Intraoperative aneurysmal subarachnoid hemorrhage after rupture of a previously undiagnosed intracranial aneurysm during Chiari decompression: case report and literature review

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Publication Type pre-print
School or College School of Medicine
Department Neurosurgery
Creator Couldwell, William T.
Other Author Sorour, Mohammad; Bowers, Christian A.
Title Intraoperative aneurysmal subarachnoid hemorrhage after rupture of a previously undiagnosed intracranial aneurysm during Chiari decompression: case report and literature review
Date 2014-01-01
Description Type 1 Chiari malformation occurs when caudal displacement of cerebellar tonsils below the level of foramen magnum obstructs the normal flow of cerebrospinal fluid (CSF) between the cranial and spinal spaces, a condition that often needs surgical decompression to restore normal CSF circulation. Abrupt changes in CSF flow dynamics after Chiari decompression can affect the intracranial CSF dynamics to the extent that a previously undiagnosed intracranial aneurysm remote from the site can rupture. The authors describe the development of intraoperative aneurysmal subarachnoid hemorrhage that occurred as a result of spontaneous rupture of a previously undiagnosed right distal posterior inferior cerebellar artery in a 57-year-old woman with type 1 Chiari malformation who was undergoing surgical decompression. The mechanism of the aneurysmal rupture appears to be related to the changes of CSF flow dynamics during surgical decompression. Normally, pressure equilibrium between the two sides of the aneurysmal wall prevents its rupture, but factors that significantly affect this equilibrium, such as systemic hypertension, can cause the aneurysm to rupture. The concept of spontaneous intraoperative rupture of intracranial aneurysm remote from the site of surgery has been described twice previously but under different scenarios. This scenario, to the best of our knowledge, has not been previously described.
Type Text
Publisher Elsevier
Volume 21
Issue 3
First Page 524
Last Page 526
Language eng
Bibliographic Citation Sorour, M., Bowers, C. A., & Couldwell, W. T. (2014). Intraoperative aneurysmal subarachnoid hemorrhage after rupture of a previously undiagnosed intracranial aneurysm during Chiari decompression. Journal of Clinical Neuroscience, 21(3), 524-6.
Rights Management (c) Elsevier ; Authors manuscript from Sorour, M., Bowers, C. A., & Couldwell, W. T. (2014). Intraoperative aneurysmal subarachnoid hemorrhage after rupture of a previously undiagnosed intracranial aneurysm during Chiari decompression. Journal of Clinical Neuroscience, 21(3), 524-6. http://dx.doi.org/10.1016/j.jocn.2013.06.001
Format Medium application/pdf
Format Extent 1,211,904 bytes
Identifier uspace,18527
ARK ark:/87278/s6hh9v5b
Setname ir_uspace
Date Created 2014-04-25
Date Modified 2014-04-25
ID 712504
Reference URL https://collections.lib.utah.edu/ark:/87278/s6hh9v5b
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