No abstract

No abstract

No abstract

Rupture of a cerebral aneurysm is often accompanied by intracerebral hematoma or massive subarachnoid hemorrhage. Postoperative hematoma expansion could have adverse effects on patient outcome 2) . In our hospital's treatment of ruptured cerebral aneurysms accompanied by hematoma, we focused on the risk of hematoma expansion after acute phase surgery and retrospectively analyzed the perioperative treatment strategy.Methods: During January 2007-September 2018, 106 patients who met our inclusion criteria were included in this study. We examined the relationship between volume and localization of hematomas, aneurysm treatment, and timing of postoperative anti-vasospasm treatment as factors for postoperative hematoma expansion.Results: Hematoma expansion was observed in 23 patients (21.7%), and an association between hematoma expansion and worse outcomes was observed. The initiation of anti-vasospastic drugs was earlier in this group. Hematoma expansion occurred in 9.1% of patients who underwent clipping proce-dures─significantly lower than the 42.5% of patients who underwent coil embolization procedures (p=0.0001). A high rate of increase in Sylvian fissure hematomas was observed (p＜0.05).Summary : In the treatment of ruptured aneurysms accompanied by hematomas, prevention of hematoma expansion may contribute to improved outcomes. Elapsed time from the onset to embolization was implicated as an effector of hematoma expansion associated with coil embolization. Therefore, it may be better to select clipping when possible and to initiate administration of anti-vasospastic drugs 24 hours postoperatively.