[Role of ischemic cerebral infarction in the development of lethal outcomes in ruptured intracranial arterial aneurysm]. / Rol' ishemicheskogo infarkta mozga v razvitii letal'nykh iskhodov pri razryve vnutricherepnykh arterial'nykh anevrizm.

Analysis of 320 autopsy cases of death after the rupture of brain arterial aneurysms (AA) without a surgical treatment is performed. The frequency of ischemic infarction among these cases was 15.3% and in 11.2% the infarction was an immediate cause of death. The lethal outcome due to the infarction occurred at the end of the 1st and during the 2nd week with a maximum at 9-12 days. Ischemic infarction as a cause of death usually had a wide zone of spread involving 2 and more brain lobes. The thrombosis of the big brain artery was a cause of ischemic complications in 19.4% of cases. Morphological alterations of the basis cerebri in such cases consisted of changes in the intima, elastic membrane, medial layer and adventitia resulting in the lumen narrowing.

[Ischemic complications in the development of fatal outcomes after the rupture of cerebral aneurysms]. / Ishemicheskie oslozhneniia v razvitii letal'nykh iskhodov posle razryva anevrizm golovnogo mozga.

A total of 320 unoperated-on patients who had died due to rupture of arterial aneurysms of the brain were clinically and anatomically examined. The incidence rate of ischemic infarct of the brain exposed to sections was 15.3%. In 11.3% of cases, ischemic infarct was the main cause of death, while in 4.1% it was concurrent. The time course of changes in the patient's status due to cerebral ischemia, typical changes on a brain computed tomogram and cerebral angiogram were shown.

[Cerebral artery aneurysms: Clinico-anatomic analysis of 610 cases]. / Anevrizmy arterii golovnogo mozga: kliniko-anatomicheskii analiz 610 nabliudenii.

Analysis of 610 aneurysms in 537 patients is performed. Main localization of aneurysms (88.7%) was the anterior region of Willis's circle. Congenital dysplasias of the arterial wall are transformed into the aneurysm when the risk factors join (essential or transitory arterial hypertension, atherosclerosis) this being confirmed by an advanced age (63%). Subarachnoidal hemorrhages predominated (29.9%). Most frequent immediate causes of death were hemorrhage into the brain ventricles (42.9%), edema and brain dislocation (40.7%). Ischemic brain softening played a role in the anatogenesis among non-operated patients in 7.3% cases and in 37.1% among operated patients. Histologic examination revealed that the maximum of repeated hemorrhages occur during the first 14 days after the aneurysm rupture-the time of noncompleted thrombus organization.

[The clinical picture of hemorrhages as a consequence of the rupture of cerebral arterial aneurysms]. / Klinicheskaia kartina krovoizliianii vsledstvie razryva arterial'nykh anevrizm golvonogo mozga.

Arterial aneurysms were found in 516 (45.9%) patients among 1,124 patients with subarachnoid hemorrhage (SH). Five clinical and anatomical types of hemorrhages in ruptures of arterial aneurysms were distinguished. The degree of the clinical manifestations of dislocation of the brain stem and/or occlusion of the CSF tract were taken into account, which plays a role in the choice of the tactics of management. SH took an atypical course in 28% of patients. Six variants of the atypical course were distinguished.

[Clinico-anatomical analysis of the causes of death in ruptures of intracranial arterial aneurysms]. / Kliniko-anatomicheskii analiz prichin smerti pri razryvakh intrakranial'nykh arterial'nykh anevrizm.

Causes of lethal outcome in patients after subarachnoid hemorrhage due to cerebral aneurysm rupture were analysed. The major death cause in the operated patients was cerebral edema and dislocation, while in non-operated ones it was the penetration of blood into the ventricles of the brain. Cerebral edema and dislocation syndrome were mainly caused after surgery by ischemic changes in cerebral tissue. A relationship between the aneurysm localization and the extent of subarachnoid hemorrhage was revealed as well as between the hematoma localization and incidence of hemorrhage into the ventricles of the brain.