Local Fibrinolysis in Surgical Treatment of Non-Traumatic Intracranial Hemorrhages

Vv, Krylov; Sa, Burov; Vg, Dash'ian; Ie, Galankina

doi:10.15690/vramn.v68i7.708

Cited by 6 publications

(3 citation statements)

References 9 publications

(11 reference statements)

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“…The fibrinolytic system is an integral part of the hemostatic system, since it always accompanies blood coagulation and is even activated by the same factors as the hemocoagulation process [4].…”

Section: Fibrinolytic Systemmentioning

confidence: 99%

“…Open surgeries in neurology and neurosurgery are increasingly being replaced by minimally invasive interventions, which allow, while maintaining the radicality of hemorrhage removal, to improve the functional outcomes of the disease. One of the promising areas of minimally invasive surgery for hemorrhagic stroke is the method of local fibrinolysis of hemorrhages [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Modern concepts of the fibrinolytic system

2020

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Among all medical pathologies, cardiovascular diseases are the most dangerous and deadly. On the one hand, thrombosis is a natural reaction of a person to damage to blood vessels, on the other hand, thrombosis is often the cause of death in the event of cardiovascular disease. There is a natural process called fibrinolysis to dissolve a blood clot after the bleeding has stopped and preventing vascular occlusion. This article examines current understanding of the human fibrinolytic system, main elements of fibrinolytic system and also addresses the topic of thrombolytic therapy.

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Section: Fibrinolytic Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modern concepts of the fibrinolytic system

2020

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“…Среди ишемических инфарктов головного мозга 5,7 % приходится на инфаркты мозжечка [2]. Кровоснабжение мозжечка осуществляется тремя парами артерий: верхней (ВМА), передней нижней (ПНМА) и задней нижней (ЗНМА) мозжечковыми артериями [3,4].…”

Section: Introductionunclassified

Asymmetry of the structure of the superficial vascular bed of the human cerebellum.

Stepanenko¹

2017

Morphologia

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Исследование проведено в рамках научно-исследовательской работы "Строение и закономерности индивидуальной анатомической изменчивости головного мозга человека" (номер государственной регистрации 0115U000231). Реферат. Цель исследования-установить различия структуры поверхностной сосудистой сети верхней и нижней поверхностей мозжечка и их связь с величиной и формой мозжечка. У пропорциональных по форме мозжечков значения фрактального индекса верхней и нижней поверхности совпадают практически функционально, и масса мозжечка не влияет на это соотношение. Отклонение формы мозжечка от пропорциональной увеличивает различия структуры сосудистой сети на верхней и нижней поверхности. Ширина мозжечка влияет на структуру сосудистой сети на обеих его поверхностях. Длина мозжечка больше влияет на структуру сосудистой сети нижней поверхности, чем верхней. Высота одинаково влияет на обе поверхности мозжечка.

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Comparative analysis of the results of endoscopic surgery and external ventricular drainage in patients with intraventricular hemorrhage

Годков¹,

Dashyan

Elfimov³

et al. 2022

Nejrohirurgiâ (Mosk.)

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Background. The comparison of external ventricular drainage and endoscopic surgery in patients with intraventricular hemorrhages is carried out.The aim of the study is to perform comparative analysis of external ventricular drainage and endoscopic surgery results in patients with intraventricular hemorrhage.Materials and methods. A retrospective analysis was performed in 29 patients with intraventricular hemorrhage who underwent surgery at the N. V. Sklifosovsky Research Institute for Emergency Medicine, Moscow, and the Yaroslavl Regional Clinical Hospital. Endoscopic surgery for intraventricular hemorrhage was performed in 15 cases (treatment group), and in 3 cases endoscopic removal was accompanied by external ventricular drainage. External ventricular drainage without endoscopic surgery was performed in 14 cases (control group), and in 3 of these cases local fibrinolysis was also performed. In the treatment group, mean age was 59.6 ± 16.7 years, level of consciousness per the Glasgow Coma Scale prior to surgery was 9.9 ± 3.3, severity of intraventricular hemorrhage per the Graeb Scale was 7.3 ± 2.5. In the control group, mean age was 52.8 ± 9.6 years, level of consciousness per the Glasgow Coma Scale prior to surgery was 10.7 ± 3.2, severity of intraventricular hemorrhage per the Graeb Scale was 5.0 ± 2.6. Outcomes were assessed on the 30th day after hemorrhage using the modified Rankin Scale.Results. Endoscopic method allows to effectively remove clots from the lateral and III ventricles, decreasing the volume of intraventricular hemorrhage from 7.3 ± 2.5 to 3.9 ± 2.5 points per the Graeb Scale. Comparative analysis showed no difference in hydrocephalus resolution in the treatment and control groups. There were no intracranial infectious complications in the treatment group, but in the control group bacterial meningitis was diagnosed in 2 (14.3 %) of the 14 patients. Favorable outcome (score 0–2 per the modified Rankin Scale) was observed in 40.0 % of patients in the treatment group and 28.6 % in the control group. Mortality was 13.3 % in the treatment group and 57.1 % in the control group (χ2 = 8.6, p <0.01).Conclusion. Endoscopic surgery is an effective and safe method for intraventricular hemorrhage management and third ventriculostomy for occlusive hydrocephalus resolution, allowing to achieve better functional results and decrease mortality in patients with nontraumatic intraventricular hemorrhage.

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Local Fibrinolysis in Surgical Treatment of Non-Traumatic Intracranial Hemorrhages

Cited by 6 publications

References 9 publications

Modern concepts of the fibrinolytic system

Modern concepts of the fibrinolytic system

Asymmetry of the structure of the superficial vascular bed of the human cerebellum.

Comparative analysis of the results of endoscopic surgery and external ventricular drainage in patients with intraventricular hemorrhage

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