Causes of morbidity and mortality from surgery of aneurysms of the distal basilar artery

H. H. Batjer, D. S. Samson

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Despite modern neurosurgical technology and neuroanesthetic care, treatment of aneurysms of the distal basilar artery remains fraught with complications. Between 1982 and 1988, 126 patients with aneurysms of the distal basilar artery who had been treated by 2 surgeons were retrospectively analyzed to determine the causes of morbidity and mortality from this disease and its treatment. Ten patients (8%) died, and 14 patients (11%) suffered permanent neurological disability after treatment. The causes of failed management could be grouped into the following categories: 1) direct effects of hemorrhage; 2) errors in surgical timing; 3) conceptual errors; 4) technical errors; 5) morbidity from delayed cerebral ischemia; and 6) complications of hypertensive/hypervolemic therapy for symptomatic vasospasm; a small group of patients who died despite having received what we consider excellent management were grouped under a seventh category, 'bad luck'. Frequently, patients who did poorly suffered from multiple complications, each of which contributed to their overall morbidity. It is our hope that increased awareness of these potential pitfalls and the further evolution of intravascular technique in selected cases will, in time, improve the outlook for patients suffering from these dangerous lesions.

Original languageEnglish (US)
Pages (from-to)904-916
Number of pages13
JournalNeurosurgery
Volume25
Issue number6
StatePublished - 1989

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Intracranial Aneurysm
Morbidity
Mortality
Medical Errors
Endovascular Procedures
Therapeutics
Brain Ischemia
Hemorrhage
Technology

Keywords

  • basilar artery aneurysm
  • subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Causes of morbidity and mortality from surgery of aneurysms of the distal basilar artery. / Batjer, H. H.; Samson, D. S.

In: Neurosurgery, Vol. 25, No. 6, 1989, p. 904-916.

Research output: Contribution to journalArticle

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