Neurological Surgery No Shinkei Geka Volume 45, Issue 11 (November 2017)

Outcome of Coil Embolization for Subarachnoid Hemorrhage Accompanied with Intracerebral Hematoma Fumiaki MARUYAMA 1 , Koreaki IRIE 1 , Ichiro YUKI 2 , Jun TAKEI 1 , Keisuke HATANO 1 , Toshihide TANAKA 1 , Yuzuru HASEGAWA 1 , Yuichi MURAYAMA 2 1Department of Neurosurgery, The Jikei University Kashiwa Hospital 2Department of Neurosurgery, The Jikei University School of Medicine Keyword: subarachnoid hemorrhage , intracerebral hematoma , coil embolization , endovascular surgery pp.955-963
Published Date 2017/11/10
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 OBJECT:Aneurysmal subarachnoid hemorrhage(SAH)associated with intracerebral hematoma(ICH)typically has a poor outcome. SAH with ICH tends to have a worse prognosis than SAH alone. The aim of the present study was to evaluate whether coil embolization during endovascular surgery with ventricle drainage and without ICH evacuation is an appropriate treatment.

 METHODS:A retrospective review was conducted between March 2012 and May 2015. Thirteen patients with SAH with ICH who underwent coil embolization were retrospectively analyzed. Modified Rankin Scale(mRS)scores were compared for postoperative clinical outcomes of different hematoma locations.

 RESULTS:All ruptured aneurysms in the present series of patients were treated using endovascular surgery. Six patients underwent additional ventricle drainage. Only one patient underwent craniotomy for evacuation of the hematoma following coil embolization. Despite ten out of thirteen patients(76.9%)having a preoperative SAH clinical grade, as evaluated using the World Federation of Neurosurgical Societies grading system of Ⅳ or Ⅴ, six(46.2%)patients had a favorable outcome(mRS=0-2).

 CONCLUSIONS:Coil embolization for ruptured aneurysms, especially those located in the frontal lobe, with ICH and without cerebral herniation may be a feasible alternative and less invasive treatment.

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Neurological Surgery 脳神経外科
45巻11号 (2017年11月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院