Cerebral embolism with acute aneurysmal surgery

• Published in: Japanese Journal of Stroke Vol. 30; no. 3; pp. 478 - 483
• Main Authors: Watanabe, Zenichiro, Maeno, Kazusige, Watanabe, Sadayosi, Tamura, Sinya, Izaki, Kenji, Kikuchi, Yasuhiro, Gotou, Hiromi, Koizumi, Jinichi, Watanabe, Kazuo
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 2008
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.30.478

Background and Purpose: Ischemic events are the most common complication in cases with ruptured cerebral aneurysms. We report the incidence and give an analysis of cerebral embolism with acute aneurysmal surgery. Methods: Between 2004 and 2006, we studied 131 cases of subarachnoid hemorrhage (SAH) treated with titanium aneurysm clips at the acute stage (within 48 hr after the onset). We performed serial examinations by MRI in the perioperative state (at admission and within 5 days after the surgery). We made a diagnosis of cerebral embolism based on postoperative diffusion weighted images (DWI) of MRI and andertook an analysis of the cases. Results: Single or multiple embolic infarctions appeared in 11 (8.4%) of the 131 cases on DWI, and in 8 of them the lesions were only on the operative side. In 4 cases, lesions were appeared in the perfusion area of the artery that was occluded temporarily during the operation. In 3 cases, embolic infarctions occurred in areas without surgical manipulation. One case which developed bilateral multiple infarctions had symptoms. Conclusion: The origin of embolisms with acute aneurysmal surgery showed a close relation to the surgical procedure, but there were some cases with embolisms of unknown origin. Further examinations and detailed studyies of this complication are thus needed.