A 40 year male admitted in emergency with CT diagnosis of left frontal temporal ICH on CT Angiogram MCA aneurysm was diagnosed and patient was posted for emergency clipping size of aneurysm. It was approx 10 by 12mm and patient had GCS EVM 456 with headache and no focal neurological deficit. His Hunt and Hess grade is 1. Patient intubated and pterional craniotomy was done. During craniotomy slight dural tear occurred while drilling the sphenoid ridge, patient brain suddenly started bulging and operating neurosurgeon had abandoned the procedure immediately.
Questions are: What are the causes of intraoperative brain swelling in aneurysmal cases? What should be the ideal blood pressure during aneurysmal clipping? Is it appropriate to stop the procedure as there was no abnormality in the vital parameters of the patient? Patient remained stable in ICU after 24 hrs then when should perform…
