Surgery Aids Patients with Aneurysm Hemorrhage

A study has demonstrated that surgical removal of a large segment of the skull lessens the pressure from swelling and improves the outcomes of patients who are comatose due to hemorrhage from a burst aneurysm. Conducted by surgeons from the Massachusetts General Hospital (Boston, MA. USA), the study was presented at the 2001 Clinical Congress of the American College of Surgeons in New Orleans (LA, USA).

In the study, six of the eight patients who underwent the hemicraniectomy had good or excellent outcomes. These included five patients who had been comatose but not moribund and one patient who was comatose and moribund. In the procedure, surgeons excise a wide portion of the skull (10-cm long and 7-cm wide), extending from just behind the corner of the eyebrow to a point well behind the ear. After the section is removed, surgeons place it in a subcutaneous pouch in the patient's abdomen to keep the bone sterile and safe until it is replaced, which may be six weeks to four or five months later. During that interval, the patient wears a protective helmet.

"There's no magic interval until the bone is replaced,” said Dr. Christopher Ogilvy, director of cerebrovascular surgery at Mass General. "It depends on when the swelling comes down and the patient seems to be improving.”




Related Links:
American College of Surgeons