RESUMEN

Objective To evaluate emergency surgery for cerebral hernia patients with CT manifestatious of ruptured anterior circulation aneurysm combined with intracerebral hematoma.Methods A total of 11 cerebral hernia patients underwent emergency operation based on CT manifestations from December 2007 to December 2010 for acute intracerebral hematoma due to suspected aneurysm rupture. Three dimensional computer tomographic angiography (3D-CTA) was performed one week postoperation.The locatious of aneurysms were investigated to analyze relationship between CT manifestations and emergency surgery. Results The cause of intracerebral hematoma in the 11 patients proved to be aneurysms rupture.The aneurysm was located at the anterior communicating artery in 2 cases,at the posterior communicating artery in 3 and at the middle cerebral artery in 6.Of the 2patients who harbored multiple aneurysms, one had a middle artery aneurysm (responsible) plus a homonymy aneurysm at the posterior communicating artery,the other had an aneurysm at the posterior communicating artery (responsible) plus an opposite side aneurysm at the middle artery.Postoperative Glasgow Outcome Scale (GOS) showed grade V in 6 cases,grade Ⅳ in 2,grade Ⅲ in 1,grade Ⅰ in 2.Conclusion CT manifestations are useful indications for emergency surgery, including direct craniotomy, hematoma evacuation and aneurysm clipping, in cerebral hernia patients with ruptured anterior circulation aneurysm combined with intracerebral hematoma.