CDE Detailed Report

If the bone flap is not replaced, then the procedure is listed as a craniectomy, whether or not the bone is replaced at a later time during the episode of care for SAH.

From initiation of vascular access to access closure or equivalent during the procedure for treatment of the aneurysm.

Craniotomy for removal of an acute intraparenchymal, subdural, or epidural hematoma caused by the index aneurysm, for the purpose of reducing mass effect on the brain, with or without definitive open aneurysm treatment at the same episode of care.

Degree of occlusion of aneurysm following endovascular repair, as confirmed with post-procedure angiography using Raymond-Roy grading.

Placement of a temporary clip at any time during microsurgical aneurysm clipping; the temporary clip must be removed at some point during the microsurgical clipping.

Success of surgical intervention describes degree of aneurysm occlusion, as measured by postoperative imaging with diagnostic radiology as gold standard; any residual aneurysm filling is graded as partial occlusion.

For patient with multiple aneurysms, include documentation of treatment of additional aneurysm, whether ruptured or unruptured, at any time during the episode of SAH care

The maximum duration of any one temporary clip application from the time of placement until removal, in minutes.

Any episode of intraoperative rupture of the ruptured aneurysm during the open aneurysm treatment procedure, at any time between incision and closure, whether spontaneous or as a result of microsurgical manipulation. Major - requiring blood transfusion, leading to increased intracranial pressure necessitating additional surgery (e.g. craniectomy, additional bone removal, brain resection), resulting in hypotension. Minor - any other rupture from any treated aneurysm.

The day of intervention will be timed from the moment of SAH ictus; day of rupture is day 0.

Type of endovascular repair described in detail including all endovascular devices utilized, alone or in combination. Flow diverters include all stent technology intended to alter flow into the aneurysm sac. Stent in this context means a non-flow diverting stent.

Procedure-related complication, directly attributable to the microsurgical procedure.

External ventriculostomy placement for treatment of hydrocephalus at any time during the episode of care for aneurysmal SAH, placed either at bedside or in the operating room, alone or in combination with other procedures.

Procedure-related complication, directly attributable to the endovascular procedure and identified during the procedure.

Any administration of blood products during the microsurgical clipping procedure.

Surgery involves craniotomy and microsurgery, including one or more of the following: clipping, trapping, Hunterian ligation, bypass, or wrapping; attempted/failed includes all aneurysms which did not receive definitive treatment via one of the aforementioned modalities; "definitive" means that at the conclusion of the procedure the prevention of immediate re-rupture has been achieved.