ABSTRACT
Preventive temporary clipping of the carrying arteries reduces the incidence of intraoperative hemorrhage in anterior connecting arterial aneurysms from 26 to 13%, in middle cerebral arterial arterial aneurysms from 29 to 4%. In anterior connecting arterial aneurysms, the use of preventive temporary clipping of the carrying arteries fails to affect surgical outcomes. In middle cerebral arterial arterial aneurysms, this procedure decreases postoperative mortality from 17 to 12% by reducing the incidence of intraoperative hemorrhage; however, the rates of disability due to possible brain ischemia in the middle cerebral arterial bed rates increases from 32 to 40%.
Subject(s)
Cerebral Arteries/surgery , Intracranial Aneurysm/surgery , Aneurysm, Ruptured/mortality , Aneurysm, Ruptured/surgery , Cerebral Hemorrhage/epidemiology , Cerebral Hemorrhage/prevention & control , Cerebral Hemorrhage/surgery , Constriction , Hematoma/mortality , Hematoma/surgery , Humans , Incidence , Intracranial Aneurysm/complications , Intracranial Aneurysm/mortality , Intraoperative Complications/epidemiology , Intraoperative Complications/prevention & control , Intraoperative Complications/surgery , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
The study indicated that intraoperative hemorrhages more frequently occurred at early surgery. During operations made in the first 7, 8-14 days of and after a fortnight of aneurysmal rupture, the incidence of hemorrhage was 27.5, 23, and 22%, respectively. Intraoperative hemorrhage more commonly occurred from carotid aneurysms at surgery within the first 14 days after the onset of bleeding and from anterior connective arterial aneurysm at surgery made later. Intraoperative hemorrhage deteriorated surgical outcomes. In bleeding from the anterior communicans, carotid, and middle cerebral artery aneurysms, the postoperative mortality showed 1.5-, 2-, and 2.5-fold increases, respectively. At the same time, the outcomes of interventions depended on the duration of temporary clipping of the great cerebral arteries.
Subject(s)
Cerebral Hemorrhage/etiology , Intracranial Aneurysm/complications , Intraoperative Complications/etiology , Cause of Death , Cerebral Hemorrhage/epidemiology , Cerebral Hemorrhage/surgery , Humans , Incidence , Intracranial Aneurysm/mortality , Intracranial Aneurysm/surgery , Intraoperative Complications/epidemiology , Intraoperative Complications/surgery , Severity of Illness Index , Time Factors , Treatment OutcomeSubject(s)
Cerebellar Diseases/diagnosis , Intracranial Aneurysm/diagnosis , Adult , Cerebellar Diseases/complications , Cerebellar Diseases/surgery , Emergencies , Hematoma/diagnosis , Hematoma/etiology , Hematoma/surgery , Humans , Intracranial Aneurysm/complications , Intracranial Aneurysm/surgery , Male , Rupture, Spontaneous/complications , Rupture, Spontaneous/diagnosis , Rupture, Spontaneous/surgery , Subarachnoid Hemorrhage/diagnosis , Subarachnoid Hemorrhage/etiology , Subarachnoid Hemorrhage/surgeryABSTRACT
It is shown in seven patients with partial commissurotomy in connection with arterial aneurysms of the anterior conjunctival and pericallosal arteriae, that the section of the corpus callosum leads to memory disturbances, qualitatively differing by their structure from mnemic disorders described in literature. Important role of the knee of the Corpus callosum in genesis of these disturbances is revealed, their types are described and neuropsychological are criteria formulated of evaluation of disturbance of interhemispheric interaction in the mnemic sphere, opening new perspectives in diagnosis and correction of mental processes disturbances at local brain lesions.