Neurosurgery for aneurysm

Name: Mrs. Hu
Gender: Female
Country: China
Age: 58
Diagnosis: Aneurysm

Background

Mrs. Hu, a 58 year old Female Patient from China, was admitted into Beijing Tiantan Puhua International Hospital on 29th April 2007, due to sudden unconsciousness. On arrival at Tiantan Puhua International Hospita, she had been unconscious for two days.

Medical condition pre surgery

Mrs Hu experienced a sudden unconsciousness while bathing. She was found by her families sitting on the ground. They were not able to contact her att all. She did not suffer from any tics but did suffer from urinary and fecal incontinence. She had two episodes of non projectile vomiting. Her vomit contained only gastric contents, no coffee-ground vomit was found. Her unconsciousness was somewhat relieved after a half hour. She could move her left limbs, however, she had slight to no movement of her right limbs. She did not respond to questions.

She was immediately taken by ambulance to the First Hospital of Shunyi in Beijing, where she immediately underwent a cerebral CT scan. The result revealed a subarachnoid hemorrhage [SAH]. After dehydration therapy with Mannitol, she was sent to the emergency department of Beijing Tiantan Puhua International Hospital. In the emergency care unit, she received treatments such as: dehydration therapy to reduce intracranial pressure, antifibrinolysis, preventing and curing cerebral angio spasms, and supportive treatment such as fluid infusion. She was then admitted into the Hospital for a further treatment. Since acquiring this disease, her mental spirit has been poor. She could not intake water, and retained a catheter for urination. Most of the time, she was in a state of sleep.

While examined, it was discovered that her biceps reflex and achilles reflex were weak on both sides. Her bilateral pussep signs were positive. Her meningeal irritation signs - neck rigidity, was positive.

Cerebral CT scan revealed that there were high density shadows in the areas of: suprasellar cistern, interpeduncular cistern, cisterna ambiens, diastema, longitudinal fission, and both lateral fissions.

Routine Blood Test: WBC 9.4×10E9/L, NE 81.6%, RBC 3.5×10E12/L, Hgb 114g/L, HCT 34%, PLT136×10E9/L

Surgical approach

Under general anesthesia, the medical team performed a giant post carotid-ophthalmic aneurysms clipping and resection via the left frontal-temporal approach.

Surgery lasted for six hours.

Medical condition post surgery

Following the successful procedure, her condition became stable. No severe postoperative complications occurred. Her conscious recovered gradually. She did not vomit or become unconscious again. Upon discharge from hospital, she was conscious and was able to communicate with her family and others normally. No apparent abnormal signs were found.