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Ruptured Middle Cerebral Artery Aneurysm Presenting with Hematoma 

Ruptured Middle Cerebral Artery Aneurysm Presenting with Hematoma
Ruptured Middle Cerebral Artery Aneurysm Presenting with Hematoma

Joseph M. Zabramski

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date: 12 April 2021

Abstract: This chapter reviews the surgical management of ruptured middle cerebral artery aneurysms associated with hematoma. Ruptured middle cerebral artery aneurysms occasionally present with mass effect from a large subarachnoid and/or intraparenchymal hematoma. In the case of significant hematoma size, midline shift, or increased intracranial pressure, these lesions are surgical emergencies. They can present significant management challenges because the presence of the hematoma makes operative management more difficult. Given the large and functionally critical territory supplied by the middle cerebral artery, preservation of the both the afferent and efferent branches is critical. Decision-making regarding the timing and strategy of clot evacuation is discussed.

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