Study Objective: To identify the differences in physiological parameters in groups of patients in an acute period of haemorrhagic parenchymatous stroke (supratentorial hemisphere hematomas) with favourable outcome and fatality. Study Design: prospective study. Materials and Methods. We have examined 96 patients with supratentorial haemorrhagic stroke. Haemorrhagic stroke was diagnosed on the basis of neuroimaging results, clinical symptoms and medical history, as well as clinical and laboratory data. A cluster analysis and expert examinations made it possible to divide patients into two groups: 49 patients who died of the acute haemorrhagic stroke and 47 patients with a favourable outcome. We evaluated the level of consciousness, cognitive functions, neurophysiological parameters: electroencephalography (EEG), cognitive evoked potentials Р300, heart rate variability (HRV). Study Results. In patients with a favourable outcome, an overall amplitude of the EEG spectrum was higher vs. patients with lethal outcome (statistically significant results were noted in all leads). A significant increase in the mean frequency of theta waves was seen in both groups, especially in the group with lethal outcomes. When Р300 in patients with lethal outcome was evaluated, a significantly lower P2N2 amplitude in Fz was noted vs favourable outcome group: 5.1 (2.6; 9.1) μV vs 8.9 (5.6; 20.4) μV (U = 148; p = 0.021). A comparative analysis of HRV revealed significant differences only in heart rate (mean R-R): it was lower in patients who died in the acute period of haemorrhagic stroke: 696 (608; 836) ms vs 806 (743; 911) ms (U = 181; p = 0.033). In patients with lethal outcomes, there is an increase in the number of linear correlations in physiological parameters vs. favourable outcome group. Conclusion. Deaths from acute haemorrhagic stroke are preceded by reduction in the basic cortical rhythm, growth in slow waves activity, reduction in the stimuli recognition mechanism activation (according to cognitive evoked potentials Р300). An analysis of the rate of correlation in physiological mechanisms of brain activity regulation (EEG), neurophysiological correlates in stimuli recognition and decisionmaking (Р300), as well as autonomic regulation mechanisms (HRV) shows limited functional reserves in patients with lethal outcomes. Keywords: haemorrhagic stroke, event-associated potential, heart rate variability, correlation analysis.
Physiological Parameters in Various Prognosis of the Acute Period of Haemorrhagic Stroke