The Rebleeding of Ruptured Intracranial Aneurysm during Induction of Anesthesia / 대한마취과학회지

ABSTRACT

The intraoperative rupture of an intracranial aneurysm can dramatically interrupt the fine operative procedure and jeopardize the patient's chance for meaningful survival. A sudden increase of the arterial pressure and intracranial pressure during laryngoscopy and intubation is potentially dangerous and may lead to fresh bleeding from an aneurysm in patient with recent subarachnoidal hemorrhage due to aneurysmal rupture. But aneurysmal rupture during induction occurs rarely. Recently we experienced rebleeding due to sudden increased arterial blood pressure during laryngoscopy and intubation in 39 years old female patient who was scheduled for clipping of ruptured intracranial aneurysm on 11th day after ictus. And she died of cerebral death on 6th postoperative day. Here we discuss the incidence, prognosis, diagnosis, management and prophylaxis of the aneurysmal rupture during induction with a brief review of the literature.