Skip to main content
Log in

Intracranial aneurysms in India—Microsurgical approach

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

This is a retrospective study of 100 cases of intracranial aneurysms, treated in an Indian hospital, reflecting the special situation and experiences in our country.

The incidence of subarachnoid haemorrhage due to ruptured aneurysm has been more or less the same as is reported from other parts of the world. The cases of recurrent haemorrhage resulting in poor clinical status are more common in our situation. Delayed referral and diagnosis were responsible for recurrent haemorrhage, increased morbidity and mortality. Forty two percent developed cerebral vasospasm within two weeks after the bleed. The use of a temporary clip on the parent vessel prevented the intraoperative rupture of the aneurysm while dissecting round about the aneurysm. Operative mortality was eight percent in the present series.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Allen GS, Ahn HS, Preziost TJ, Battye R, Boone SC, Chou SN, Kelly DL, Weit BK, Crabbe RA, Lavik PJ, Rosenbloom SB, Dorsey FC, Ingram CR, Mellits DE, Bertsch LA, Boisvert DJ, Hundley MB, Johnson RK, Strom JA, Transou CR (1983) Cerebral arterial spasm—a controlled trial of nimodipine in patients with subarachnoid haemorrhage. N Engl J Med 308: 619–621

    PubMed  Google Scholar 

  2. Aoyagi Norio, Hayakawa Isao (1984) Analysis of 223 ruptured intracranial aneurysms with special reference ot rerupture. Surg Neurol 21: 445–452

    PubMed  Google Scholar 

  3. Auer LM (1983) Acute surgery of cerebral aneurysms and prevention of symptomatic vasospasm. Acta Neurochir (Wien) 69: 273–281

    Google Scholar 

  4. Auer LM, Brandt L, Ebeling U, Gilsbach J, Groeger U, Harders A, Ljunggren B, Oppel F, Reulen HJ, Saveland H (1986) Nimodipine and early aneurysm operation for good condition SAH patients. Acta Neurochir (Wien) 82: 7–13

    Google Scholar 

  5. Bolander HG, Kourtopoulos H, West KA (1984) Retrospective analysis of 162 consecutive cases of ruptured intracranial aneurysms. Total mortality and early surgery. Acta Neurochir (Wien) 70: 31–41

    Google Scholar 

  6. Dalal PM (1965) Incidence of cerebrosvascular lesions at the Nair Hospital, Bombay. Neurology (India) 13: 37–39

    Google Scholar 

  7. De Palme RG, Chidi CC, Sternfeld WC, Koletsky S (1977) Pathogenesis and prevention of trauma provoked atheromas. Surgery 82: 429–437

    PubMed  Google Scholar 

  8. Dodson RF, Tagashira Y, Chu LW-F (1976) Acute ultrastructural changes in MCA due to injury and ischaemia of surgical clamping. Can J Neurol Sci 3: 23–27

    PubMed  Google Scholar 

  9. Dujovny M, Wakenhut N, Kossovsky N, Gomes CW, Laha RK, Leff L, Nelson D (1979) Minimal occlusive force. J Neurosurg 51: 662–668

    PubMed  Google Scholar 

  10. Ebina K, Iwabuchi T, Suzuki S (1982) Histological change in permanently clipped or ligated cerebral arterial wall. Part II: Autopsy cases of aneurysmal neck clipping. Acta Neurochir (Wien) 66: 23–42

    Google Scholar 

  11. Epinsoa F, Weir B, Overton T, Castor W, Grace M, Boisuent D (1984) A randomised placebo-controlled double blind trial of nimodipine after SAH in monkeys. Part I: Clinical and radiological findings. J Neurosurg 60: 1167–1175

    PubMed  Google Scholar 

  12. Epinosa F, Weir B, Shnitka T, Overton T, Boisuent D (1984) A randomised placebo-controlled double blind trial of nimodipine after SAH in monkeys. Part 2: Pathological findings. J Neurosurg 60: 1176–1185

    PubMed  Google Scholar 

  13. Gilsbach JM, Harders AG, Eggert HR, Hornyak ME (1988) Early aneurysm surgery: a 7 year clinical practice report. Acta Neurochir (Wien) 90: 91–102

    Google Scholar 

  14. Hori S, Suzuki J (1979) Early intracranial operations for ruptured aneurysms. Acta Neurochir (Wien) 46: 93–104

    Google Scholar 

  15. Hotta T, Tokuda S, Nishiya M, Tanaka Y, Nakamura J (1982) Surgical results of intracranial ruptured aneurysms in the acute stage. Acta Neurochir (Wien) 63: 193–200

    Google Scholar 

  16. Hunt WE, Hess RM (1986) Surgical risks as related to time of intervention in the repair of intracranial aneurysm. J Neurosurg 28: 14–20

    Google Scholar 

  17. Ito U, Tomito H, Yamazaki Sh, Takada Y, Inaba Y (1986) Enhanced cisternal drainage and cerebral vasospasm in early aneurysm surgery. Acta Neurochir (Wien) 80: 18–23

    Google Scholar 

  18. Jabre A, Symon L (1987) Temporary vascular occlusion during aneurysm surgery. Surg Neurol 27: 47–63

    PubMed  Google Scholar 

  19. Jomin M, Lesoin F, Lozes G (1984) Prognosis with 500 ruptured and operated intracranial aneurysms. Surg Neurol 21: 13–18

    PubMed  Google Scholar 

  20. Kassell NF, Kongable GL, Torner JC, Adams HP Jr, Haia Mazuz BS (1985) Delay in referral of patients with ruptured aneurysms to neurosurgical attention. Stroke 16: 587–590

    PubMed  Google Scholar 

  21. Kassell NJ, Peerless SJ, Durward QJ, Beck DW, Dake CG, Adams HP (1982) Treatment of ischemie deficits from vasospasm with intravascular volume expansion and induced arterial hypertension. Neurosurgery 11: 337–341

    PubMed  Google Scholar 

  22. Kassell NJ, Torner JC (1983) Aneurysmal rebleeding: a preliminary report from the Cooperative Aneurysm Study. Neurosurgery 13: 479–481

    PubMed  Google Scholar 

  23. Ljunggren B, Brandt L, Kaagstrom E, Sundbarg G (1981) Results of early operations for ruptured aneurysms. J Neurosurg 54: 437–439

    Google Scholar 

  24. Loughheed WM, Marshall BM (1973) Management of aneurysms of the anterior circulation by intracranial procedure. In: Youmans JR (ed) Neurological surgery, vol 2. Saunders, Philadelphia, pp 731–767

    Google Scholar 

  25. Mathai KV, Chandy J (1965) Incidence of subarachnoid haemorrhage. Neurology (India) 13: 40–41

    Google Scholar 

  26. Nibbelink DW, Torner J, Henderson WG(1977) Intracranial aneurysms and SAH. Stroke 8: 202–218

    PubMed  Google Scholar 

  27. Philippon J, Grob R, Dagreou F, Guggiary M, Rivierez M, Viars P (1986) Prevention of vasospasm in subarachnoid haemorrhage. A controlled study with nimodipine. Acta Neurochir (Wien) 82: 110–114

    Google Scholar 

  28. Pia HW (1978) Microsurgical treatment of cerebral aneurysms. Neurosurgery Rev 1/2: 15

    Google Scholar 

  29. Prakash B, Tandon PN, Reddy AK (1982) Spontaneous subarachnoid haemorrhage. Seara Med Neuro-Cir 11: 23–32 (Macro)

    Google Scholar 

  30. Ramamurthi B (1965) Are subarachnoid haemorrhages uncommon in India? Neurology (India) 13: 42–43

    Google Scholar 

  31. Saito I, Sano K (1978) Timing and indication of surgery for ruptured intracranial aneurysms with regard to cerebral vasospasm. Acta Neurochir (Wien) 41: 49–60

    Google Scholar 

  32. Sambasivan M, Ramachandan Nair SK, Sanal Kumar P, Jaya Kumar K (1984) Analysis of 1000 cases of SAH and experience with intracranial aneurysms. Neurology (India) 3: 17–24

    Google Scholar 

  33. Sano K, Saito I (1980) Early operation and washout of blood clots for prevention of cerebral vasospasm. In: Wilkins RH (ed) Cerebral arterial spasm, Proc second international workshop. Williams and Wilkins, Baltimore, pp 510–513

    Google Scholar 

  34. Sugita K, Hiroti T, Iguchi I, Mizutani T (1976) Comparative study of the pressure of various aneurysm clips. J Neurosurg 44: 723–727

    PubMed  Google Scholar 

  35. Suzuki J (1979) Prognosis of 1000 pure saccular aneurysms operated upon. In: Pia HW, Langmaid C, Zunski J (eds) Cerebral aneurysms: advances in diagnosis and therapy. Springer, Berlin Heidelberg New York, pp 413–418

    Google Scholar 

  36. Suzuki J, Kodama N, Yoshimoto T, Mizoi K (1982) Ultra early surgery of intracranial aneurysms. Acta Neurochir (Wien) 63: 185–191

    Google Scholar 

  37. Suzuki J, Onuma T, Yoshimoto T (1979) Results of early opeation of cerebral aneurysms. Surg Neurol 11: 107–112

    PubMed  Google Scholar 

  38. Symon L (1973) Vasospasm. (Reprint from International congress series, no 320.) In: Recent progress in neurological surgery. Proc 5th international congress of neurological surgery, Tokyo. Excerpta Medica, Amsterdam

    Google Scholar 

  39. Takahashi SH, Sonobe M, Nagamine Y (1981) Early operations for ruptured intracranial aneurysms. Comparative study with computed tomography. Acta Neurochir (Wien) 57: 23–31

    Google Scholar 

  40. Tandon PN, Ramamurthi B, Kak VK, Chatterjee RN, Sambasivan M (1981) Collaborative epidemiological study of subarachnoid haemorrhage in India. Proc XXXI annual conference of the neurological society of India

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saxena, A., Prakash, B. Intracranial aneurysms in India—Microsurgical approach. Acta neurochir 101, 18–22 (1989). https://doi.org/10.1007/BF01410063

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01410063

Keywords

Navigation