Immediate results of patients treatment with intracranial hemorrhages on account of the arterial aneurisms rupture and their prediction
Keywords:intracranial aneurismal hemorrhage, recurrent cerebral ischemia, factors of risk of complications developing, simvastatin, therapeutic hypothermia, rules of prognosis
The purpose. To identify risk factors of complications and unfavorable results after surgery in patients with intracranial aneurismal hemorrhages and to make rules of their prediction.
Materials and methods. 328 patients with intracranial aneurismal hemorrhages were included into research. Immediate results were estimated just after hospital treatment, after 30 days and 6 months. The relationships between quality indicators were studied on the base of criterion χ2. To determine the strength of the relationship between these indicators based on statistics χ2 were used Cramer coefficient. Prediction terms were built in a form of decision trees using C4.5 algorithm.
Results. Using simvastatin at arterial spasm contributed to improvement treatment outcomes. In patients with intracranial aneurismal hemorrhages and recurrent cerebral ischemia therapeutic hypothermia is reliably decreases the number of unsatisfactory treatment results. Cerebrocardial syndrome, arterial spasm, glycemia above 6.3 mmol/l, leucocytes level above 9.8×109/l revealed at hospitalization were the risk factors of unsatisfactory treatment results. In a case of arterial spasm after surgery in 88% patients had recurrent ischemia; in patients without angiospasm at whom arteries temporary clipping was performed (longer than 6 minutes) secondary ischemia was detected at coronary artery disease. In patients been operated within 6 days after the hemorrhage occurring with complications therapeutic hypothermia and decompressive trepanation are recommended in order to prevent and treat recurrent cerebral ischemia.
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