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Journal of Korean Neurosurgical Society > Volume 30(6); 2001 > Article
Journal of Korean Neurosurgical Society 2001;30(6): 699-704.
The Clinical Analysis of Bleeding Pattern in Patients with Ruptured Middle Cerebral Artery Aneurysm.
Hun Kim, Young Bo Shim, Hyung Sik Hwang, Jae Jun Choi, Sung Min Kim, Yong Kee Park, Sun Kil Choi
Department of Neurosurgery, College of Medicine, Hallym University, Seoul, Korea.
OBJECTIVES: The rupture of middle cerebral artery(MCA) aneurysm usually cause or is associated with higher incidence of intracerebral hemorrhages(ICH) than any other aneurysmal ruptures. Also, the outcome of patients who had ICH is known to be worse than patients who had subarachnoid hemorrhage(SAH) only. The authors report the bleeding pattern and outcome of ruptured MCA aneurysm patients. PATIENTS AND
A total 106 ruptured MCA aneurysm patients who were surgically treated were included and they were divided into 2 groups by the initial brain CT findings according to the presence or absence of ICH over 10cc in amount. The clinical data were analysed retrospectively.
The overall mortality was 18.9%. Among 81 patients(76.4%) who had subarachnoid hemorrhage(SAH) only, 68 patients(84%) showed favorable outcome. Twenty five patients(23.6%) had ICH over 10cc in amount with or without SAH, and among them, 11 patients(44%) showed favorable outcome. The ICH was located in temporal lobe(15 patients, 60%), frontal lobe(3, 12%), sylvian fissure(6, 24%) and frontal-temporal lobe(1, 4%). Among 15 patients who had ICH in temporal lobe, only 4 patients(26.6%) showed favorable outcome and all 3 patients who had ICH in frontal lobe showed favorable outcome.
ICH was presented in 23.6% of ruptured MCA aneurysm patients and the prognosis of patients with ICH was worse than patients with SAH only. The ICH was located mainly in the temporal lobe and sylvian fissure.
Key Words: Subarachnoid hemorrhage; Intracerebral hemorrhage; Ruptured middle cerebral artery aneurysm
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