DOI: https://doi.org/10.22141/2224-0713.4.106.2019.174047

The structural and morphometric peculiarities of the brain in patients who suffered from aneurysmal subarachnoid hemorrhage

K.V. Duve

Abstract


Background. Studying structural changes of the brain in patients who suffered from aneurysmal subarachnoid hemorrhage (aSAH), finding out their connection with the functional state of patient, his cognitive and psycho-emotional disorders contributes to the improvement of diagnostic approaches and optimize prediction of the disease course. Materials and methods. We carried out a comprehensive examination of 114 patients in the recovery and residual periods of aSAH. Such parameters were taken into account as clinical and anatomical type of hemorrhage, data of Montreal Cognitive Assessment (MoCA), Barthel index and modified Rankin scale score, the assessment of psycho-emotional state using the Hospital Anxiety and Depression Scale. The brain computed tomography measurements were evaluated and followed by the determination of morphometric parameters and indices. For statistical processing of the results, Microsoft Excel 2011, Statistica 10 and SPSS Statistics were used. Results. According to the morphometry data, patients who underwent aSAH were presented with central cerebral atrophy, severe in 41 (35.96 %) cases, mild and moderate — in 21 (18.43 %), and with cortical cerebral atrophy, diffuse — in 29.82 %, and focal — in 14.03 % of patients. According to the extension of the atrophic process, only central cerebral atrophy was manifested in 25.43 % of patients, only cortical one — in 17.54 % and mixed — in 28.07 %. As a result, bifrontal index, frontal horn ratio, Schaltenbrand-Nürnberger index, as well as ­Evans ratio were significantly higher compared to the control group (p < 0.01). Moreover, with increasing sizes of the right and left lateral ventricles, the cognitive test scores became worse (r = –0.380; p = 0.000 and r = –0.479; p = 0.000). Significantly lower results of MoCA, which corresponded to moderate level of cognitive impairment, were observed in groups of patients with central and mixed types of cerebral atrophy. Conclusions. Cerebral atrophy was detected in about 71.04 % of patients who had aneurysmal subarachnoid hemorrhage: central — in 25.43 %, cortical — in 17.54 % and mixed — in 28.07 %. The study found the correlation between the morphometric indices typical for subcortical and cortical cerebral atrophy, and the severity of cognitive impairment.


Keywords


aneurysm; subarachnoid hemorrhage; computed tomography; cerebral atrophy

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