Does a routine operation for intracranial aneurysm incur brain damage?

Area of Science:

• Neurosurgery
• Neurology
• Biochemistry

Background:

• Subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms poses significant risks.
• Assessing intraoperative brain injury is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the BB-isozyme of Creatine Kinase (CK BB) as a biochemical marker for brain cell damage following surgery for ruptured intracranial aneurysms.
• To correlate postoperative CK BB levels with the degree of brain injury and patient outcomes.

Main Methods:

• CSF-CK BB levels were measured before and after surgery in 60 patients undergoing aneurysm repair.
• CK BB activity was determined after immunological inactivation of CK-M.
• Patients were categorized based on pre-operative condition, surgical timing, and postoperative course.

Main Results:

• Pre-operative CSF-CK BB levels were slightly elevated in acutely operated patients, likely due to SAH.
• A significant increase (p<0.01) in postoperative CSF-CK BB was observed in patients with immediate neurological deterioration compared to those with uneventful recovery.
• 52 out of 60 patients showed a rise in CSF-CK BB post-operation; a mean increase of 0.02 mikrokatal was considered acceptable in uncomplicated cases.

Conclusions:

• CSF-CK BB is a sensitive indicator of brain cell damage after intracranial aneurysm surgery.
• Elevated postoperative CSF-CK BB levels are significantly associated with immediate neurological deterioration.
• This marker aids in evaluating the extent of brain injury and predicting patient outcomes.