Rudenko S. Pathomorphological changes of the brain and lungs in patients, been operated because of arterial aneurysms and arteriovenous malformations: thanatogenesis features

The thesis is devoted to determination of features of pathomorphological changes of the brain and lungs and their role in thanatogenesis at raptures of arterial aneurysms (АА) and arteriovenous malformations in patients after neurosurgical interventions for justification of measures of their prophylactics and correction. On the base of analysis of lung causes and complications at intracranial hemorrhages in 204 lethal cases, caused by rapture of АА and arteriovenous malformations, it was defined that morphological verification of lung complications was 86.3%. In case of patients' death in first five days after operation, pneumonia was taped in 15.7% (p<0.05) observations; at acute disturbance of blood circulation of the brain caused by АА rapture - in 39.4% (p<0.05). In 58.2% cases pneumonic infiltration was revealed on the side, opposite to intracerebral hematoma; in patients with acute disturbance of blood circulation of the brain bilateral pneumonia was taped more often. Thanatogenesis and lung complications are defined by level and volume of brain lesion, irrespective of the hemorrhage reason. In early postoperative period patients' death was immediately cause by intracerebral vital complications (secondary hemorrhages in the brain stem). Since second day after operation, lungs edema and signs of acute pulmonary distress syndrome developed; since the fifth day - bronchopneumonia. In different terms infectious and neurotrophic complications mainly meet. Lung complications worsen the disease flow and results of neurosurgical treatment of acute disturbance of blood circulation of the brain. The analysis of pulmonary complications morphogenesis and thanatogenesis at acute disturbance of blood circulation of the brain in early postoperative period let to improve their diagnostics efficiency and treatment schemes. Improvement of standards of maintaining of such category of patients is necessary.