Incidence, Management, and Outcome of Patients with Premature Rupture of Cerebral Aneurysms During Surgery

Seifert, Volker; Stolke, D.; Trost, H. A.; Brüning, A; Schäffer, Jürgen

doi:10.1007/978-3-642-74279-8_34

Cited by 8 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of six (21%) operations with premature aneurysm rupture is in line with other reports where the frequency of premature aneurysm rupture ranges between 15 and 35 percent [4,22,52]. According to our results, intra-operative aneurysm rupture had no effect on cognition few days after surgery.…”

Section: Premature Aneurysm Rupture and Temporary Clippingsupporting

confidence: 93%

“…According to our results, intra-operative aneurysm rupture had no effect on cognition few days after surgery. In contrast, Seifert et al [52] found an unfavourable effect of premature aneurysm rupture during surgery on subsequent neurological outcome (GOS). But in the present study, only patients with a good late result (GOS = I) were examined, while Seifert et al [52] also included patients with a poor neurological outcome according to the GOS.…”

Section: Premature Aneurysm Rupture and Temporary Clippingmentioning

confidence: 92%

“…In contrast, Seifert et al [52] found an unfavourable effect of premature aneurysm rupture during surgery on subsequent neurological outcome (GOS). But in the present study, only patients with a good late result (GOS = I) were examined, while Seifert et al [52] also included patients with a poor neurological outcome according to the GOS. Batjer and Samson [4] found that if the rupture was secondary to blunt trauma to the aneurysm associated with inappropriate premature clipping, this was linked to a substantially worse neurological result.…”

Section: Premature Aneurysm Rupture and Temporary Clippingmentioning

confidence: 92%

“…[9] concluded from their study about temporary clipping in aneurysm surgery that this technique can be regarded as a safe procedure. Other neurosurgeons have important objections to temporary clipping [44,50,52]. Schramm et al [50] found that some of their patients in whom temporary vessel occlusion was used showed new postoperative deficits due to ischaemia during surgery.…”

Section: Premature Aneurysm Rupture and Temporary Clippingmentioning

confidence: 98%

See 3 more Smart Citations

Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage

Hütter

Gilsbach

1996

Acta neurochir

View full text Add to dashboard Cite

In order to disclose the immediate cognitive sequelae of early aneurysm surgery and subarachnoid haemorrhage (SAH), a series of 28 patients was examined neuropsychologically one to 13 days (median 5 days) after surgery. Cognitive deficits emerged in short- and long-term memory, language and in different functions of attention. There was no effect of ACoA aneurysm location on neuropsychological test performance. No substantial effect of premature aneurysm rupture or surgical approach could be revealed. Temporary clipping of vessels was associated with significantly worse selective attention and phasic alertness (p < 0.05, respectively). Partial resection of the gyrus rectus led to a worse short-term memory (p = 0.02). In regression analyses, the duration of temporary clipping was associated with worse short-term memory (adjusted r2 = 0.68; p = 0.007) and decreased phasic alertness (adjusted r2 = 0.47; p = 0.035). The clinical state on admission (Hunt and Hess) predicted an impaired phasic alertness (adjusted r2 = 0.43; p = 0.004). It is concluded from the results, that certain procedures and events in aneurysm surgery can have neuropsychological effects. The present study is restricted by the small sample size. Therefore, a prospective study with a larger patient sample is required for further confirmation of the present findings.

show abstract

Section: Premature Aneurysm Rupture and Temporary Clippingsupporting

confidence: 93%

Section: Premature Aneurysm Rupture and Temporary Clippingmentioning

confidence: 92%

Section: Premature Aneurysm Rupture and Temporary Clippingmentioning

confidence: 92%

Section: Premature Aneurysm Rupture and Temporary Clippingmentioning

confidence: 98%

See 2 more Smart Citations

Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage

Hütter

Gilsbach

1996

Acta neurochir

View full text Add to dashboard Cite

show abstract

“…44 Several reports have described important measures taken to control intraoperative aneurysmal rupture, including proximal and distal control for temporary clipping prior to aneurysm dissection, tamponade, suction, performing surgery with or without hypotension, and cerebral protection with hypothermia or pharmacological agents. 28,44,46,63,64 In the event of an intraoperative rupture, free cotton applied to a bleeding site will tamponade the hemorrhage and provide a larger surface area where suction can be applied to facilitate visualization and clip placement. The cotton-clip construct acts as a durable bolster, which is located far enough distally on the neck to maintain patency of the parent vessel lumen (Fig.…”

Section: Utility and Techniques Of Cotton-clipping And Cotton-augmentmentioning

confidence: 99%

Techniques and long-term outcomes of cotton-clipping and cotton-augmentation strategies for management of cerebral aneurysms

Safavi–Abbasi

Moron²,

Sun

et al. 2016

JNS

View full text Add to dashboard Cite

obJective To address the challenges of microsurgically treating broad-based, frail, and otherwise complex aneurysms that are not amenable to direct clipping, alternative techniques have been developed. One such technique is to use cotton to augment clipping ("cotton-clipping" technique), which is also used to manage intraoperative aneurysm neck rupture, and another is to reinforce unclippable segments or remnants of aneurysm necks with cotton ("cottonaugmentation" technique). This study reviews the natural history of patients with aneurysms treated with cotton-clipping and cotton-augmentation techniques. methods The authors queried a database consisting of all patients with aneurysms treated at Barrow Neurological Institute in Phoenix, Arizona, between January 1, 2004, and December 31, 2014, to identify cases in which cotton-clipping or cotton-augmentation strategies had been used. Management was categorized as the cotton-clipping technique if cotton was used within the blades of the aneurysm clip and as the cotton-clipping technique if cotton was used to reinforce aneurysms or portions of the aneurysm that were unclippable due to the presence of perforators, atherosclerosis, or residual aneurysms. Data were reviewed to assess patient outcomes and annual rates of aneurysm recurrence or hemorrhage after the initial procedures were performed. results The authors identified 60 aneurysms treated with these techniques in 57 patients (18 patients with ruptured aneurysms and 39 patients with unruptured aneurysms) whose mean age was 53.1 years (median 55 years; range 24-72 years). Twenty-three aneurysms (11 cases of subarachnoid hemorrhage) were treated using cotton-clipping and 37 with cotton-augmentation techniques (7 cases of subarachnoid hemorrhage). In total, 18 patients presented with subarachnoid hemorrhage. The mean Glasgow Outcome Scale (GOS) score at the time of discharge was 4.4. At a mean follow-up of 60.9 ± 35.6 months (median 70 months; range 10-126 months), the mean GOS score at last follow-up was 4.8. The total number of patient follow-up years was 289.4. During the follow-up period, none of the cotton-clipped aneurysms increased in size, changed in configuration, or rebled. None of the patients experienced early rebleeding. The annual hemorrhage rate for aneurysms treated with cotton-augmentation was 0.52% and the recurrence rate was 1.03% per year. For all patients in the study, the overall risk of hemorrhage was 0.35% per year and the annual recurrence rate was 0.69%. coNclusioNs Cotton-clipping is an effective and durable treatment strategy for intraoperative aneurysm rupture and for management of broad-based aneurysms. Cotton-augmentation can be safely used to manage unclippable or partially clipped intracranial aneurysms and affords protection from early aneurysm re-rupture and a relatively low rate of late rehemorrhage.

show abstract

Human Memory Dysfunctions Due to Septal Lesions

Cramon

Markowitsch²

2000

The Behavioral Neuroscience of the Septal Region

View full text Add to dashboard Cite

Incidence, Management, and Outcome of Patients with Premature Rupture of Cerebral Aneurysms During Surgery

Cited by 8 publications

References 12 publications

Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage

Early neuropsychological sequelae of aneurysm surgery and subarachnoid haemorrhage

Techniques and long-term outcomes of cotton-clipping and cotton-augmentation strategies for management of cerebral aneurysms

Human Memory Dysfunctions Due to Septal Lesions

Contact Info

Product

Resources

About