[Surgical removal of a cerebral arterial aneurysm complicating renal failure; anaesthesiological and post-operative problems (author's transl)].

A case of cerebral arterial aneurysm associated with renal failure is reported which was treated by surgery. The anaesthesiological and post-operative problems are discussed. Surgery of the aneurysm is urgently indicated in these cases on account of the increased risk of subarachnoid haemorrhage due to heparinization during haemodialysis. Pre-operative replacement of haemodialysis by peritoneal dialysis is advisable to facilitate the treatment of cerebral oedema, maintain the electrolyte and water balance and ensure adequate post-operative enteral and parenteral feeding. The choice of anaesthetic technique, the use of controlled hypotension, the treatment of hypertensive crises, laboratory tests and the post-operative care of these cases are discussed. Experience has shown that from the anaesthesiological point of view there is no contra-indication to neurosurgery or vascular surgery in cases of renal failure provided adequate precautions are taken.