Management of Patients with Ruptured Cerebral Aneurysms

Some Considerations from Recent Experience
  • Ludwig M. Auer
Conference paper


As the recent international cooperative aneurysm study again shows the old problems of aneurysm surgery are the same as the present problems. Who should be operated upon? Who should be operated upon early and who should undergo delayed operation? Is rebleeding really a significant problem influencing prognosis and, hence, worth consideration in the timing of surgery? Does early rebleeding really exist and thus justify acute management of patients after subarachnoid bleeding? Is delayed ischemia from vasospasm really a significant problem or are these patients a hidden pool of surgical complications?


Intracranial Aneurysm Unfavorable Outcome Cerebral Aneurysm Acute Management Aneurysm Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Allen GS, Ahn HS, Preziosi TJ, Battye R, Boone SC, Chou SN, Kelly DL, Weir BK, Crabbe RA, Lavik PJ, Rosenbloom SB, Dorsey SC, Intram CR, Mellits VE, Bertsch LA, Voisyert DPJ, Huntley MB, Johnson RK, Strom JA, Transou CR (1983) Cerebral arterial spasm: A controlled trial of nimodipine in patients with subarachnoid hemorrhage. N Engl J Med 308:619–624PubMedCrossRefGoogle Scholar
  2. 2.
    Auer LM (1983) Acute surgery of cerebral aneurysms and prevention of symptomatic vasospasm. Acta Neurochir 69:273–281PubMedCrossRefGoogle Scholar
  3. 3.
    Auer LM (1985) Timing of aneurysm surgery. Second International Symposium on Cerebral Aneurysm Surgery in the Acute Stage, 1984, Graz. Gruyter, BerlinGoogle Scholar
  4. 4.
    Auer LM (1986) Management of patients with subarachnoid hemorrhage from ruptured cerebral aneurysms: What remains to be done? 1st International Workshop on Intracranial Aneurysms, 1986, TokyoGoogle Scholar
  5. 5.
    Auer LM, Brandt L, Ebeling U, Gilsbach J, Groeger U, Härders A, Ljunggren B, Oppel F, Reulen HJ, Saeveland H (1986) Nimodipine and early aneurysm operation in good condition SAH patients. Acta Neurochir 82:7–13PubMedCrossRefGoogle Scholar
  6. 6.
    Auer LM, Heppner F, Symon L (1982) Aneurysm surgery in the acute stage. First International Symposium on Cerebral Aneurysm Surgery in the Acute Stage, 1981, Graz. Acta Neurochir 63:1–306 Springer, ViennaGoogle Scholar
  7. 7.
    Kassell N (1986) Timing of surgery: Results in cooperative aneurysm study. First International Workshop on Intracranial Aneurysms, 1986, TokyoGoogle Scholar
  8. 8.
    Kassell NF, Boarini DJ, Adams HP Jr, Sahs AL, Graf CJ, Tomer JC, Gerk M (1981) Overall management of ruptured aneurysm: Comparison of early and late operation. Neurosurgery 9:120–128PubMedCrossRefGoogle Scholar
  9. 9.
    Kassell NF, Drake CG (1982) Timing of aneurysm surgery. Neurosurgery 10:514–519PubMedCrossRefGoogle Scholar
  10. 10.
    Kassell NF, Torner JC (1984) The international cooperative study on timing of aneurysm surgery: An update. Stroke 15:566–570PubMedCrossRefGoogle Scholar
  11. 11.
    Mee EW, Dorrance DE, Low D, Neil-Dwyer G (1986) Cerebral blood flow and neurological outcome: A controlled study of nimodipine in patients with subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry 49:469Google Scholar
  12. 12.
    Ono H, Mizukami M, Kitamura K, Kikuchi H, and the Cooperative Study Group in Japan (1983) Preventive effect of ticlopidine on cerebral ischemia due to cerebral vasospasm following ruptured aneurysm: A double-blind cooperative study. 52nd Annual Meeting of the American Association of Neurological Surgeons, 24–28 April 1983, Washington, DCGoogle Scholar
  13. 13.
    Philippon J, Grob R, Dagreou F, Guggiari M, Rivierez M, Viars P (1986) Prevention of vasospasm in subarachnoid haemorrhage: A controlled study with nimodipine. Acta Neurochir 82:110–114PubMedCrossRefGoogle Scholar
  14. 14.
    Yamamoto I, Hara M, Ogura K, Suzuki Y, Nakane T, Kaneyama N (1983) Early operation for ruptured intracranial aneurysms: Comparative study with computed tomography. Neurosurgery 12:169–174PubMedCrossRefGoogle Scholar
  15. 15.
    Taneda M (1982) Effect of early operation for ruptured aneurysms on prevention of delayed ischemic symptoms. J Neurosurg 57:622–627PubMedCrossRefGoogle Scholar
  16. 16.
    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. In: Auer LM, Heppner F, Symon L (eds) Proceedings of the symposium on aneurysm surgery in the acute stage. Acta Neurochir 63:201–208Google Scholar

Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Ludwig M. Auer
    • 1
  1. 1.Department of NeurosurgeryUniversity HospitalGrazAustria

Personalised recommendations