Внутригоспитальный геморрагический инсульт — вариант острого нарушения мозгового кровообращения по геморрагическому типу, включающий все формы нетравматического внутричерепного кровоизлияния (в том числе субарахноидальное кровоизлияние), развившиеся у пациентов, находящихся на стационарном обследовании или лечении по поводу другого заболевания либо госпитализированных для проведения диагностической или лечебной процедуры. В отличие от внутригоспитального ишемического инсульта, эпидемиология внутригоспитальных геморрагических инсультов остается малоизученной. Внутригоспитальный геморрагический инсульт является относительно редкой конкурирующей патологией, однако характеризуется высокой частотой неблагоприятных исходов (летальность может достигать 50%), что может вносить существенный вклад в структуру внутрибольничной летальности и, по аналогии с внутригоспитальным ишемическим инсультом, имеет высокую актуальность и требует активного изучения. В патогенезе внутригоспитального геморрагического инсульта помимо общих и специфических факторов риска важную роль играют уникальные факторы риска, непосредственно связанные с проводимыми в стационаре лечебно-диагностическими мероприятиями. В статье рассматриваются наиболее частые лечебные процедуры, проведение которых сопровождается наибольшим риском развития внутригоспитального геморрагического инсульта — эндоваскулярные хирургические вмешательства, системная тромболитическая терапия, антитромботическая терапия. На основе анализа факторов риска представлены современные возможности дифференцированной профилактики. Выделение внутригоспитального геморрагического инсульта в отдельную форму создаст условия для его более эффективной дифференцированной профилактики, что позволит снизить показатели внутрибольничной летальности и улучшить исходы внутригоспитального геморрагического инсульта.

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