Kaixuan YAN, MD, Department of Neurosurgery, The Affiliated Jiangyin hospital, School of Medicien, Southeast University, No.163 Road of Shou Mountain, Jiangyin city, Jiangsu Province, CHINA, 214400.

Heng Gao, MD, PhD, Department of Neurosurgery, The Affiliated Jiangyin hospital, School of Medicien, Southeast University, No.163 Road of Shou Mountain, Jiangyin city, Jiangsu Province, CHINA, 214400.

Abstract
Background and importance We describe a patient who occurred intraoperative aneurysm ruptured (IAR) of aneurysms neck and the surgeon use a piece of endocranium to assisted clip and achieve a good result.Clinical presentation A 62-year-old women was admitted with an acute subarachnoid hemorrhage (SAH). She underwent, after 2h, a right frontotemporal craniotomy for clip ligation of the subarachnoid aneurysms. IAR occurred during the dissection of the aneurysm neck, and then surgeon selected a free piece of endocranium（about 3cm×2cm）wrapping to repair tear of aneurysm neck assist clipping. Long-term clinical follow up shows that patient recuperate well and with a 0’ Modified Rankin scale scores eventually.Conclusion This report illustrates that The IAR of neck is the most devastating complication. Endocranium-clipping technique is an effective measure to repair tear at the neck.

Keywords
Aneurysm; Intraoperative aneurysm rupture; Aneurysm clipping

Cite this paper
Kaixuan YAN, MD, Heng Gao, MD, PhD, Endocranium mater warp to repair tear of aneurysm neck assist clipping: A Case Report , SCIREA Journal of Clinical Medicine. Volume 1, Issue 1, October 2016 | PP. 1-11.

References

[ 1 ]	Andrade GC, Braga FM. Intraoperative rupture in the aneurysmal neck: suggestion for surgical management [inPortuguese]. Arq Neuropsiquiatr 2002, 60: 666- 669.
[ 2 ]	Batjer H, Samson D (1986) Intraoperative aneurysmal rupture: Incidence, outcome, and suggestions for surgical management. Neurosurgery 18: 701-707.
[ 3 ]	Cronk K, Spetzler RF. Commentary for recurrent intracranial aneurysms after successful neck clipping. World Neurosurg 2010; 74:437-438. doi: 10.1016/j.wneu.2010.10.032. Epub 2011 Jan 12.
[ 4 ]	Daniel L, Robert F. Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear: A Technical Note. Neurosurgery 2011,68: 294- 299.
[ 5 ]	Fujimura M, Nishijima M, Umezawa K, Hayashi T, Mino Y, Sakuraba T, Midorikawa H. Optochiasmal arachnoiditis following cotton wrapping of anterior communicating artery aneurysm treated by surgical removal of granuloma. J Clin Neurosci. 2003;10(2): 254-257.
[ 6 ]	Giannotta SL, Oppenheimer JH, Levy ML, Zelman V (1991) Management of intraoperative rupture of aneurysm without hypotension. Neurosurgery 28: 531-536.
[ 7 ]	Houkin K, Kuroda S, Takahashi A, Takikawa S, Ishikawa T, Yoshimoto T, Itamato K (1999) Intra-operative premature rupture of cerebral aneurysms: Analysis of the causes and management. Acta Neurochir (Wien) 141:1255-1263.
[ 8 ]	Lanzino G, Spetzler RF. Clip wrapping for partial avulsion of the aneurysm neck. Technical note.J Neurosurg. 2003 Nov; 99 (5):931-932.
[ 9 ]	Lavin P. Muslin-induced optochiasmatic arachnoiditis? Neurosurgery. 1997: 20(3): 505.
[ 10 ]	Leipzig TJ, Morgan J, Horner TG, Payner T, Redelman K, Johnson CS. Analysis of intraoperative rupture in the surgical treatment of 1694 saccular aneurysms. Neurosurgery. 2005;56 (3):455-468.
[ 11 ]	Menovsky T, de Vries J, Grotenhuis JA. Cotton-clipping technique: piece of smashed muscle as an alternative. Neurosurgery. 2011 Nov; 69(5): E1183-5; author reply E1185. doi: 10.1227/NEU.0b013e31822ed4b4.
[ 12 ]	Origitano TC, Schwartz K, Anderson D, Azar-Kia B, Reichman OH. Optimal clip application and intraoperative angiography for intracranial aneurysms.Surg Neurol. 1999 Feb;51(2):117-24; discussion 124-128.
[ 13 ]	Paul RL, Arnold JG (1970) Operative factors influencing mortality in intracranial aneurysms surgery: Analysis of 186 consecutive cases. J Neurosurg 32: 289-294.
[ 14 ]	Yong Zhen, Kaixuan Yan, Hengzhu Zhang, Shaokun Zhao, Yao Xu, Hengzhong Zhang, Liang He, Linhai Shen.Analysis of the relationship between different bleeding positions on intraoperative rupture anterior circulation aneurysm and surgical treatment outcome.Acta Neurochir(2014)156:481–491.