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Subdural hematoma due to ruptured intracranial aneurysm
K Kamiya1, T Inagawa, M Yamamoto
1Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Neurologia Medico-Chirurgica
|February 1, 1991
Summary
Subdural hematoma (SDH) complicates aneurysmal subarachnoid hemorrhage (SAH). Early surgical intervention for ruptured aneurysms with SDH improves prognosis, even in severe cases.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) is a life-threatening condition often associated with complications.
- Subdural hematoma (SDH) is a recognized but less common complication of SAH.
Observation:
- This study analyzed 15 cases of SDH in 484 patients with aneurysmal SAH.
- The majority of patients with SDH were female, with ages ranging from 39 to 75.
- Ruptured aneurysms were frequently located in the middle cerebral artery (MCA) and distal anterior cerebral artery (ACA).
Findings:
- Seven patients underwent acute surgical intervention (aneurysmal clipping and SDH removal) with good outcomes in five.
- Eight patients who did not receive surgical intervention in the acute stage all died.
- Surgical intervention in the acute stage correlated with improved survival and functional outcomes.
Implications:
- Direct surgical intervention in the acute phase is crucial for improving outcomes in patients with ruptured intracranial aneurysms and concomitant SDH.
- Prompt surgical management can offer a good prognosis even for patients presenting with poor clinical grades.
- This highlights the importance of considering surgical options early in the management of complex SAH cases.