Surg Neurol
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The purpose of this study was to investigate the effects of blood pressure, temperature, and anesthetic agents on outcome in patients undergoing craniotomy for cerebral aneurysms. ⋯ Multivariate analysis of intraoperative factors affecting outcome in patients undergoing craniotomy for ruptured aneurysms shows that decreased intraoperative blood pressure and use of propofol are associated with improved outcome. Univariate analysis suggests that decreasing the magnitude of drop in blood pressure intraoperatively from preoperative values in patients with ruptured or unruptured aneurysms is associated with better outcome. Intraoperative hypothermia did not affect outcome.
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Paraclinoid aneurysms include those that are distal to the cavernous segment of the internal carotid artery and proximal to the posterior communicating artery. The purpose of this study was to review our experience with the endovascular treatment of this group of aneurysms, which are difficult to treat surgically. ⋯ Properly selected paraclinoid aneurysms can be successfully treated by endovascular technology. The morbidity and mortality rate of the endovascular approach in our experience is equal to or better than the published surgical series of similar aneurysms. We recommend that the endovascular approach be given primary consideration in the treatment of paraclinoid aneurysms.