{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:22:46Z","timestamp":1785770566259,"version":"3.56.0"},"reference-count":30,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>\n<jats:bold>Background<\/jats:bold>\u2003Intraoperative aneurysmal rupture (IAR) is a catastrophic complication; however, its impact on neurological outcome is debatable. We studied the effects of IAR on intraoperative and postoperative complications and neurological outcome.<\/jats:p>\n<jats:p>\n<jats:bold>Methods<\/jats:bold>\u2003In this retrospective study, adult patients who underwent aneurysmal clipping over a period of 2 years were divided as follows: group R (with IAR) and group N (without IAR). Various perioperative parameters, intraoperative and postoperative complications were noted. Glasgow outcome scale (GOS) was noted at discharge from hospital and categorized as favorable (GOS IV and V) and unfavorable (GOS I, II and III). Collected data was statistically analyzed. Univariate and multiple logistic regression analyses were performed to identify predictors of IAR. A <jats:italic>p<\/jats:italic> value &lt; 0.05 was considered significant.<\/jats:p>\n<jats:p>\n<jats:bold>Results<\/jats:bold>\u2003Thirty-two out of 195 (16.41%) patients suffered IAR, with majority involving anterior communicating artery aneurysm (46.88%). Duration of temporary clipping (<jats:italic>p<\/jats:italic> &lt; 0.001), volume of blood loss, and fluid and blood transfusion were significantly more in group R. Postoperatively, significantly more patients in group R developed intracranial hematoma, cerebral infarct, and required prolonged ventilatory support (\u22655 days). Unfavorable neurological outcome was observed more in group R (<jats:italic>p<\/jats:italic> = 0.013). In univariate analysis, blood loss &gt; 500 mL, use of colloids, and duration of surgery &gt; 5 hours were found to be associated with IAR. After multiple logistic regression analysis, only use of colloids and duration of surgery &gt; 5 hours were the most predictive variables for IAR.<\/jats:p>\n<jats:p>\n<jats:bold>Conclusions<\/jats:bold>\u2003IAR is associated with serious intraoperative and postoperative complications and unfavorable neurological outcome.<\/jats:p>","DOI":"10.1055\/s-0041-1724228","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T01:19:29Z","timestamp":1618363169000},"page":"382-388","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Complications and Neurological Outcome following Intraoperative Aneurysm Rupture in Adult Patients Undergoing Intracranial Aneurysmal Clipping: A Retrospective Study"],"prefix":"10.25259","volume":"12","author":[{"given":"Nayani","family":"Radhakrishna","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Army Hospital Research and Referral, Delhi Cantt, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Khandelwal","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra Singh","family":"Chouhan","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir Prakash","family":"Pandia","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourav","family":"Burman","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi Rani","family":"Mahapatra","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"issue":"5","key":"10.1055\/s-0041-1724228\/ref-1","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1161\/STROKEAHA.107.504670","article-title":"Predictors and outcomes of intraprocedural rupture in patients treated for ruptured intracranial aneurysms: the CARAT study","volume":"39","author":"Elijovich","year":"2008","journal-title":"Stroke"},{"key":"10.1055\/s-0041-1724228\/ref-2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.4103\/2152-7806.171257","article-title":"Surgical management of ruptured small cerebral aneurysm: Outcome and surgical notes","volume":"6","author":"Grasso","year":"2015","journal-title":"Surg Neurol Int"},{"key":"10.1055\/s-0041-1724228\/ref-3","first-page":"63","article-title":"Clinical outcome of intracranial aneurysms: a retrospective comparison between endovascular coiling and neurosurgical clipping","volume":"52","author":"Gupta","year":"2008","journal-title":"Indian J Anaesth"},{"key":"10.1055\/s-0041-1724228\/ref-4","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/S0140-6736(75)92830-5","article-title":"Assessment of outcome after severe brain damage","volume":"1","author":"Jennett","year":"1975","journal-title":"Lancet"},{"key":"10.1055\/s-0041-1724228\/ref-5","first-page":"398","author":"Pertuiset","year":"1979","unstructured":"Intraoperative aneurysmal rupture and reduction by coagulation of the sac. 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