Incidence of cerebral infarction associated with ruptured intracranial aneurysms

THE CAUSE of death after rupture of a berry aneurysm has often been in doubt in cases in which the amount and position of the hemorrhage were inadequate to account for the fatality. In an attempt to elucidate this problem, we have made a study of the brains of all patients with ruptured intracranial aneurysm received in this department over a period of eighteen months. From these, we have selected 8 patients with aneurysm of the anterior cerebralanterior communicating complex who died from three days to four and a half weeks after the first rupture. Apart from diagnostic lumbar puncture and carotid arteriography, no surgical procedures had been undertaken in these patients. Hypothermia was used terminally in l, and another was treated by this method for five days. The patients, 6 of whom were hypertensive, ranged in age from 37 to 78 years, with an average age of 58. In instances of ruptured aneurysm, we have frequently confirmed Robertson's' observation of gross cerebral infarctions at post mortem, and these 8 brains have therefore been studied in detail to determine the extent, distribution, and possible etiology of such infarcts.