Korean J Crit Care Med.  2008 Jun;23(1):40-43. 10.4266/kjccm.2008.23.1.40.

Reversal of Focal Neurologic Deficit due to Preoperative Intracranial Pressure Reduction in a Patient with Early Rebleeding of Cerebral Aneurysm: A Case Report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. hppark@snu.ac.kr
  • 2Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Abstract

In the first hours after initial hemorrhage, up to 15% of patients with subarachnoid hemorrhage (SAH) due to aneurysmal rupture may have a sudden episode of clinical deterioration resulting from rebleeding. In patients suffering from an aneurismal rebleeding, the prognosis becomes much poor. Early detection of rebleeding and preoperatively appropriate medical treatment for increased intracranial pressure (IICP) might be crucial to decrease the overall mortality and morbidity rate in a patient with aneurismal rebleeding. We report a case of a successful reversal of focal neurological deficit showed in a patient with abrupt rebleeding of ruptured aneurysm whose intracranial pressure was preoperatively reduced with hyperventilation, and thiopental and mannitol administration under general anesthesia in angiography suite, although the patient ended up in death due to postoperative IICP.

Keyword

Cerebral aneurysm; Focal neurological deficit; Intracranial pressure control; Rebleeding

MeSH Terms

Anesthesia, General
Aneurysm
Aneurysm, Ruptured
Angiography
Hemorrhage
Humans
Hyperventilation
Intracranial Aneurysm
Intracranial Pressure
Mannitol
Neurologic Manifestations
Prognosis
Rupture
Stress, Psychological
Subarachnoid Hemorrhage
Thiopental
Mannitol
Thiopental
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