Temporary vessel occlusion and barbiturate protection in cerebral aneurysm surgery.

Abstract:

:In a review of 147 patients with intracranial aneurysms surgically treated by one surgeon (FAD) between 1980 and 1987, 36 selected patients received intraoperative barbiturate protection with sodium thiopental during temporary arterial occlusion. Thiopental doses of 5 to 15 mg/kg were used. Twenty-nine of 36 (81%) had ruptured aneurysms. Occlusion times ranged from 3 to 93 minutes, with a mean of 16.2 minutes. Seven patients had new neurological deficit in the immediate postoperative period, but in only two did these persist. Twenty-one patients (72%) with subarachnoid hemorrhage and 6 with incidental aneurysms made a good recovery. Of the 9 patients with significant permanent deficit, all but 2 were related to either the severity of the initial hemorrhage or to delayed vasospasm. In only one instance might temporary arterial occlusion have led to permanent neurological sequelae. Temporary arterial occlusion with barbiturate protection is a safe technique. For aneurysms that are more surgically complex, it allows for complete dissection of the aneurysm neck and identification and preservation of the surrounding vascular anatomy, while reducing the risk of intraoperative rupture and postoperative stroke.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

McDermott MW,Durity FA,Borozny M,Mountain MA

doi

10.1097/00006123-198907000-00010

subject

Has Abstract

pub_date

1989-07-01 00:00:00

pages

54-61; discussion 61-2

issue

1

eissn

0148-396X

issn

1524-4040

journal_volume

25

pub_type

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