Diagnosis and treatment of intracerebral hematoma due to ruptured intracranial aneurysms

Objective To discuss the diagnosis and treatment of intracerebral hematoma (ICH) due to ruptured intracranial aneurysms.Methods In this retrospective study, twenty-seven patients of ICH following ruptured intracranial aneurysms were analyzed. There were 15 males and 12 females ranging from 18~67 years with the mean age of 51 years. All patients with ICH were diagnosed by CTA or DSA. Among these patients, 7 cases were anterior communicating artery aneurysms, 10 cases posterior communicating artery aneurysms, 9 cases middle cerebral artery aneurysms, and 1 case middle cerebral artery and posterior communicating artery aneurysm.Results A total of 24 patients were microsurgically treated by pterional approach to evacuate ICHs and to clip the ruptured aneurysms. Two patients accepted endovascular embolization. One patient died before surgery due to re-rupture of aneurysm. According to Glasgow Outcome Scale, there were 3 cases in grade Ⅰ, 1 case in grade Ⅱ, 3 cases in grade Ⅲ, 7 cases in grade Ⅳ, and 13 cases in grade Ⅴ. Conclusion Preoperative angiography or CTA are essential for the correct diagnosis of ICHs due to ruptured intracranial aneurysms. Early surgical management should be performed to evacuate ICHs and to clip the ruptured aneurysms.