Volume 26
Number 0
Jan 2018
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Original articles
W.M. van den Bergh, J.M. Dieleman, A.J.C. Slooter, D. van Dijk

Introduction: The overall prevalence of unruptured intracranial aneurysms is 3.2%. The rupture risk of an intracranial aneurysm during cardiopulmonary bypass requiring full heparinisation is unknown. \
Patients and Methods: Rupture risk was assessed using data from a trial in which dexamethasone was compared with placebo in 4482 patients undergoing cardiac surgery with cardiopulmonary bypass.

Results: Not a single haemorrhagic stroke occurred during surgery and only one patient had a subarachnoid haemorrhage three weeks after cardiac surgery.
Discussion: Although the actual prevalence of intracranial aneurysms in the study population is unknown, based on patient characteristics, it is likely that the incidence is not below the average of 3.2% of the general population. So probably at least 143 patients with an intracranial aneurysm underwent surgery with full heparinisation without any rupture.
Conclusion: Cardiopulmonary bypass with heparinisation is not a risk factor for rupture of an intracranial aneurysm. An unruptured intracranial aneurysm should not hinder lifesaving surgery for which cardiopulmonary bypass is required.

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