Posterior Circulation Aneurysms
Ninety-eight patients with aneurysms of the posterior circulation were admitted to our department from 1993 to 1997. Sixty of them underwent microsurgical treatment, mostly in the acute stage of subarachnoid hemorrhage. Peri- and intraoperative management
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Y. Yonekawa et al.
Table I. Management of Patients with Ruptured Aneurysms in the Acute Stage Perioperative management against vasospasm nimodipine administration (2 mg/hour i.v.) for 10 days to 2 weeks enough hydration to moderate hypervolemia triple H therapy interventional endovascular administration of papaverine with or without angioplasty (barbiturate coma for refractory vasospasm) Intraoperative management opening of the lamina terminalis and the membrane of Liliequist optimal neck clipping with the use of temporary clipping topical administration of papaverine to spastic vessels hemodynamic monitoring for checking the patency of important vessels with micro-Doppler sonography and Peltier stack closure of craniotomy without any drainage
Trannygomati
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