main clinical manifestations (headache, level of impaired consciousness, meningeal, cerebral symptoms, dysfunction of the cranial nerves, motor disorders, cerebellar symptoms, severity of the patient's condition) and X-ray anatomical (prevalence of subarachnoidal, ventricular hemorrhage, liquorodynamic violations, cererebral angiospasm and secondary ischemic brain damage characteristic of the acute period of a single primary aneurysmal hemorrhage due to the rupture of arterial aneurysms posterior circulanion.
Conclusions. Localization of aneurysms in the area of the main artery bifurcation, main artery — superior cerebellar artery, vertebral artery complex — posterior lower cerebellar artery, which in total is 78.7 % of cases of hemorrhagic disease, should be considered as the main causes of aneurysmal hemorrhage due to rupture of the posterior semicircle. In the presented group of patients, patients with saccular aneurysms convincingly prevail — 199 (95.7 %) cases. The main symptoms of arterial aneurysm rupture of the vertebro-basilar basin, the evaluation of which requires careful research and increased attention, are headache, level of impaired consciousness, meningeal, cerebral symptoms, dysfunction of the cranial nerves, motor impairment, and cerebellar symptoms. The determining components of treatment planning tactics and predicting the outcome of treatment are the severity of the patient’s condition, the prevalence of aneurysmal hemorrhage, the presence and spread of ventricular hemorrhage, the presence of liquorodynamic disorders, cerebral angiospasm, and secondary ischemic brain damage.