Reoperations in Patients with Aneurysmal Clippings

Lee, Kuen Woo; Hamm, In Suk; Sung, Joo Kyung

Abstract

The authors have clinically analysed the patients who required the reoperations after the aneurysmal clippings with intention to decrease the rate of reoperation as predicting the risk factors causing the postoperative complications or sequelae of subarachnoid hemorrhage. Between 1991 and 1996, we have performed total operation on 691 patients with aneurysmal subarachnoid hemorrhage. Among these, 72 patients(10.4% of total) required to be reoperated due to various causes. The shunt for hydrocephalus which was the most common cause of reoperation, performed in 57 patients(79.2% of the reoperated), and next, trephination for the subdural hygroma in 12 cases (16.7%), removal of the intracranial hematoma on the operated site in 7 cases(9.7%), reclipping of aneurysms for the regrowing of aneurysm rest or undiscovered aneurysm preoperatively in 5 cases(7%), and decompressive surgery for postoperative brain swelling and vasospasm in 2 cases(2.8%). The authors suggest that the perfect aneurysmal clipping and the detailed evaluation to decrease these complications of aneurysmal surgery, and careful attention should be given to find out the hidden or regrowing of aneurysmal rest are needed on pre-, postoperatively, and during the operation procedure.