Intracranial hematomas following aneurysmal rupture: Experience with 309 cases

Pasqualin, A.; Bazzan, Alberto; Cavazzani, Paolo; Scienza, Renato; Licata, Claudio; Pian, R. Da

doi:10.1016/0090-3019(86)90107-2

Cited by 155 publications

(64 citation statements)

References 25 publications

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“…Pasqualin, et al, [14] have reported that the incidence rate was 34% in 899 patients with an ICH due to a ruptured aneurysm and that the most frequent site of aneurysm rupture was the MCA (55%). Important factors that predispose to intracerebral aneurysm rupture include the rapid obstruction of the subarachnoid space by blood, fibrin, and fibrous arachnoid and the adhesion of the aneurysmal sac to the pia mater.…”

Section: Hematoma Typementioning

confidence: 99%

Surgical indications in patients with an intracerebral hemorrhage due to a ruptured middle cerebral artery aneurysm

Shimoda¹,

Oda²,

Mamata³

et al. 1996

FOC

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The authors retrospectively analyzed surgical outcomes in patients with an intracerebral hemorrhage (ICH) due to a ruptured middle cerebral artery aneurysm. A total of 47 patients with ICH who underwent early aneurysm surgery and hematoma evacuation within 24 hours following onset were studied. The types of ICH were classified into three groups by computerized tomography findings: 1) temporal ICH; 2) intrasylvian hematoma; and 3) ICH with diffuse subarachnoid hemorrhage (SAH). Overall, 25 patients (54%) had a favorable outcome and 18 (38%) died. Prognostic factors that predicted a favorable outcome included age less than 60 years, temporal ICH, World Federation of Neurological Surgeons Grade II or III, absence of a surgical complication, and a hematoma volume of less than 25 ml. In the patients with temporal ICH, eight of nine patients had a good recovery, and no patient developed a surgical complication or a delayed ischemic deficit. The most important predictive factor for a favorable outcome in patients with an intrasylvian hematoma was that they underwent early surgery (within 6 hours after symptom onset). In patients with a temporal ICH or intrasylvian hematoma, the initial neurological examination did not accurately predict outcome. By contrast, in the patients with ICH and diffuse SAH, those who developed an ICH with a volume of 25 ml or greater had a poor prognosis. These results suggest that aggressive surgical treatment should be initiated in patients with a temporal ICH or an intrasylvian hematoma, regardless of neurological findings on admission. In patients with an ICH and diffuse SAH, careful review of surgical indications is required.

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Section: Hematoma Typementioning

confidence: 99%

Surgical indications in patients with an intracerebral hemorrhage due to a ruptured middle cerebral artery aneurysm

Shimoda¹,

Oda²,

Mamata³

et al. 1996

FOC

View full text Add to dashboard Cite

show abstract

“…In 1986, Pasqualin et al [8] treated 142 ruptured aneurysms accompanying ICH by clipping the aneurysms with simultaneous ICH evacuation via a single craniotomy. Thirty-four (24%) of 142 patients had good results and were functionally independent, while 82 (58%) of 142 patients died.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of an ICH from a ruptured aneurysm is known to be a negative prognostic factor and is associated with high mortality rates [3,8]. The most common location of aneurysm accompanying ICH is the middle cerebral artery (MCA) [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…The most common location of aneurysm accompanying ICH is the middle cerebral artery (MCA) [1,2]. It has been generally accepted that the standard treatment of ruptured aneurysms with ICH should be surgical clipping with simultaneous ICH evacuation, although the mortality rates have been shown to be high with a reported range of 21 to 85% [8][9][10][11]. However, ICHs caused by ruptured anterior communicating artery (AcomA) aneurysms have characteristics different from those caused by ruptured MCA aneurysms; therefore, they are treated with different methods: Ruptured anterior communicating artery (AcomA) aneurysms have less mass effect than MCA aneurysms, and consequently, early and ultra-early evacuation of ICHs often is not necessary.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of ruptured anterior communicating artery aneurysm accompanying intracerebral hematomas: endovascular coiling followed by hematoma evacuation with burr hole trephination and catheterization

et al. 2009

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“…1,3,5,6,17,19,29,34) Patients do not always achieve outcomes consistent with their initial neurological status, and 50-60% of patients affected by rupture of an intracranial aneurysm can become functional survivors. 3,[9][10][11][12]14,18,20,22,25,26) However, insufficient surgical intervention may result in loss of potentially salvageable function or life.…”

Section: Introductionmentioning

confidence: 99%

Poor-Grade Ruptured Middle Cerebral Artery Aneurysm With Intracerebral Hematoma: Bleeding Characteristics and Management

Kazumata

Kamiyama

Yokoyama

et al. 2010

Neurol. Med. Chir.(Tokyo)

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Poor-grade ruptured middle cerebral artery aneurysm is frequently associated with intraparenchymal hemorrhage, which is associated with high morbidity rates. We analyzed the clinical presentations and surgical strategies of 23 cases of ruptured middle cerebral artery aneurysm. Hematomas were divided into three types: temporal hematoma (7 patients), sylvian hematoma (10 patients), and frontal hematoma (6 patients). In 13 of 23 patients, preoperative brainstem symptoms suggested impeding uncal herniation. Surgical procedures included external decompression in 11 patients, simple lateral temporal lobectomy in 5, and selective uncectomy in 9. Three patients died. Favorable outcome defined as upper half of severely disabled or better in the extended Glasgow Outcome Scale was achieved in 13 patients. Patients with frontal hematomas presented with both uncal herniation and brainstem signs preoperatively, but this subgroup showed unexpectedly good recovery. Patients with sylvian hematomas had relatively poor outcomes. The present series suggests that aggressive decompression and evacuation of hematoma in the acute stage may prevent significant postoperative brain swelling, and will not compromise the treatment of vasospasm.

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Intracranial hematomas following aneurysmal rupture: Experience with 309 cases

Cited by 155 publications

References 25 publications

Surgical indications in patients with an intracerebral hemorrhage due to a ruptured middle cerebral artery aneurysm

Surgical indications in patients with an intracerebral hemorrhage due to a ruptured middle cerebral artery aneurysm

Treatment of ruptured anterior communicating artery aneurysm accompanying intracerebral hematomas: endovascular coiling followed by hematoma evacuation with burr hole trephination and catheterization

Poor-Grade Ruptured Middle Cerebral Artery Aneurysm With Intracerebral Hematoma: Bleeding Characteristics and Management

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