The Comprehensive Evaluation of Patients’ Condition in Recovery and Residual Periods of Aneurysmal Subarachnoid Hemorrhage

Abstract

The aim: is to evaluate peculiarities of clinical and neurological characteristics, quality of life, brain morphometry changes and metabolic deviations of patients, who suffered from aneurysmal subarachnoid hemorrhage. Materials and methods: In the period of 2016-2019 we examined 114 patients, who signed the informed consent, taking into account their age, clinical and anatomical form of hemorrhage, disease duration, Hunt-Hess severity grade, complications of acute period. Such parameters were evaluated, as clinical and neurological characteristics, the degree of the Barthel index and the modified Rankin scale, cognitive functioning (MoCA), psycho-emotional sphere and quality of life (HADS, SF-36), morphometric parameters based on brain computed tomography measurements, explored the indicators of apoptosis, mitochondrial dysfunction, intracellular oxidative stress. Results: Сephalgia (90,35 %), pyramidal syndrome (53,50 %), sensibility deficit (36,84 %) were leading among the all neurological syndromes. Slight dependence and disability grade was found during assessment of the Barthel index and the modified Rankin scale. In 85,96 % of patiens we revealed cognitive impairment of different severity grades. The anxiety was manifested in 65,79 %, depression – in 64,91 % of patients. Due to the morphometry data, the process of cerebral atrophy was detected (central – in 26,31 % of patients, cortical – in 16,67% and mixed – in 28,07 %). AnV+ and PI+ – cells level exceeded normal values in 2,88 and 1,96 times while the level of JC-1+ and ROS+-cells – in 2,17 and 2,82 times (p<0,01). Conclusions: Having studied clinical and neurological, neuropsychological, morphometric and metabolic factors, we found their pathogenetic role in the course of late recovery and residual periods of aneurysmal subarachnoid hemorrhage, that would help us to improve the diagnostic tactics and reveal the predictors of unfavorable outcome.

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Characteristics of cerebral hemodynamics in patients with chronic brain ischemia

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