Khrushch O. Surgical treatment of arterial aneurysms of carotid region in the acute period of intracranial hemorrhage, complicated with their intraoperative rupture

In dissertation factors that lead to intraoperative ruptures (IOR) of arterial aneurysms (AA) of carotid region in the acute period of subarachnoidal hemorrhage were analyzed. The significant influence on AA IOR occurring of such factors as quantity of hemorrhages, terms of operation performing, subdural hemorrhage presence and lateral ventricle puncture using was find out. AA IOR significantly (P=0,018) worsen the results of treatment: the number of convalescences decreased in 2.4 times, and the postoperative lethality increased in 4.1 times. Main causes of patients' with AA IOR death were brain edema - in 63% cases and it's infarction - in 25.9%. The way for forecasting AA IOR high risk has been developed. At prognosticated high risk of AA IOR controlled arterial hypotension at anesthesia induction and trachea intubation is needed and also application of AA temporary clipping up to 10 minutes. Surgical tactics in case of AA IOR depends on the type of rupture. Results of surgical treatment of patients with brain АА were improved: frequency of their IOR decreased from 35.8 to 15.4%, lethality - from 23.4 to 15.3%.