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KMID : 0604020080230010040
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Korean Journal of Critical Care Medicine
2008 Volume.23 No. 1 p.40 ~ p.43
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Reversal of Focal Neurologic Deficit due to Preoperative Intracranial Pressure Reduction in a Patient with Early Rebleeding of Cerebral Aneurysm
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Na Hyo-Seok
Park Sang-Heon
Jeon Young-Tae
Do Sang-Hwan
Kim Hwan-Hee
Kim Hwan-Hee
Lee Sang-Chul
Park Hee-Pyoung
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Abstract
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In the first hours after initial hemorrhage, up to 15% of patients with subarachnoid hemorrhage (SAH) due to
aneurysmal rupture may have a sudden episode of clinical deterioration resulting from rebleeding. In patients suffering
from an aneurismal rebleeding, the prognosis becomes much poor. Early detection of rebleeding and preoperatively
appropriate medical treatment for increased intracranial pressure (IICP) might be crucial to decrease the
overall mortality and morbidity rate in a patient with aneurismal rebleeding. We report a case of a successful reversal
of focal neurological deficit showed in a patient with abrupt rebleeding of ruptured aneurysm whose intracranial
pressure was preoperatively reduced with hyperventilation, and thiopental and mannitol administration under
general anesthesia in angiography suite, although the patient ended up in death due to postoperative IICP.
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KEYWORD
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Cerebral aneurysm, Focal neurological deficit, Intracranial pressure control, Rebleeding
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