Postoperative Rupture of an Untreated Aneurysm on the 3rd Day After Subarachnoid Hemorrhage Surgery-Case Report-
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- HASHIMOTO Yuji
- Department of Neurosurgery, Hakodate Municipal Hospital
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- HORITA Yoshifumi
- Department of Neurosurgery, Hakodate Municipal Hospital
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- IMAIZUMI Toshio
- Department of Neurosurgery, Hakodate Municipal Hospital
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- NIWA Jun
- Department of Neurosurgery, Hakodate Municipal Hospital
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- タイトル別名
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- —Case Report—
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A 58-year-old male presented with severe consciousness disturbance and left hemiparesis. Computed tomography (CT) revealed subarachnoid hemorrhage (SAH) and acute subdural hematoma caused by a ruptured right middle cerebral artery aneurysm. The aneurysm was clipped and the hematoma was evacuated. The patient had almost recovered without new neurological deficits on the next day. Arterial systolic blood pressure was postoperatively controlled within 120 to 150 mmHg. Continuous ventricular and cisternal drainage from the level 10 cm above the external auditory meatus was performed to drain bloody cerebrospinal fluid and prevent vasospasm. Three days after surgery, the patient suddenly lapsed into a coma. CT demonstrated diffuse SAH and bilateral intraventricular hemorrhage caused by rupture of an anterior communicating artery aneurysm. Neck clipping was performed immediately. Unfortunately, the patient died of primary damage due to SAH 3 days after the second surgery. In this case, cisternal drainage was probably important in the aneurysm rupture because of decreased intracranial pressure and change in the perianeurysm environment. Postoperative management of patients with residual untreated aneurysms must consider the possibility that cisternal drainage may result in higher transmural pressure, leading to rupture of the untreated aneurysms.<br>
収録刊行物
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 45 (5), 249-252, 2005
一般社団法人 日本脳神経外科学会
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詳細情報 詳細情報について
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- CRID
- 1390282680026617856
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- NII論文ID
- 110002283590
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- NII書誌ID
- AN00358613
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- ISSN
- 13498029
- 04708105
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- PubMed
- 15914965
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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