Surg Neurol
-
Case Reports
Cerebral vein thrombosis associated with aneurysmal subarachnoid bleeding: implications for treatment.
Cerebral vein thrombosis associated with aneurysmal subarachnoid bleeding is an uncommon event rarely described in the literature. We report here a case and summarize the problems in the management of this patient. ⋯ The fatal outcome with the documented extended thrombosis, despite careful anticoagulation therapy, indicates the necessity of closely meshed follow-up studies examining the sinus patency in such complicated cases with associated pathology.
-
The natural history of unruptured cerebral aneurysms and the surgical risks are modified by several factors including size, location, and presence of subarachnoid hemorrhage (SAH). The main confusion arises because the backgrounds of the past reports describing the natural history or the surgical complication of unruptured cerebral aneurysms were different. The present study aimed to adjust the backgrounds and investigate the surgical indication with close monitoring of both surgically treated and untreated unruptured cerebral aneurysms. ⋯ The present results indicated that prophylactic surgery has a benefit for the medium-size aneurysms (5-15 mm) of the anterior circulation. For large aneurysms, individual investigation is necessary because of the variety of surgical difficulties, and the complex symptoms because of rupture and the mass effect as well as cerebral embolism. In small aneurysms, careful observation may be a reasonable choice unless the aneurysm is at a specially high risk of rupture.