Intraoperative rupture of aneurysms

site of rupture did not influence the outcome after IAR. This study was designed to examine how to reduce the incidence and improve clinical course of intraoperative aneurysmal ruptures (IAR). Out of 535 aneurysmal surgeries, major bleeding or minor leakage from aneurysm occurred in 98 cases (18.3%); 5 cases (0.9%) before dissection, 60 (11.2%) during dissection and 33 (6.2%) during clipping. IAR occurred more frequently as the size of aneurysm increased, and the incidence was almost same in early (18.5%) and delayed (17.9%) surgery. IAR occurred at the dome of aneurysm in all cases of predissection and in 85% of dissection stage. Good outcome resulted in 62% of cases with IAR and in 79% without; for preoperative Hunt & Hess grade I & II patients, 80% with and 93% without IAR. But there was no significant difference in outcome concerning the site of rupture and location of aneurysm. In conclusion, surgery should be done by well experienced neurosurgeons to prevent IAR that will cause a poor outcome, especially for good grade (I & II) and large aneurysms. Timing of surgery, Fisher grade, location of aneurysm and