Summary
Ninety-two cerebral aneurysm cases treated by clipping under moderate hypothermia are reviewed. Twenty-three of these cases received pentobarbitone during surgery in doses sufficient to render the EEG flat. The overall combined mortality and morbidity (complication rate) among 69 non-barbiturate cases was 21.7%. There were significant differences in results between aneurysms in different anatomical locations. The complication rate among eight middle cerebral artery aneurysm cases was 62.5% and among ten internal carotid artery bifurcation cases 40%, while that among nineteen internal carotid artery cases was 16% and among 27 anterior communicating complex cases 7.4%. The overall complication rate among 23 pentobarbitone cases was 17%. There were no complications among eight middle cerebral artery cases; one of two internal carotid bifurcation cases became hemiplegic following occlusion of the middle cerebral artery at its origin. The complication rate among nine internal carotid cases was 22%. No difficulties were experienced regarding haemodynamic stability or cardiac rhythm while using pentobarbitone at normothermia or at 28 °C. It is suggested that cerebral aneurysms involving the middle cerebral artery which appear to be most at risk may have the most to gain by the prophylactic use of pentobarbitone during surgery.
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Belopavlovic, M., Buchthal, A. & Beks, J.W.F. Barbiturates for cerebral aneurysm surgery. Acta neurochir 76, 73–81 (1985). https://doi.org/10.1007/BF01418464
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DOI: https://doi.org/10.1007/BF01418464