scholarly journals Early Operations for Ruptured Intracranial Aneurysms—Study of 31 Cases Operated on within the First Four Days after Ruptured Aneurysm

1978 ◽  
Vol 18pt1 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Jiro SUZUKI ◽  
Takashi YOSHIMOTO ◽  
Takehide ONUMA
Keyword(s):  
Intracranial Aneurysms ◽  
Ruptured Aneurysm ◽  
Early Operations ◽  
Ruptured Intracranial Aneurysms

Occurrence and Implications of Seizures in Subarachnoid Hemorrhage Due to Ruptured Intracranial Aneurysms

Neurosurgery ◽  
1981 ◽  
Vol 8 (4) ◽  
pp. 417-421 ◽  
Author(s):  
Robert G. Hart ◽  
John A. Byer ◽  
James R. Slaughter ◽  
John E. Hewett ◽  
Donald J. Easton
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Acute Phase ◽  
Intracranial Aneurysms ◽  
Ruptured Aneurysm ◽  
Pathogenic Mechanisms ◽  
Prognostic Implications ◽  
Ruptured Intracranial Aneurysms ◽  
Early Seizures

Abstract The records of 100 consecutive cases of subarachnoid hemorrhage due to ruptured aneurysm were reviewed to determine the incidence and the prognostic implications of seizures during the acute phase. Seizures occurred in 26% of the patients. Sixty-three per cent of the seizures occurred near the onset of the initial hemorrhage. The occurrence of these early seizures did not correlate with the location of the aneurysm or the prognosis. Most of the remaining seizures occurred immediately after rebleeding, with no greater morbidity or mortality compared to all patients who rebled. Pathogenic mechanisms of seizures associated with subarachnoid hemorrhage are proposed and discussed.

Ruptured Intracranial Aneurysms With Small Basal Outpouching

Neurosurgery ◽  
2012 ◽  
Vol 71 (5) ◽  
pp. 994-1002 ◽  
Author(s):  
Jaechan Park ◽  
Hyunjin Woo ◽  
Dong-Hun Kang ◽  
Yongsun Kim ◽  
Seung Kug Baik
Keyword(s):  
High Risk ◽  
Intracranial Aneurysms ◽  
Optimal Treatment ◽  
Ruptured Aneurysm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Aneurysm Clip ◽  
Ruptured Aneurysms ◽  
Ruptured Intracranial Aneurysms

Abstract BACKGROUND: Recognizing an aneurysmal basal rupture using angiographic evaluation is crucial for optimal treatment. OBJECTIVE: To evaluate the incidence of a small basal outpouching (the most common angiographic configuration suggesting a basal rupture), the incidence of a ruptured basal outpouching, and the results of surgical and endovascular treatments. METHODS: The occurrence of small basal outpouchings was determined in the initial angiographic examinations of 471 patients with a ruptured aneurysm. Information was also obtained from patient charts, surgical and interventional reports, operative video records, and reviews of radiological investigations. RESULTS: A small basal outpouching was identified in 41 (8.7%) of the 471 ruptured aneurysms. In the surgical series (n = 286), a basal rupture was identified in 8 (30.8%) of the 26 cases of a basal outpouching and successfully treated by aneurysm clip placement. In the endovascular series (n = 185), intraprocedural aneurysm rebleeding developed in 5 of the 15 patients (33.3%) with a basal outpouching, which was most commonly observed with anterior communicating artery aneurysms. CONCLUSION: The current surgical series included a 9% incidence of ruptured intracranial aneurysms with a small basal outpouching, and a 31% incidence of these basal outpouchings being identified as the rupture point. The results also suggested that endovascular coiling of a basal outpouching carries a high risk of intraprocedural aneurysm rebleeding, whereas surgical clipping is safer and provides more protection against rebleeding of aneurysms with a basal rupture.

scholarly journals Finnish flow diverter study: 8 years of experience in the treatment of acutely ruptured intracranial aneurysms

2021 ◽  
pp. neurintsurg-2021-017641
Author(s):  
Kemal Alpay ◽  
Tero Hinkka ◽  
Antti E Lindgren ◽  
Juha-Matti Isokangas ◽  
Rahul Raj ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Intracranial Aneurysms ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Flow Diverter ◽  
Supporting Evidence ◽  
Complication Rates ◽  
Related Complication ◽  
Anterior Circulation ◽  
Clinical And Radiological Results ◽  
Ruptured Intracranial Aneurysms

BackgroundFlow diversion of acutely ruptured intracranial aneurysms (IAs) is controversial due to high treatment-related complication rates and a lack of supporting evidence. We present clinical and radiological results of the largest series to date.MethodsThis is a nationwide retrospective study of acutely ruptured IAs treated with flow diverters (FDs). The primary outcome was the modified Rankin Scale (mRS) score at the last available follow-up time. Secondary outcomes were treatment-related complications and the aneurysm occlusion rate.Results110 patients (64 females; mean age 55.7 years; range 12–82 years) with acutely ruptured IAs were treated with FDs between 2012 and 2020 in five centers. 70 acutely ruptured IAs (64%) were located in anterior circulation, and 47 acutely ruptured IAs (43%) were blister-like. A favorable functional outcome (mRS 0–2) was seen in 73% of patients (74/102). Treatment-related complications were seen in 45% of patients (n=49). Rebleeding was observed in 3 patients (3%). The data from radiological follow-ups were available for 80% of patients (n=88), and complete occlusion was seen in 90% of aneurysms (79/88). The data from clinical follow-ups were available for 93% of patients (n=102). The overall mortality rate was 18% (18/102).ConclusionsFD treatment yields high occlusion for acutely ruptured IAs but is associated with a high risk of complications. Considering the high mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of rebleeding is crucial. Thus, FD treatment may be justified as a last resort option.

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