Modern approaches and experiences of surgical treatment of non-traumatic intracranial hematomas

SUMMARY. The article presents the results of diagnostics and surgical treatment of patients with non-traumatic intracranial hematomas using modern technologies. The main causes of intracranial hematomas are: hypertension (55.2 %), cerebral aneurysm (15.7 %), arteriovenous vascular malformations (21.5 %) and other causes (angiopathy, vasculopathy, amyloidosis — 7.8 %).

1. Molyneux AJ., Kerr RS., Yu LM., Clarke M., Sneade M., Yarnold J. A., Sandercock P. International subarachnoida neurysmtrial (ISAT) of neurological clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized comparison of effect of survival, dependency, seizures, rebreeding, subgroups and aneurysm occlusion. Lancet. 2005; 366(9488):809–817. Doi: 10.1016/S0140–6736(05)672145.

2. Gaberel T., Magheru C., Parienti J. J., Huttner H.B., Vivien D., Emery E. Intraventricular fibrinolysis versus external ventricular drainage alone in intraventricular hemorrhage: a meta-analysis. Stroke. 2011; 42(10):2776–81. Doi: 10.1161/STROKEAHA.111.615724.

3. Meshkova K. S., Gudkova V. V., Stakhovskaya L. V. Dependence of stroke development on arterial hypertension and issues of choice of antihypertensive therapy. Farmateka. 2014; 13(286):8–13 (In Russ.)

4. Dash'yan V.G., Korshikova A. N., Godkov I. M., Krylov V. V. Endoscopic surgery for hemorrhagic stroke. Journal of Neurology and Psychiatry. Zhurnal nevrologii I psikhiatriim. S.S. Korsakova. Spetsvypuski. 2014; 114 (3–2):7–13 (In Russ.).

5. Krylov V. V., Burov S. A., Dash'yan V.G., Galankina I. Ye. Method of local fibrinolysis in surgery of non-traumatic intracranial hemorrhage. Vestnik RAMN. 2013; 7:24–31 (In Russ.).

6. Krylov V. V., Prirodov A. V. Risk factors for surgical treatment of middle cerebral artery aneurysms in the acute period of hemorrhage. Neyrokhirurgiya. 2011; 1:31–41 (In Russ.)

7. Microsurgery of cerebral aneurysms / ed. V. V. Krylov. — M.: Novoe vremy, 2011.— 536 c (In Russ.).

8. Krylov V. V., Godkov I. M. Application of video endoscopy in microsurgery of cerebral aneurysms. Endoskopicheskaya khirurgiya. 2014; 20(5):31–36 (In Russ.).

9. Kassell N.F., Torner J.C., Haley E.C. Jr., et al. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results// J. Neurosurg.— 1990. — Vol. 73, N. 1. — P. 18–36.

10. Sen'ko I. V. Surgery of aneurysms of the anterior cerebral and anterior communicating arteries in the acute period of hemorrhage. Neyrokhirurgiya. 2011; 4:74–79 (In Russ.).

11. Krylov V. V., Klimov A.B., Polunina N. A. Diagnostics and treatment of patients with giant cerebral aneurysms. Neyrokhirurgiya. 2010; 3:14–24 (In Russ.).

12. Krylov V. V., Dmitriyev A. Yu. Risk factors for surgical treatment of cerebral arteriovenous malformations in combination with intracerebral hematomas. Neyrokhirurgiya. 2012; 3:26–33 (In Russ.).

13. Kaplunova O. A., ChaplyginaYe.V., Dombrovskiy V.I., Sukhanova O.P., Blinov I. M. Development of intracerebral vessels and arteriovenous malformations. Zhurnal anatomii i gistopatologii. 2015; 4(4):18–25. Doi: 10.18499/222573572015441825 (In Russ.).

14. Gaab M. R. Intracerebral hemorrhages from cerebral arteriovenous malformations: prognostic grading. World Neurosurgery. 2016; 93:471–473. Doi: 10.1016/j.wneu.2016.05.068.

15. Spetzler R. F., Martin N. A. A proposed grading system for arteriovenous malformations. J. Neurosurg.1986; 65(3):476–83. Doi:10.3171/jns.1986.65.4.0476.

16. Solomon R. A., Connolly E.S., Arteriovenous malformations of the Brain. N. Engl. J. Med.2017; 376:1859–1866. doi: 10.1056/NEJMra1607407.

17. Gaab M. R. Intracerebral hemorrhages from cerebral arteriovenous malformations: prognostic grading. World Neurosurgery. 2016; 93:471–473. Doi: 10.1016/j.wneu.2016.05.068.

18. Spetzler R.F., Martin N. A. A proposed grading system for arteriovenous malformations. J. Neurosurg. 1986; 65(3):476–83. Doi:10.3171/jns.1986.65.4.0476.

19. Solomon R.A., Connolly E. S. Arteriovenous malformations of the Brain. N. Engl. J. Med.2017; 376:1859–1866. Doi: 10.1056/NEJMra1607407.

20. Bobinov V. V., Petrov A. E., Goroshchenko S. A., Ivanova N. A., Rozhchenko L. V., Sinitsyn P.S., Ivanov A. A., Voronov V.G., Ivanov A. Yu. Istoricheskie aspekty khirurgicheskogo lecheniya tserebral’nykh anevrizm. Chast’ I. Rossiiskii neirokhirurgicheskii zhurnal,— 2020, vyp. 1, str. 5–11. (In Russ.)

21. Dubovoi A. V., Gulai Yu.S., Ovsyannikov K.S., Starikova O. V. Intra-intrakranial’nye mikroanastomozy: ideologicheskaya dilemma i tenicheskii vyzov. Rossiiskii neirokhirurgicheskii zhurnal imeni professora A. L. Polenova. 2018;10(2):25–35. (In Russ.).