Borovik O. Acute symptomatic epileptic seizure in the clinic of hemorrahagic stroke. - Qualifying scientific work on the rights of the manuscript

The thesis is devoted to the studies of the course and features of treatment of acute symptomatic epileptic seizures (GSEN) in patients with hemorrhagic stroke, determining the impact of GSEN on the clinical course of hemorrhagic stroke, based on which the treatment strategy for patients with epileptic seizures in intracerebral and subarachnoid hemorrhage can be improved. The occurrence of GSEN in hemorrhagic stroke is a prognostically unfavorable factor, as it is associated with increased mortality and disability, in the case of subarachnoid hemorrhage due to rupture of the cerebral aneurysm GSEN often leads to re-rupture of the aneurysm. The dissertation presents a theoretical generalization, definition and practical application of clinical, pathohistological and neuroimaging criteria associated with epileptic seizures in patients with hemorrhagic stroke. An analysis of 436 patients with hemorrhagic strokes. The influence of various factors (age, sex, location, size of the hematoma, estimates on standardized scales, duration of the disease) on the probability of epileptic seizures and their course in the future. Namely: we found a number of clinical factors associated with the presence of epileptic seizures in the acute and separate period of intracerebral hemorrhage and subarachnoid hemorrhage. It was first confirmed that the medial localization of stroke hematoma does not increase the likelihood of epileptic seizures in the acute period, but affects the likelihood of their development in the distant period after the disease. It was also found that an epileptic seizure in the acute period of SAC significantly increases the likelihood of death, but reduces the likelihood of severe disability. That is, patients who have had an epileptic seizure in the acute period of SAC usually either have very good treatment results or die, the presence of intermediate results is very rare. Based on these observations, we first developed a method of treating epileptic seizures in the acute period of subarachnoid hemorrhage. The technique is to prescribe high doses of tablets of levetiracetam immediately after the first attack and for the entire acute period of hemorrhagic stroke with its subsequent cancellation.The practical value of the obtained results is that today there are no detailed algorithms on how to conduct epileptic seizures in the acute period of hemorrhagic strokes. treatment of epileptic seizures in patients with this pathology