Does intraoperative mild hypothermia prevent postoperative neurological deficits in patients with intracranial aneurysm?

2016 ◽  
Author(s):  
Terry J. Quinn
Keyword(s):  
Intracranial Aneurysm ◽  
Mild Hypothermia ◽  
Neurological Deficits

scholarly journals How Intracranial Aneurysm Rupture Damages the Brain

2008 ◽  
Vol 14 (1_suppl) ◽  
pp. 9-12 ◽  
Author(s):  
T. Trojanowski
Keyword(s):  
Blood Flow ◽  
Intracranial Aneurysm ◽  
Brain Dysfunction ◽  
Aneurysm Rupture ◽  
Acute Stage ◽  
Neurological Deficits ◽  
Arterial Bleeding ◽  
Secondary Haemorrhage ◽  
Global Brain ◽  
The Brain

Intracranial aneurysm rupture causes arterial bleeding into the subarachnoid space (SAH). In the acute stage lasting around 5 minutes intracranial pressure (ICP) rises rapidly up to the level between systolic and diastolic blood pressures, which slows down the outflow of blood, facilitates clot formation in the site of rupture and leads to arrest of bleeding. Increased ICP lowers cerebral perfusion pressure, causing brain ischemia, which is unevenly distributed throughout the brain as a result of interhemispheric pressure gradients, arterial spasms and other factors. No-reflow phenomenon in the capillaries following temporary arrest or considerable slowing of circulation produces areas of hypoperfusion and reduced capacity of blood flow autoregulation scattered irregularly in the brain in the subacute stage up to 30 minutes following haemorrhage. Disturbed regional cerebral blood flow is accompanied by spots of damaged blood brain barrier resulting in brain oedema. After SAH the brain remains vulnerable to reduction of blood flow and hypoxaemia, which explains greater brain damage after secondary haemorrhage, and in some cases persistent neurological deficits or global brain dysfunction.

scholarly journals A Controlled Study of Continuous Lumbar Drainage of Fluid and Lumbar Puncture Drainage for Aneurysmal SAH after Intracranial Aneurysm Clipping

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Fei Duan ◽  
Guofei Wang ◽  
Xiaohu Ma ◽  
Yue Zhao ◽  
Xuanle Xu ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intracranial Aneurysm ◽  
Lumbar Puncture ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Effective Rate ◽  
Neurological Deficits ◽  
Controlled Study ◽  
Lumbar Drainage ◽  
Aneurysm Clipping ◽  
Continuous Drainage

Objective. To analyze the different effects of Continuous Lumbar Drainage of fluid and lumbar puncture drainage for aneurysmal subarachnoid hemorrhage (SAH) after intracranial aneurysm clipping. Method. Seventy-five patients with aneurysmal SAH who underwent aneurysm clipping were retrospectively analyzed and were divided into two groups according to the different postoperative drainage methods. The lumbar spine group received lumbar puncture drainage, and the lumbar cistern group received lumbar pool continuous drainage to compare the efficacy. Result. The time to normalize intracranial pressure and headache relief after drainage treatment in the lumbar cistern group was shorter than that in the lumbar spine group. The GOS score was higher than that in the lumbar spine group, and the cerebral artery flow velocity and NIHSS score were significantly lower than those in the lumbar spine group ( P < 0.05 ). The total effective rate of drainage treatment was 76.32% in the lumbar cistern group, which was higher than that in the lumbar spine group (54.05%) ( P < 0.05 ). The total complication rate was 18.42% in the lumbar cistern group, which was lower than that in the lumbar spine group (40.54%) ( P < 0.05 ). Conclusion. Continuous Lumbar Drainage of fluid after intracranial aneurysm clipping for aneurysmal SAH can control symptoms more rapidly, reduce neurological deficits, and improve prognosis than lumbar puncture. Also, the drainage is safer and more widely used.

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