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Re-exploration of the craniotomy after surgical treatment of unruptured intracranial aneurysms.

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Re-exploration of the craniotomy after surgical treatment of unruptured intracranial aneurysms.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Park, Wonhyoung Ahn, Jae Sung Park, Jung Cheol Kwon, Do Hoon Kwun, Byung Duk Kim, Chang Jin
Description	Author Affiliation: Park W ( Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.)
Abstract	BACKGROUND: Unplanned re-exploration of the craniotomy after surgical treatment of unruptured intracranial aneurysms (UIAs) is sometimes required, but the underlying causes and rates of these procedures are seldom reported. This study retrospectively analyzed the causes of such re-explorations to identify methods for decreasing their necessity. METHOD: From January 2000 to December 2011, 1,720 patients with a total of 1,938 UIAs underwent surgical treatment at our institution. From this cohort, 26 patients (1.5 %) with 38 UIAs required re-exploration. Clinical data, aneurysm characteristics, treatment methods, and the incidence and causes of re-exploration of the craniotomy were analyzed for these 26 patients. RESULTS: Several causes of re-exploration were identified: compromised distal blood flow (eight patients, 0.47 %), hemorrhagic venous infarction (four patients, 0.23 %), brain retraction injury (three patients, 0.17 %), newly identified aneurysms (three patients, 0.17 %), bleeding from an incompletely clipped aneurysm (two patients, 0.12 %), epidural hematoma (two patients, 0.12 %), failed aneurysm clipping (two patients, 0.12 %) and other causes (two patients, 0.12 %). Annual re-exploration incidence rates ranged from 0 to 3.1 %. Annual incidence rates gradually decreased following the introduction of several intraoperative monitoring systems. CONCLUSIONS: Precise surgical planning and careful operative techniques can reduce the incidence of unplanned re-exploration of the craniotomy. The introduction of various intraoperative monitoring systems can also contribute to a reduction in this incidence.
File Format	HTM / HTML
ISSN	00016268
Issue Number	5
Volume Number	156
e-ISSN	09420940
Journal	Acta Neurochirurgica
Language	English
Publisher	Springer
Publisher Date	2014-05-01
Publisher Place	Austria
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Reoperation Adverse Effects Humans Middle Aged Duplicate Publication Intracranial Aneurysm Male Treatment Outcome Discipline Neurosurgery Epidemiology Standards Journal Article Incidence Etiology Surgery Craniotomy Vascular Surgical Procedures Female Statistics & Numerical Data Aged Retrospective Studies Postoperative Complications
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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