intraoperative rupture of unruptured cerebral aneurysm during craniotomy: a case report

intraoperative rupture of unruptured cerebral aneurysm during craniotomy: a case report

;Kenji Yoshiki;Kouichi Misaki;Iku Nambu;Issei Fukui;Masanao Mohri;Naoyuki Uchiyama;Mitsutoshi Nakada
journal of neuro-oncology 2017 Vol. 9 pp. 261-266
116
yoshiki2017caseintraoperative

Abstract

An unruptured aneurysm was incidentally found in the right middle cerebral artery in a 67-year-old woman. During an attempt to turn the temporalis muscle for surgical clipping, systolic blood pressure suddenly increased. After opening the dura mater, we found a subarachnoid hemorrhage and severe brain swelling. We promptly expanded the craniotomy area to reach the aneurysm while pulling part of the frontal lobe to apply a clip. We retrospectively analyzed the aneurysm using computational fluid dynamics. Our analysis suggests that the rupture of the aneurysm occurred at a location with very low wall shear stress.

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257132
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