[Role of the barrier system of the cerebral membranes in subarachnoid hemorrhage].

On the basis of literary and his own data the author distinguishes 3 stages of subarachnoidal hemorrhage, each having its own specific pathophysiological and pathomorphological features. The extracerebral barrier system can be divided into 3 structural and functional groups, such as: a) barriers between the cerebrospinal liquor and the blood; b) barriers between the liquor and the border tissues, and c) histohematic barriers. In the conditions of subarachnoidal hemorrhage accompanied with development of arterial spasm one observes disturbances of the liquor microcirculation because of blood clotting in the liquor and sticking of the blood clots in various parts of the subarachnoidal space, as well as changes in the ultrastructure of the morphological substrate of the extracerebral barrier system. All this, in the author's opinion, leads to damaging the innervation apparatus elements and smooth muscle cells of the cerebral arteries and arterioles; promotes the development of cerebral edema, etc. The data obtained make it possible to evaluate the role of the extracerebral barrier system of the meninges in cases of subarachnoidal hemorrhage with accompanying arterial spasm.