Retrospective Analysis of 162 Consecutive Cases of Ruptured Intracranial Aneurysms. Total Mortality and Early Surgery

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 1984 Jan 1

PMID 6741629

Citations 7

Authors

H G Bolander

H Kourtopoulos

K A West

Affiliations

Soon will be listed here.

Abstract

A retrospective analysis of 162 consecutive cases with ruptured intracranial aneurysm treated during the years 1979-1981 is presented. Total mortality was 33%. Eighty-four patients were in Botterell grades I-II and 62 were operated with a direct attack on the aneurysm. Thirty-eight were operated early with a mortality of 5% compared with 13% for those operated late. There was no difference in morbidity between the two groups. Of the patients operated with clipping, 66% made a "complete recovery" and 21% were classified as independent. Signs of delayed ischaemia were recorded in 42% of patients operated early as compared with 25% in the late surgery group. The frequency of rebleedings in the total material was 15%. Hospitalization time was significantly reduced in the early operated group. The importance of analysing the total management mortality and morbidity for evaluation and comparison between early and delayed surgery is discussed.

Citing Articles

Incidence of delayed cerebral ischaemia following subarachnoid haemorrhage of unknown cause.

Barlow P J Neurol Neurosurg Psychiatry. 1985; 48(2):132-6.

PMID: 3981169 PMC: 1028212. DOI: 10.1136/jnnp.48.2.132.

[The phenomenology and morphology of spontaneous fatal cerebral aneurysmal hemorrhages].

Bratzke H, Puschel K, Colmant H Z Rechtsmed. 1986; 96(4):245-73.

PMID: 3765903 DOI: 10.1007/BF00200705.

Does the timing of aneurysm surgery neglect the real problems of subarachnoid haemorrhage?.

Freckmann N, Noll M, Winkler D, Nowak G, Rehn H, Neuss M Acta Neurochir (Wien). 1987; 89(3-4):91-9.

PMID: 3434353 DOI: 10.1007/BF01560372.

Early aneurysm surgery: a 7 year clinical practice report.

Gilsbach J, Harders A, Eggert H, Hornyak M Acta Neurochir (Wien). 1988; 90(3-4):91-102.

PMID: 3354369 DOI: 10.1007/BF01560561.

Intracranial aneurysms in India--microsurgical approach.

Saxena A, Prakash B Acta Neurochir (Wien). 1989; 101(1-2):18-22.

PMID: 2603761 DOI: 10.1007/BF01410063.

References

Sano K, Saito I . Timing and indication of surgery for ruptured intracranial aneurysms with regard to cerebral vasospasm. Acta Neurochir (Wien). 1978; 41(1-3):49-60. DOI: 10.1007/BF01809136. View

NORLEN G, Olivecrona H . The treatment of aneurysms of the circle of Willis. J Neurosurg. 1953; 10(4):404-15. DOI: 10.3171/jns.1953.10.4.0404. View

Fodstad H, Forssell A, LILIEQUIST B, Schannong M . Antifibrinolysis with tranexamic acid in aneurysmal subarachnoid hemorrhage: a consecutive controlled clinical trial. Neurosurgery. 1981; 8(2):158-65. DOI: 10.1227/00006123-198102000-00004. View

Hori S, Suzuki J . Early intracranial operations for ruptured aneurysms. Acta Neurochir (Wien). 1979; 46(1-2):93-104. DOI: 10.1007/BF01407684. View

Adams Jr H, Kassell N, Torner J, NIBBELINK D, SAHS A . Early management of aneurysmal subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study. J Neurosurg. 1981; 54(2):141-5. DOI: 10.3171/jns.1981.54.2.0141. View

Ljunggren B, Brandt L, Kagstrom E, Sundbarg G . Results of early operations for ruptured aneurysms. J Neurosurg. 1981; 54(4):473-9. DOI: 10.3171/jns.1981.54.4.0473. View

Lundberg N . Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiatr Scand Suppl. 1960; 36(149):1-193. View

Fodstad H, LILIEQUIST B, Schannong M, THULIN C . Tranexamic acid in the preoperative management of ruptured intracranial aneurysms. Surg Neurol. 1978; 10(1):9-15. View

GRAF C, NIBBELINK D . Cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Report on a randomized treatment study. 3. Intracranial surgery. Stroke. 1974; 5(4):557-601. DOI: 10.1161/01.str.5.4.557. View

10.

Weir B, Aronyk K . Management mortality and the timing of surgery for supratentorial aneurysm. J Neurosurg. 1981; 54(2):146-50. DOI: 10.3171/jns.1981.54.2.0146. View

11.

Taneda M . Effect of early operation for ruptured aneurysms on prevention of delayed ischemic symptoms. J Neurosurg. 1982; 57(5):622-8. DOI: 10.3171/jns.1982.57.5.0622. View

12.

HUNT W, Hess R . Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968; 28(1):14-20. DOI: 10.3171/jns.1968.28.1.0014. View

13.

Fortuny L, Prieto-Valiente L . Long-term prognosis in surgically treated intracranial aneurysms. Part 2: Morbidity. J Neurosurg. 1981; 54(1):35-43. DOI: 10.3171/jns.1981.54.1.0035. View

14.

Locksley H . Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. J Neurosurg. 1966; 25(3):321-68. DOI: 10.3171/jns.1966.25.3.0321. View

15.

Jane J, Winn H, Richardson A . The natural history of intracranial aneurysms: rebleeding rates during the acute and long term period and implication for surgical management. Clin Neurosurg. 1977; 24:176-84. DOI: 10.1093/neurosurgery/24.cn_suppl_1.176. View

16.

Fortuny L, Prieto-Valiente L . Long-term prognosis in surgically treated intracranial aneurysms. Part 1: Mortality. J Neurosurg. 1981; 54(1):26-34. DOI: 10.3171/jns.1981.54.1.0026. View