Clinical Features of Acute Subdural Hematomas Caused by Ruptured Intracranial Aneurysms
Journal of Korean Neurosurgical Society
; : 6-10, 2011.
Article
ي En
| WPRIM
| ID: wpr-48922
المكتبة المسؤولة:
WPRO
ABSTRACT
OBJECTIVE: Spontaneous acute subdural hematomas (aSDH) secondary to ruptured intracranial aneurysms are rarely reported. This report reviews the clinical features, diagnostic modalities, treatments, and outcomes of this unusual and often fatal condition. METHODS: We performed a database search for all cases of intracranial aneurysms treated at our hospital between 2005 and 2010. Patients with ruptured intracranial aneurysms who presented with aSDH on initial computed tomography (CT) were selected for inclusion. The clinical conditions, radiologic findings, treatments, and outcomes were assessed. RESULTS: A total of 551 patients were treated for ruptured intracranial aneurysms during the review period. We selected 23 patients (4.2%) who presented with spontaneous aSDH on initial CT. Ruptured aneurysms were detected on initial 3D-CT angiography in all cases. All ruptured aneurysms were located in the anterior portion of the circle of Willis. The World Federation of Neurosurgical Societies grade on admission was V in 17 cases (73.9%). Immediate decompressive craniotomy was performed 22 cases (95.7%). Obliteration of the ruptured aneurysm was achieved in all cases. The Glasgow outcome scales for the cases were good recovery in 5 cases (21.7%), moderate disability to vegetative in 7 cases (30.4%), and death in 11 cases (47.8%). CONCLUSION: Spontaneous aSDH caused by a ruptured intracranial aneurysm is rare pattern of aneurysmal subarachnoid hemorrhage. For early detection of aneurysm, 3D-CT angiography is useful. Early decompression with obliteration of the aneurysm is recommended. Outcomes were correlated with the clinical grade and CT findings on admission.
Key words
النص الكامل:
1
الفهرس:
WPRIM
الموضوع الرئيسي:
Subarachnoid Hemorrhage
/
Weights and Measures
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Angiography
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Intracranial Aneurysm
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Circle of Willis
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Aneurysm, Ruptured
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Craniotomy
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Hematoma, Subdural, Acute
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Decompression
/
Aneurysm
نوع الدراسة:
Screening_studies
المحددات:
Humans
اللغة:
En
مجلة:
Journal of Korean Neurosurgical Society
السنة:
2011
نوع:
Article