Clinical Significance on Fundal Hemorrhage in Patients of Intracranial Aneurysms with Subarachnoid Hemorrhage.

Hwang, Sung Kyoo; Kim, Seung Lae

Original Article

Journal of Korean Neurosurgical Society 1981;10(1): 147-156.

Department of Neurosurgery, Kyungpook National University Hospital, Taegu, Korea.

ABSTRACT

A clinical studies were conducted on 71 patients with subarachnoid hemorrhage by ruptured intracranial aneurysms, to evaluate the significance of fundal hemorrhage. Fundal hemorrhage was found in 20 patients(28%), mainly preretinal in location, and it occurred more frequently in patients with aneurysms of internal carotid artery, and in ipsilateral or bilateral, rather than contralateral side. Significant relationship was noted between fundal hemorrhage and increased intracranial pressure. However, there was no such relationship with frequency of aneurismal rupture and hypertension. Intracranial complications by ruptured aneurysms were significantly higher(50%) in patients with fundal hemorrhage, compared to patients without it. Also, there were more severe neurological abnormalities as grade III-V according to Botterell's classification in patients with fundal hemorrhage. After surgical and/or nonsurgical treatment, 20% of patients with and 11.7% of patients without fundal hemorrhage could not lead their normal lives. Mortality rate in patients with fundal hemorrhage was higher by 30%, compared to that in patients without fundal hemorrhage(19.6%).