Disturbances of the hemostasis system in patients with aneurysmatic subarachnoidal hemorrhage in the neuro-intensive department of RRCEMPA AF

The urgency of the problem. Subarachnoid hemorrhages (SAH) due to rupture of cerebral aneurysms are characterized by high mortality. More than 25% of patients who survived after aneurysmal SAH (aSAH) develop delayed cerebral ischemia, which is one of the main causes of disability. The mechanisms underlying the formation of delayed ischemia are still not fully understood. It was previously believed that the development of vasospasm is the only cause of delayed ischemia. Recently, however, data have been obtained indicating that disturbances in the hemostasis system, characteristic of this category of patients, cause the formation of blood clots in the arteries of the brain, which is one of the main pathophysiological mechanisms for the development of delayed ischemia. This review presents an analysis of published scientific papers on hemostasis disorders in patients with aSAH, their pathophysiological mechanisms and role in the development of cerebral ischemia.