{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T14:31:28Z","timestamp":1774362688163,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The use of thrombin-based hemostatic agents (TBHAs) has become common practice in most neurosurgical procedures, both cranial and spinal.<\/jats:p><jats:p>\n          Methods\u2003We present the case of a 40-year-old woman who was referred to our institution with intense headache and Fisher grade 3 subarachnoid hemorrhage (SAH) mainly at the level of the right sylvian fissure, caused by a 5.71-mm right middle cerebral artery (MCA) bifurcation aneurysm, with hourglass morphology and a bleb on the bottom. Cerebral angiography demonstrated aneurysm enlargement, compared with the prior angiographic computerized tomography scan.<\/jats:p><jats:p>\n          Results\u2003A right pterional craniotomy was performed. After initial arachnoid dissection to get proximal vascular control, but before we obtained it, we witnessed profuse bleeding from the aneurysm. Floseal, a gelatin-thrombin matrix sealant, was sprayed over the breach of the aneurysm, and cottonoids were gently pressed with a self-retaining spatula, stopping the hemorrhage. After that, we obtained proximal control with an extradural clinoidectomy and temporary clipping of the right internal carotid artery (ICA) and MCA. Finally, aneurysm dissection and final clipping were performed with the application of two clips. The postoperative course was uneventful, and the patient was discharged on postoperative day 10.<\/jats:p><jats:p>\n          Conclusion\u2003Intraoperative aneurysm rupture (IAR) is a dangerous event that carries great risks\u2014even death. Proper use of TBHAs is a useful and safe way to stop the bleeding, take a deep breath, and achieve proximal vascular control. To the best of our knowledge, this is the first report of the use of TBHA during aneurysm clipping.<\/jats:p>","DOI":"10.1055\/s-0040-1720986","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:20:13Z","timestamp":1614039613000},"page":"383-387","source":"Crossref","is-referenced-by-count":5,"title":["Use of Gelatin-thrombin Hemostatic Matrix for Control of Ruptured Cerebral Aneurysm"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-431X","authenticated-orcid":false,"given":"Giuseppe Emmanuele","family":"Umana","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-2506","authenticated-orcid":false,"given":"Gianluca","family":"Scalia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Spitaleri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Alberio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Fricia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santino Ottavio","family":"Tomasi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Paracelsus Medical Private University, Salzburg, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni Federico","family":"Nicoletti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Cicero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,2,22]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.wneu.2019.10.009","article-title":"Posttraumatic triple acute epidural hematomas: first report of bilateral synchronous epidural hematoma and a third delayed","volume":"133","author":"M Fricia","year":"2020","journal-title":"World Neurosurg"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.23736\/S0390-5616.20.04886-9","article-title":"Minimally invasive percutaneous anterior odontoid screw fixation: institutional experience with a simple and effective technique","author":"G E Umana","year":"2020","journal-title":"J Neurosurg Sci"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.wneu.2019.12.179","article-title":"Chronic epidural hematoma caused by traumatic intracranial pseudoaneurysm of the middle meningeal artery: review of the literature with a focus on this unique entity","volume":"136","author":"G E Umana","year":"2020","journal-title":"World Neurosurg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3171\/jns.2002.96.3.0515","article-title":"Intraoperative complications in aneurysm surgery: a prospective national study","volume":"96","author":"S Fridriksson","year":"2002","journal-title":"J Neurosurg"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1227\/00006123-198606000-00004","article-title":"Intraoperative aneurysmal rupture: incidence, outcome, and suggestions for surgical management","volume":"18","author":"H Batjer","year":"1986","journal-title":"Neurosurgery"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.clineuro.2003.10.011","article-title":"Does intraoperative aneurysm rupture influence outcome? 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