[Treatment of ruptured intracranial aneurysms].
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Biomedical subjects
Publications and source records attributed to V V Lebedev.
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In a series of 61 patients the authors studied the effect of some risk factors on the development of recurrences of haemorrhage from arterial aneurysms of cerebral vessels in the acute period of their rupture. The highest risk of recurrences was associated with an elevated fibrinolytic activity of the cerebrospinal fluid, spasm of the cerebral vessels, aneurysms of the anterior connective and internal carotid arteries as well as the patients' grave condition. Consideration of these factors makes it possible to specify the indications for surgical or conservative treatment. Antifibrinolytic therapy conducted in 5 patients with elevated fibrinolytic activity of the spinal fluid elicited good response.
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Two cases of the apathetic form of thyrotoxicosis in women aged 39 and 54 were described. The disease was characterized by the absence of typical signs of thyrotoxicosis in the presence of ptosis, cardiovascular disorders and thyrotoxic myopathy confirmed by EMG findings. Clinical symptoms were not registered after surgical therapy or chemotherapy with mercazolyl.
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The authors suggest a complex of measures for examination of patients with subarachnoidal hemorrhage (SAH), which makes it possible to elucidate the genesis of the hemorrhage and to decide on the tactics of treatment within the first hours after the stroke. They prove the necessity of hospitalization or transfer of patients with SAH to neurosurgical departments as well as of surgery in the acute stage of aneurysmal rupture.
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Thirty patients with acutely developed intracranial hematomas of traumatic and nontraumatic origin were subjected to a combined examination. In all cases, cerebral angiography was performed and evoked auditory trunk potentials were studied. Comparison of the resultant findings with the data from a clinical-neurologic and echoencephalographic examinations and also with pathomorphological evidence made it possible to identify new diagnostic criteria for determining an acute dislocation syndrome at the temporal-tentorial level, particularly for the purpose of detecting cerebral infiltrations.
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