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RERUPTURING OF RUPTURED INTRACRANIAL ANEURYSM DURING HOSPITALIZATION T. Ohi 1 , T. Yoshimoto 1 , Y. Sakurai 1 , J. Suzuki 1 1Division of Neurosurgery, Institute of Brain Disease, Tohoku University School of Medicine pp.977-981
Published Date 1978/9/1
DOI https://doi.org/10.11477/mf.1406204302
  • Abstract
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From the 1080 patients ot saccular aneurysms experienced in our clinic from 1965 to 1975, thirty-six hospitalized patients incurring rebleeding prior to radical surgery were selected to discuss the factors of rebleeding. Infarction cases definitely attributed to cerebral vasospasms were excluded from this investigation.

This study revealed:(1) Within five days after admission, rebleeding occurred in 28 of the 36 patients including eight cases on the day of ad-mission. One month after the first attack, the incidence of rebleeding generally decreases. How-ever, three of such patients experienced rebleeding within five days after admission. The above men-tioned factors may indicate that stress of hospitaliz-ation especially in a neurosurgical clinic may in-fluence rebleeding.(2) Only 27 of the 36 cases were in agreement with our preliminary report on the prediction of the rebleeding time based on con-sciousness levels at the first attack. In the latter nine cases, the discrepency is attributed to the enormous pressures prior to neurosurgery and un-usual characteristics of the bleeding focus.(3) In the majority of the cases, rebleeding occurred dur-ing random activities between 6 a. m. and 9 p. m.. (4) The incidence of rebleeding was high in patients with clear consciousness and those in which con-sciousness were improving.(5) Although the blood pressures in only three of 11 patients were above 150 mmHg one hour before rebleeding both mental and physical stresses prior to neurosurgery is con-sidered a major factor of rebleeding.(6) Increased frequencies of headaches and manifestation of psychic disorders commonly precede rebleeding.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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