Poor-risk Intracranial Aneurysm with Large Intracerebral Hematoma

Analyses and studies have been made on 34 cases of the combined ICH, showing mass effect among 305 male and female ruptured intracranial aneurysmal patients who were admitted to Kyungpook National University Hospital from Mar. 1984, through Feb. 1990. The incidence of the large ICH was 11.1% with 2.1 to 1 ratio of male to female. The highest age incidence of the hematoma was in the 40 to 60 years bracket. The most frequent site of the aneurysm combined with the large ICH was at MCA aneurysm, 38.6%, followed by at A-com artery aneurysm, 4.8%. The most frequent location of the hematoma was in temporal lobe, 88.2%. The rate of combined large ICH was 20.3% in multiple aneurysmal bleeding patients who revealed higher incidence of the hematoma than the single bleeding patients. In amount of the hematoma, 30-40ml bracket ranked top occupying 32.4% of all cases. After surgical treatment, 29.4% patient was improved to the good and fair on discharge. The rate of mortality was 61.8%, which was mainly due to direct effect of hematoma and cerebral infarction caused by vasospasm.

Ventricular Dilatation by Early Surgery on Aneurysms with SAH

Among 202 aneurysmal patients with SAH who were admitted to Kyungpook National University Hospital from Jan. 1984 through Jan. 1988, the incidence of ventricular dilatation confirmed by postoperative follow-up brain CT scannings was 32.2%(65 cases). And 33 cases(19.3%) was in mild ventricular dilatation, 9 cases(4.5%) was in moderate and 23 cases(11.4%) in severe who needed the shunting procedure were analysed. The incidence of ventricular dilatation to the site of aneurysm was highest in A-com A. aneurysm(42.2%), followed by P-com A. aneurysm(36.4%) and MCA aneurysm(11.3%). The incidence of ventricular dilatation and the need for shunting was higher in multiple bleeding patients than the single. The good risk patients had meaningfully lower incidence of ventricular dilatation than the poor risk group. In the delayed surgical group showed significantly more numbers of ventricular dilatation needing the shunt than the cases in early group.