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KMID : 0378119750020020619
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Chungnam Medical Journal
1975 Volume.2 No. 2 p.619 ~ p.622
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A Case of Middle Cerebral Arteryneurysm Ruptured into the Ventricle of a Child.
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Abstract
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Among all the cerebrovascular accidents, the problem of intraventricular hemorrhage presents the highest mortality and worst prognosis Of patients dying from subarachn-oid hermorhage due to ruptured anurysm, half have had significant cerbral bleeding and approximately one third have had massive intraventricular bleeding.
The outcome of direct surgical intervention has been resulted in usually high mort-ality. We had recently experienced a case of huge hematoma in the ventricle which was successfully evacuated through the direct approach.
A 13 year old boy was admitted in deep comatous state. Neurological examination showed left hemiplegia, dilation of the right pupil and neck stiffness. Angiography revealed an aneurysm of bean size at the terminal branch of middle cerebral artery as well as enlargement of "U-loop".
A craniotomy was done and the feeding vessel was clipped. On exploring the Sylvian
fissure, there was considerable intracerebral hemorrhage which has extended into the temporo-occipital horn and has formed large coagulated hematoma in it.
This has evacuated completely and the boy has regained the consciousness in few days. Follow-up study 8 months later showed normal except mild left hemiparesis and a episode of seizure.
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