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Updated: Aug 15, 2026
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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Intraoperative intracranial aneurysm rupture
N Phuenpathom1, S Ratanalert, S Saeheng
1Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Summary
Intraoperative aneurysm rupture occurred in 7.6% of surgically treated patients, with a 33.3% mortality rate. Early surgery within 72 hours may increase rupture risk, a point of ongoing debate in neurosurgery.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Surgical Outcomes
Background:
- Intracranial aneurysms require surgical intervention, but intraoperative rupture remains a significant risk.
- Understanding factors influencing intraoperative rupture is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze the incidence, management, and outcomes of intraoperative aneurysm rupture.
- To explore the potential association between early surgical timing and intraoperative rupture risk.
Main Methods:
- Retrospective analysis of 119 surgically treated intracranial aneurysm cases (1984-1997).
- Focus on nine cases with intraoperative aneurysm rupture to identify management strategies and outcomes.
- Review of techniques for hemorrhage control: induced hypotension, suction dissection, temporary parent vessel clips.
Main Results:
- The incidence of intraoperative aneurysm rupture was 7.6%.
- Mortality associated with intraoperative rupture was 33.3%.
- Controversies exist regarding early surgery (within 72 hours) and its impact on rupture and ischemic events.
Conclusions:
- Intraoperative aneurysm rupture carries a high mortality rate.
- The timing of intracranial aneurysm surgery, particularly within 72 hours, warrants further investigation regarding its effect on rupture incidence and potential ischemic complications.
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