title: Factors Influencing Intraoperative Rupture of Intracranial Aneurysms.
abstract: OBJECTIVE
  The study deals with intraoperative rupture of intracranial aneurysms (IOR) during microsurgery, analyzing factors that may be connected with IOR.
  
  
  METHODS
  During the three-year period (2006-2008), 934 patients were operated for aneurysms at the Institute of Neurosurgery, CCS, Belgrade. In total, 536 patients were observed.
  
  
  RESULTS
  IOR occurred in 14.7%. Male gender, seizures and timing of surgery proved to be risk factors for IOR. All other tested features had no significance. Localization {IOR rate 11.93% in ACM, 17.06% in ACA and 17.26% in ACI) and size (small: IOR in 68/439 (15.49%), large: 8/74 (10.8%), and very large: 3/23 (13.04%)} of aneurysm seemed to have an influence, but this could not be proved. The majority of IORs (58.23%) occurred in early surgery. Early operated patients: IOR occurred in 46/167 (27.54%), intermediary: 25/103 (24.27%), and delayed: 8/266 (3%) - with highly significant differences.
  
  
  CONCLUSIONS
  Age, hypertension, diabetes mellitus, cardiomyopathy, pregnancy, higher Fisher score, previous IOR, or the presence of vomiting and headache did not affect the occurrence of IOR, whereas the timing of surgery, male gender and epileptic seizures increased the risk. Localization and size of aneurysm tend to have an influence but statistical significance was not proved in this study.
authors.affiliation: Clinical Center of Montenegro, Director of Neurosurgery Division, Podgorica, Ljubljanska bb, Podgorica , Montenegro.
authors.forename: Novak
authors.initials: N
authors.lastname: Lakićević
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Vujotić
authors.forename: Danilo
authors.initials: D
authors.lastname: Radulović
authors.forename: Irena
authors.initials: I
authors.lastname: Cvrkota
authors.forename: Miroslav
authors.initials: M
authors.lastname: Samardžić
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D012307:Risk Factors