Intraoperative Rupture of Unruptured Cerebral Aneurysm during Craniotomy: A Case Report

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Abstract

An unruptured aneurysm was incidentally found in the right middle cerebral artery in a 67-year-old woman. During an attempt to turn the temporalis muscle for surgical clipping, systolic blood pressure suddenly increased. After opening the dura mater, we found a subarachnoid hemorrhage and severe brain swelling. We promptly expanded the craniotomy area to reach the aneurysm while pulling part of the frontal lobe to apply a clip. We retrospectively analyzed the aneurysm using computational fluid dynamics. Our analysis suggests that the rupture of the aneurysm occurred at a location with very low wall shear stress.

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Yoshiki, K., Misaki, K., Nambu, I., Fukui, I., Mohri, M., Uchiyama, N., & Nakada, M. (2017). Intraoperative Rupture of Unruptured Cerebral Aneurysm during Craniotomy: A Case Report. Case Reports in Neurology, 9(3), 261–266. https://doi.org/10.1159/000480425

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