No studies on the pathogenesis of perioperative intracranial hemorrhage have been published outside the field of neurosurgery. In a retrospective study of >11,000 patients undergoing craniotomy, Basali et al43 found a 0.77% incidence of intracranial hemorrhage after craniotomy. They evaluated the role of hypertension and found that postoperative systolic blood pressure greater than 160 mm Hg after intracranial surgery was a risk factor for intracranial hemorrhage.Eng et al44 reported a case of re-rupture during induction of anesthesia in a patient with a previously ruptured cerebral aneurysm. This patient’s tracheal intubation was complete and there were no significant hemodynamic changes during the induction of anesthesia. Nonetheless, transcranial ultrasound Doppler during the same period observed and documented the rupture of the aneurysm. A transient termination of intracranial circulation was observed by ultrasound. Although the authors did not find an association between this event and hypertension, there is nonetheless sufficient evidence to suggest that chronic hypertension is associated with subarachnoid hemorrhage as a perioperative risk factor.Ohkuma et al45 reported an association between hypertension and early aneurysm rebleeding. It supports the aggressive prevention of hypertension in patients with aneurysms. Fan Zhiyi, Department of Anesthesiology, Peking University Cancer Hospital
From the translation of Anesthesiology by Fan Zhiyi, Editor-in-Chief Science Press Translated by Yang Xudong Reviewed by Gao Ling and Liu Ruichang