Principles of Aneurysm Surgery in the Acute Stage of Subarachnoid Hemorrhage
We experienced 1646 cases of intracranial aneurysms up to the end of 1989; 1519 cases exhibited subarachnoid hemorrhage (SAH). Of these 1519 cases, 171 (11.3%) died of rebleeding while waiting for surgery mostly within 1 week after SAH. The fact has made us consider a possible advantage of early surgery for patients with ruptured aneurysms. However, if we compare the mortality (at 6 months following SAH) of early surgery (within 1 week after SAH) with that of surgery done later than the 1st week, the former was 14.5% (95/655) and the latter was 3.9% (26/674). Therefore, the latter seemed apparently better (Table 1). The latter became 15.2%, however, if the above 11.3% were added to it. Therefore, there was no marked difference in mortality between the two groups, or, one may say, early surgery was a little bit better.
KeywordsSubarachnoid Hemorrhage Operative Mortality Intracranial Aneurysm Acute Stage Cerebral Vasospasm
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