The dissertation is devoted to the study of clinical and neurological characteristics, specification of pathogenetic mechanisms of the disease and optimization of diagnostic approach to the patients with aSAH. We performed a comprehensive clinical and paraclinical examination of 114 patients in the recovery and residual periods of aSAH. Оn the basis of a comprehensive study of clinical-neurological, neuropsychological, neuroimaging with the determination of morphometric parameters, hemodynamic characteristics, cellular apoptosis, oxidative stress, mitochondrial dysfunction, clarified clinical and pathogenetic mechanisms in the recovery and residual periods of aSAH. Impairment of cognitive and emotional sphere were clarified, depending on age, sex, clinical and anatomical form of hemorrhage, characteristics of the acute period. The presence of cognitive impairment of various severity in patients in recovery and residual periods of aneurysmal subarachnoid hemorrhage has been confirmed and domains such as "visual-constructive skills", "language", "memory" and attention have undergone the greatest changes. It has been found that the degree of severity on the Hunt-Hess scale in the acute period affects the state of the cognitive sphere. The influence of the form of hemorrhage and the level of disability on the indicators of cognitive functioning is proved. A formula for cognitive prediction is proposed, taking into account the peculiarities of the acute period of hemorrhage. Indicators of life quality of patients in recovery and residual periods of aneurysmal subarachnoid hemorrhage were analyzed and the influence of clinical and neuropsychological parameters on the spheres of life quality was established.
The presence of mixed (28.07 %), internal (26.31 %) and external (16.67 %) cerebral atrophy in patients with aSAH was established. The role of some morphometric indicators (particularly BFI, BCI, VI, Hackman's index, ICPLV) which can be used as predictors of occurrence of cognitive decrease were established. Scientific data on the pathogenetic role of apoptosis, ROS and mitochondria in the recovery and residual periods of aneurysmal subarachnoid hemorrhage have been clarified and a significant increase in oxidative stress, mitochondrial dysfunction and increased cell death of peripheral blood leukocytes has been established. The correlations of age, sex, history of present illness, clinical (including at onset) characteristics and state of early and late apoptosis processes were studied and the pathogenetic role of ROS-induced early and late apoptosis during the recovery and residual periods of aneurysmal SAH was established. Scientific data on some functional hemodynamic features in the recovery and residual periods of aneurysmal subarachnoid hemorrhage have been supplemented. In particular, the relationship between systolic and end-diastolic velocities in ICA, CCA, MCA, PCA with MoCA scale parameters was revealed.
