Mamonova M. 3. Intensive care of angiospasm and brain swelling after intracranial aneurysm rupture by vasoactive medicine intra-arterial infusion.

In the course of implementation of the dissertation were indicated risk factors of angiospasm (AS) progress: hospitalization terms, status severity by Hunt- Hess, WFNS scale, concomitant disease present, compensatory hypertension and hyperthermia, degree of secondary ischemia compensation by clinic and additional examinations: cerebral angiography, CT scan, TC Doppler. The method of intraarterial prolongable pharmacological infusion (IPPI) was devised and included in general intensive care regimen for patients with ruptured aneurysms. IPPI influence on AS was studied. It was argued, that IPPI decreases AS by clinical and additional examination data. The efficacy of different vasoactive medicines (papaverin, lidocain, nimotop) was analyzed. It was argued, that papaverin and lidocain significantly better decrease AS than nimotop at severe condition patients. In moderate and easy condition patients the significant differ-ence between investigational medicines was absent. In critical condition patients theIPPI application was not effective. It was shown, that the papaverin using leads to significant reduction of the disability and to increase of favorable out-comes (recovery with earning capacity retention without substantial neurological deficit) - in 65%, lidocain using - in 55% of patients and nimotop - in 42.5%, on the other hand the same index in the control group was only 32.5%.