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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Acute subdural hematoma from ruptured cerebral aneurysm
Serge Marbacher1, Javier Fandino, Anton Lukes
1Department of Neurosurgery, Inselspital, University of Bern, 3010 Bern, Switzerland. serge.marbacher@ksa.ch
Acta Neurochirurgica
|October 27, 2009
Summary
Ruptured aneurysms with acute subdural hematomas (aSDH) are rare but can lead to poor outcomes. Prompt surgical evacuation of the hematoma and aneurysm obliteration can result in favorable recovery for patients with aneurysmal subarachnoid hemorrhage (SAH).
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Ruptured aneurysms rarely present with acute subdural hematomas (aSDH), forming a distinct subgroup of aneurysmal subarachnoid hemorrhage (SAH).
- Understanding the clinical profile, diagnostic pathways, and management strategies for this rare condition is crucial for improving patient outcomes.
Observation:
- A retrospective review of 743 SAH patients identified seven cases (0.9%) with associated aSDH.
- Patients often presented with severe neurological deficits (WFNS grade 5 in 5/7 cases).
- Mean aSDH width was 11.2 mm, with three patients initially suspected of trauma.
Findings:
- All seven patients underwent surgical evacuation of the aSDH.
- Aneurysm obliteration was achieved surgically in four patients, with two undergoing delayed endovascular or surgical treatment.
- Outcomes included complete recovery in three patients, mild disability in three, and one mortality.
Implications:
- The low incidence of aSDH associated with ruptured aneurysms underscores its rarity.
- Early surgical intervention for both the hematoma and the aneurysm is associated with favorable outcomes, even in critically ill patients.
- CT angiography (CTA) is recommended for all aSDH patients without clear trauma to identify associated aneurysms.
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