Factors disposing to morbidity in surgery of intracranial aneurysms with special regard to deep controlled hypotension

Abstract

✓ In 200 cases of intracranial saccular aneurysm a technique of short-term deep blood pressure reduction, as a rule induced with halothane, was used during the ligation of the aneurysm. The systolic blood pressure was reduced in most cases to about 50 mm Hg. This hypotension gives great advantages in the operative procedure. The vascular tree becomes more mobile, which facilitates the final phase of the dissection. The aneurysmal sac becomes softer, diminishing the risk of rupture when the ligature is being applied, and facilitating control of hemorrhage should it occur. The disadvantage of deep blood pressure reduction is the risk of anoxic damage. The surgical morbidity and mortality were therefore analyzed in detail with respect to the probable cause. In all but one case the symptoms or death could be attributed to one or more other factors (cerebral edema, vascular spasm, surgical trauma, etc.)