Incidence of Rebleeding Following Craniotomy in Cases of Subarachnoid Hemorrhage Caused by Ruptured Intracranial Aneurysms

Abstract

The primary goal in managing subarachnoid hemorrhage (SAH) caused by ruptured cerebral aneurysms is to prevent re-rupture. We analyzed 478 consecutive cases of ruptured aneurysms treated with craniotomy clipping at Sapporo Teishinkai Hospital from April 2012 to March 2024. We examined preoperative imaging, intraoperative findings, surgical techniques, and postoperative outcomes in patients who experienced re-bleeding within six months of rupture. Only one case (0.2%) of postoperative re-bleeding involving a vertebral artery dissecting aneurysm was observed. The very low rates of re-treatment and re-bleeding were achieved by ensuring direct visualization and hemostasis of the rupture point.