Abstract:
PURPOSE:The present study investigated the incidence of acute rebleeding after successful coil embolization of a ruptured cerebral aneurysm, including clinical outcomes, and possible mechanisms of the events other than coil compaction and/or incomplete embolization. MATERIALS AND METHODS:This study included 591 consecutive patients who presented with aneurysmal subarachnoid hemorrhage, were treated with coil embolization, and whose post-procedural angiography revealed successful embolization. Data were collected retrospectively from six patients who showed acute rebleeding despite that angiographically successful coil embolization was achieved. All clinical, radiological data and intraoperative videos were reviewed to identify causative factors which could have contributed to the occurrence of rebleeding. RESULTS:Incidence of acute rebleeding after successful coil embolization of ruptured cerebral aneurysm was 1.0% (6/591). In all of these six patients, complete angiographic occlusion was achieved except in one case where a small residual neck was intentionally left to avoid compromise of the parent artery. Four of the six patients showed poor clinical courses, either died or recovered with severe disability. Whenever possible, we performed an immediate craniotomy for exploration and additional clipping. Based on intraoperative findings, we hypothesized that uneven distribution of the coil masses and spontaneous resolution of thrombus among the strands of coil (inter-coil-loop thrombolysis) could be possible mechanisms of rebleeding. CONCLUSION:Acute rebleeding is extremely rare, but is possible as a complication of coil embolization of a ruptured cerebral aneurysm even when a case is angiographically successful. The higher degree of morbidity and mortality is a major concern. Therefore, further investigation to discover risk factors and causative mechanisms for such a complication is sorely needed.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Kang DH,Kim YS,Baik SK,Park SH,Park J,Hamm ISdoi
10.1007/s00701-009-0593-xsubject
Has Abstractpub_date
2010-05-01 00:00:00pages
771-81issue
5eissn
0001-6268issn
0942-0940journal_volume
152pub_type
杂志文章abstract::Anterior spinal decompression and fusion was used as the primary treatment for thoracolumbar fractures in eleven patients with neurological deficits. Each patient achieved stability by interbody fusion. Significant progressive kyphosis did not occur. No patients with a complete neurological deficit was improved by ope...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01664845
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abstract:BACKGROUND:The excitotoxic amino acid glutamate is known to aggravate pre-existing neuropathology. Since volatile anesthetics increase plasma amino acid levels, we investigated if the anesthetics isoflurane and propofol increase plasma and cerebrospinal fluid (CSF) glutamate in neurosurgical patients. METHODS:In disce...
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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journal_title:Acta neurochirurgica
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s00701-011-1129-8
更新日期:2011-11-01 00:00:00
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abstract::We present a case of recurrent metastatic brain tumour spread across a cranial fixation device. ...
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更新日期:2007-12-01 00:00:00
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journal_title:Acta neurochirurgica
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abstract::Syringomyelia is an important cause of neurological deficit. Most cases of non-traumatic syringomyelia occur in association with a Chiari malformation. We present three unusual examples of syringomyelia with such an association. The first case is that of syringomyelia in a young woman with Marfan's syndrome, a spontan...
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pub_type: 杂志文章
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