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Management Results of a Series of Predominantly Delayed Operations on Ruptured Aneurysms

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Book cover Neurosurgical Standards Cerebral Aneurysms Malignant Gliomas

Part of the book series: Advances in Neurosurgery ((NEURO,volume 20))

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Abstract

Using a comprehensive statistical analysis, Kassell and Drake [9] were able to illustrate the fatal consequences of aneurysmal rupture. Many authors have advocated an early operation to reduce both the rebleeding and vasospasm rates [2, 4, 11–13, 21]. Nevertheless, the results of early operations have been varied and, in their interpretation, are not uncontroversial. Discussion centered mainly on the range of criteria for an early operation in terms of aneurysm site and grade at the time of admission [1, 5, 7, 9, 10, 15, 20]. A comparison of the various treatment strategies reveals methodological problems due to differences in selection when the patients are allocated to the clinics and due to the choice of outcome parameters [13, 16]. Generally recognized as comparison values are the definitions of management mortality and management morbidity, which were coined by Lougheed [14]. In this paper, we present the management results of a series of predominantly delayed operations on ruptured aneurysms.

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References

  1. Adams HP (1986) Early management of the patient with recent aneurysmal subarachnoid hemorrhage. Stroke 17:1068–1070

    Article  PubMed  Google Scholar 

  2. Auer LM (1983) Acute surgery of cerebral aneurysms and prevention of symptomatic vasospasm. Acta Neurochir (Wien) 69:273–281

    Article  CAS  Google Scholar 

  3. Auer LM, Brandt L, Ebeling U, Gilsbach J, Groeger U, Harders A, Ljunggren B, Oppel F, Reulen HJ, Saeveland H (1986) Nimodipine and early aneurysm operation in good condition SAH patients. Acta Neurochir 82:7–13

    Article  CAS  Google Scholar 

  4. Ausman JI, Diaz FG, Malik GM, Fielding AS, Son CS (1985) Current management of cerebral aneurysms: Is it based on facts or myths? Surg Neurol 24:625–635

    Article  PubMed  CAS  Google Scholar 

  5. Chyatte D, Fode NC, Sundt TM (1988) Early versus late intracranial aneurysm surgery in subarachnoid hemorrhage. J Neurosurg 69:326–331

    Article  PubMed  CAS  Google Scholar 

  6. Disney L, Weir B, Petruk K (1987) Effect on management mortality of deliberate policy of early operation on supratentorial aneurysms. Neurosurgery 20:695–701

    Article  PubMed  CAS  Google Scholar 

  7. Flamm ES (1986) The timing of aneurysm surgery 1985. Clin Neurosurg 33:147–158

    PubMed  CAS  Google Scholar 

  8. Gilsbach JM, Harders AG (1989) Morbidity and mortality after early aneurysm surgery — a prospective study with nimodipine prevention. Acta Neurochir 96:1–7

    Article  CAS  Google Scholar 

  9. Kassell NF, Drake CG (1982) Timing of aneurysm surgery. Neurosurgery 10:514–519

    Article  PubMed  CAS  Google Scholar 

  10. Kassell NF, Kongable GL, Torner JC, Adams HP, Mazuz H (1985) Delay in referral of patients with ruptured aneurysms to neurosurgical attention. Stroke 16:587–590

    Article  PubMed  CAS  Google Scholar 

  11. Ljunggren B, Brandt L, Kagström E, Sundbärg G (1981) Results of early operations for ruptured aneurysms. J Neurosurg 54:473–479

    Article  PubMed  CAS  Google Scholar 

  12. Ljunggren B, Brandt L, Säveland H, Nilson PE, Cronqvist S, Andersson KE, Vinge E (1984) Outcome in 60 consecutive patients treated with early aneurysm operation and intravenous nimodipine. J Neurosurg 61:864–873

    Article  PubMed  CAS  Google Scholar 

  13. Ljunggren B, Säveland H, Brandt L, Zygmunt S (1985) Early operation and overall outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg 62:547–551

    Article  PubMed  CAS  Google Scholar 

  14. Lougheed WM (1969) Selection, timing, and technique of aneurysm surgery of the anterior circle of Willis. Clin Neurosurg 16:95–113

    PubMed  CAS  Google Scholar 

  15. Marsh H, Maurice-Williams RS, Lindsay KW (1987) Differences in the management of ruptured intracranial aneurysms: a survey of practice amongst British neurosurgeons. J Neurol Neurosurg Psychiatry 50:965–970

    Article  PubMed  CAS  Google Scholar 

  16. Maurice-Williams RS, Marsh H (1985) Ruptured intracranial aneurysms: the overall effect of treatment and the influence of patient selection and data presentation on the reported outcome. J Neurol Neurosurg Psychiatry 48:1208–1212

    Article  PubMed  CAS  Google Scholar 

  17. Milhorat TH, Krautheim M (1985) Results of early and delayed operation for ruptured intracranial aneurysms in two series of 100 consecutive patients. Surg Neurol 26:123–128

    Article  Google Scholar 

  18. Öhman J, Heiskanen O (1988) Effect of nimodipine on the outcome of patients after aneurysmal subarachnoidal hemorrhage and surgery. J Neurosurg 69:683–686

    Article  PubMed  Google Scholar 

  19. Ropper AH, Zervas NT (1984) Outcome 1 year after SAH from cerebral aneurysm. Management morbidity, mortality, and functional status in 112 consecutive good-risk patients. J Neurosurg 60:909–915

    Article  PubMed  CAS  Google Scholar 

  20. Säveland H, Ljunggren B, Brandt L, Messeter K (1986) Delayed ischemic deterioration in patients with early aneurysm operation and intravenous nimodipine. Neurosurgery 18:146–150

    Article  PubMed  Google Scholar 

  21. Sakaki S, Onta S, Kuwabara H, Shiraishi M (1987) The role of ventricular and cisternal drainage in the early operation for ruptured intracranial aneurysms. Acta Neurochir 88:87–94

    Article  CAS  Google Scholar 

  22. Seiler RW, Reulen HJ, Huber P, Grolimund P, Ebeling U, Steiger HJ (1988) Outcome of aneurysmal subarachnoid hemorrhage in a hospital population: a prospective study including early operation, intravenous nimodipine, and transcranial Doppler ultrasound. Neurosurgery 23:598–604

    Article  PubMed  CAS  Google Scholar 

  23. Taneda M (1982) The significance of early operation in the management of ruptured intracranial aneurysms — an analysis of 251 cases hospitalized within 24 hours after subarachnoid haemorrhage. Acta Neurochir (Wien) 63:201–208

    Article  CAS  Google Scholar 

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© 1992 Springer-Verlag Berlin Heidelberg

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Krupp, W., Heienbrok, W., Müke, R. (1992). Management Results of a Series of Predominantly Delayed Operations on Ruptured Aneurysms. In: Piscol, K., Klinger, M., Brock, M. (eds) Neurosurgical Standards Cerebral Aneurysms Malignant Gliomas. Advances in Neurosurgery, vol 20. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77109-5_21

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  • DOI: https://doi.org/10.1007/978-3-642-77109-5_21

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-54838-6

  • Online ISBN: 978-3-642-77109-5

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