Results of surgical treatment of intrasylvian hematomas due to ruptured intracranial aneurysms

Intrasylvian hematoma caused by ruptured middle cerebral artery aneurysms predicts recovery from poor-grade subarachnoid hemorrhage

“…18 Given less initial brain damage and associated secondary brain swelling, previous studies have aimed at intervening to treat one of these pathological processes by early hematoma evacuation or external decompression and have obtained reasonable outcomes from poor-grade SAH with ISH. 2,[19][20][21] Our results also supported validity of early decompression for treatment of SAH with ISH.…”

“…Intrasylvian hematoma (ISH) is a subtype of intracranial hematoma caused by aneurysmal rupture and has distinct features. 2,18,19 Poor-grade SAH with ISH has been considered to be less associated with severe initial injury and regarded as a potential responder to intensive treatment. 2,19,20 The purpose of this study is to clarify whether the presence of ISH predicts good functional recovery from poor-grade aneurysmal SAH.…”

Comparison of Large Intrasylvian and Subpial Hematomas Caused by Rupture of Middle Cerebral Artery Aneurysm

“…If the aneurysm bursts at the dome site which is completely adherent to the pia mater without destruction of the cortex around the ruptured point, bleeding may occur directly into the brain parenchyma, causing subpial hematoma without SAH. 2) Subarachnoid blood entrapped in the relatively large sylvian fissure after aneurysm rupture may be the mechanism underlying the formation of intrasylvian hematoma. 2) The size and the direction of the ruptured aneurysms had no significant difference in the two groups in our present study (data not shown).…”

“…6,7) In a recent large series, patients with MCA aneurysms may have worse outcome than patients with other anterior circulation aneurysms. 2,4) Rupture of MCA aneurysm is reported to account for 35% of cases of intracerebral hematomas, 5,9) and the most frequent origin of aneurysmal bleeding was the MCA (55%). 1,2) Intracerebral hematoma can be classified into three types according to location as follows: subpial hematoma in the temporal lobe, intrasylvian hematoma within the sylvian fissure, or mixed hematoma of both.…”

“…2,4) Rupture of MCA aneurysm is reported to account for 35% of cases of intracerebral hematomas, 5,9) and the most frequent origin of aneurysmal bleeding was the MCA (55%). 1,2) Intracerebral hematoma can be classified into three types according to location as follows: subpial hematoma in the temporal lobe, intrasylvian hematoma within the sylvian fissure, or mixed hematoma of both. 9) The prognostic significance of these types of hematoma remains unclear, but we believe that the hematoma location and the ratio of hematoma types are important factors for the postsurgical prognosis.…”