Outcome of Aggressive Aneurysm Treatment with Early Operation and Adjunct Nimodipine in a Strictly Defined Swedish Population Served by a Small Neurosurgical Unit
Recently, much interest has been focused on improvement of the overall outcome in aneurysmal subarachnoid hemorrhage (SAH). Clinical work has demonstrated that surgery performed early after aneurysmal bleeding yields equally good or better results than does delayed surgery on a number of selected survivors from the early disasters characterizing this disease . Furthermore, attempts to treat manifest brain ischemia during the course of SAH by hemodynamic manipulations , or to prevent its occurence by use of the calcium entry blocker nimodipine, seem promising [1, 8]. The structure of the medical care system in this country permitted almost every patient in a strictly defined population of 934 000 people, who survived long enough after aneurysm rupture to be transported, to be seen in this center. Furthermore, 86% of all patients were seen within 24 h post-SAH. This provides us with a unique opportunity to roughly evaluate the overall outcome of aneurysm bleeding obtained by the therapeutic principles presently applied, and permits a good understanding of the causes of clinical deterioration in a number of patients.
KeywordsCerebral Aneurysm Aneurysm Rupture Aneurysmal Subarachnoid Hemorrhage Psychological Distur Aneurysm Bleeding
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