The Scientific World Journal / 2013 / Article / Tab 1

Review Article

Perioperative Variables Contributing to the Rupture of Intracranial Aneurysm: An Update

Table 1

Intraoperative variables contributing intracranial aneurysm rupture.

Outcome

(1) Preprocedural factors (same for coiling procedures)
Anesthesia related Poor
 Pain
 Light plane of anesthesia
 Intubation response
Acute fluctuations in TMP
 High blood pressure (induction, skull pin fixation, and incision)
 Coughing/gagging
 Raised ICP
 Large and rapid bolus mannitol
 Acute hyperventilation
(2) Intraprocedural factors Variable
Increased vessel wall fragility (same for coiling procedures)Poor
 Smoking/COPD
 Hyperlipidemia/CAD
 Lower Hunt and Hess grade
Predissection phase Poor
(Dural opening and arachnoid opening, hematoma removal, and brain retraction)
Dissection phaseVariable
 Type of artery (PICA, ACA, and PCA)
 Previously ruptured aneurysm
 Surgeon’s experience

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