Korean J Cerebrovasc Surg.  2008 Jun;10(2):383-386.

Ruptured Intracranial Aneurysm Successfully Treated by Clipping in a Patient with Idiopathic Thrombocytopenic Purpura: A Case Report

Affiliations
  • 1Department of Neurosurgery, Chonnam National University Hospital & Medical School, Gwangju, Korea. nsjsp@chonnam.ac.kr

Abstract

We report here on a case of a ruptured left posterior communicating artery (P-com) aneurysm that was treated by clipping in a patient with idiopathic thrombocytopenic purpura (ITP) and steroids were used to control the platelet count during the perioperative period. A 34-year-old female who had been suffering from ITP for four years experienced the sudden onset of a headache and vomiting while showering. She was referred to our hospital as a case of subarachnoid hemorrhage (SAH) due to a ruptured P-com aneurysm. Aneurysmal neck clipping was performed via the left pterional approach 6 hours after the ictus. The aneurysmal clipping was successful without an increased bleeding tendency during the operation. Intravenous steroid injection was given after aneurysmal clipping for 7 days and then it was tapered off. It is important to maintain an adequate platelet count in SAH patients with chronic ITP in order to avoid hemorrhagic diathesis during surgery. Intravenous steroid injection is a helpful method for maintaining an adequate platelet count in these patients during surgery.

Keyword

Aneurysm; idiopathic thrombocytopenic purpura; steroid

MeSH Terms

Adult
Aneurysm
Arteries
Female
Headache
Hemorrhage
Hemorrhagic Disorders
Humans
Intracranial Aneurysm
Neck
Perioperative Period
Platelet Count
Purpura, Thrombocytopenic, Idiopathic
Steroids
Stress, Psychological
Subarachnoid Hemorrhage
Vomiting
Steroids
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