Clinical and neurophysiological correlations in patients with acute non-traumatic hemispheric hematomas

I. S. Kurepina, R. Zorin, V. A. Zhadnov, O. V. Evdokimova, A. O. Burshinov
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Abstract

The aim of the study was to identify the relationship between clinical and neurophysiological parameters in patients with non-traumatic supratentorial hematomas. We examined 90 patients in acute period of parenchymal hemorrhagic stroke; the Glasgow Coma Scale (at first day) and the NIHSS (at 1st, 3rd, and 14th days) were used for the assessment of clinical dynamics. Two groups of patients were identified by means of cluster analysis. Cluster 1 included the patients with lower number of correlations between neurophysiologic parameters; cluster 2 included the patients with higher level of conjugacy in the mechanisms of nervous regulation. The clinical and neurophysiological correlations that differed between the groups of the patients were found. The role of EEG slow-wave activity and its association with the severity of neurological symptoms in the group of the patients with regress of neurological deficit were described. The role of desynchronizing influences in minimizing the severity of neurological deficit in patients with unfavorable course of disease was established. In conclusion, we emphasize the heterogeneity of the groups of the patients with parenchymal hemorrhagic stroke due to their clinical course; the role of synchronizing and desynchronizing influences of the brainstem structures according to EEG data in the assessment of the course of acute period of hemorrhagic stroke is highlighted.
急性非创伤性半球血肿患者的临床和神经生理学相关性
该研究的目的是确定非创伤性幕上血肿患者的临床和神经生理参数之间的关系。我们对90例脑实质出血性中风急性期患者进行了检查;采用格拉斯哥昏迷量表(第一天)和NIHSS(第1、3、14天)评估临床动态。通过聚类分析确定两组患者。聚类1包括神经生理参数相关性较低的患者;第二组为神经调节机制结合程度较高的患者。发现两组患者的临床和神经生理学相关性存在差异。本文描述了脑电图慢波活动在神经功能障碍消退组中的作用及其与神经症状严重程度的关系。在病程不利的患者中,去同步化影响在最小化神经功能缺损严重程度中的作用已被确立。总之,我们强调脑实质出血性卒中患者的临床病程存在异质性;强调脑电图数据对脑干结构同步和非同步影响在出血性脑卒中急性期病程评估中的作用。
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