Intracerebral Venous Hemorrhage after Cerebral Aneurysmal Surgery

Four cases of venous hemorrahage following aneurysmal surgery were presented for evaluate the veous circulation. These four cases had frontal irregular patchy hemorrahages with massive low density area demonstrated by CT scan. We surmise that these are hemorrahagic infarctions caused by the disturbance of venous drainage. In case 1 and case 2, the sacrificed connecting veins in the sylvian fissure were suspected to be the cause of the hemorrahagic infarction because of a poorly developed frontal ascending vein. In case 3, both a transsylvian and interhemispheric approach caused venous congestion. In case 4, the head of the clip had influenced the venous return of the sylvian vein. The number of veins and their branches to be sacrificed should be kept to a minimum because the resulting neurological deficits may not be transient. On the other hand, veous phase angiogram may also be help ful in anticipating any alteration in the direction of venous flow when sacrifice of a vein is unavoidable.

Cerebral aneurysm

Postoperative

Hemorrhage

Venous congestion