MODERN APPROACHES IN THE DIAGNOSIS AND TREATMENT OF CEREBROVASCULAR DISEASES

Abstract

Objective: To evaluate the results of diagnosis and treatment of patients with cerebrovascular diseases (CVD) using modern technologies Methods: The results of the diagnosis and treatment of 105 patients with CVD for the period from January 2018 to May 2022 were evaluated. The age of the patients ranged from 10 to 75 years. The Glasgow Coma (GCS) and Hunt-Hess (HHS) Scales were used to assess the severity of the disease. In patients with arteriovenous malformation (AVM), the Spetzler-Martin grading scale was used to determine the size, location, and drainage into the deep cerebral veins. The Fisher scale was used in all cases of subarachnoid hemorrhage (SAH). Additional research methods included computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA). Results: Of the 105 patients, operations were performed in 55, the remaining 50 patients underwent conservative treatment (due to refusal of surgery). The main reasons for the development of non-traumatic intracranial hematomas (NICH) were: hypertension – in 30 (28.5%) cases, arterial aneurysm (AA) – in 12 (11.4%) cases, AVM – in 20 (19.5%) cases and other causes in 8 (7.6%) patients. Out of 38 (69.1%) patients operated on during the acute period, 5 (9.1%) underwent surgery during the first 5 days, while 12 (21.8%) – were operated on within 10-14 days. The following interventions were performed: external ventricular drainage – 10, removal of blood clots from the basal cisterns – 1, clipping of vessels – 7, and decompressive craniotomy – 37. In the group of operated patients, mortality was 9.1% (5 patients); mortality in the conservative treatment group constituted 40% (20 patients). Conclusion: The wider use of modern and highly informative imaging methods resulted in increased detection of asymptomatic AVMs and AA. This, in turn, contributed to the application of adequate treatment techniques in a relatively safe period of the disease, thereby reducing the frequency of deaths and serious complications. Keywords: Arterial aneurysm, arteriovenous malformation, digital subtraction angiography, magnetic resonance angiography, CT angiography.