ИСТИНА

We present the series of 447 patients with BH and CA, that were examined in the period 1986 - 2016 (304 underwent surgery, 143 were managed conservatively). Neurological examination, MRI were perfomed on admission, after surgery (in surgically treated patients) and yearly in the follow up period. According to MRI, pathology revealed during surgery and histological examination we outlined two main groups: I. hematomas (180 patients; 59%); II. malformations (124 patients; 41%). The results of surgery strictly depended on pathological characteristics of the lesion. After removal of hematomas, 63% of patients improved immediately after surgery, 21% - remained unchanged, 16% - deteriorated, mortality was 0%. Less favorable results were observed in patients suffering CA with no MRI signs of hemorrhage: 73% of them worsened, and only 5% of patients improved. Clinical improvement after surgery continued for 6 months; 92% of patients with haematomas and 56% of patients with CA became significantly better than before surgery. Hemorrage after surgery occurred in 15%. There were no hemorrhages in the follow-up period In cases of CA with no signs of hemorrhages to the time of surgery. Rehemmoragerate per patient per year after surgery was 0.3%. The main reasons for conservative management were: significant regress of neurological deficit to the time of admission or mild neurological signs from the beginning of the disease with no tendency of increasing; Small size of hematoma (< 2cm3); High risk of neurological deterioration after the surgery. Hemorrages in the follow –up period occurred in 9% of patients.