Timing and Grading in the Surgical Treatment for Aneurysm

  • Bengt Ljunggren
  • Lennart Brandt
  • Hans Säveland
Conference paper


A total of 149 patients were subjected to acute stage aneurysm clipping following subarachnoid hemorrhage (SAH). In 57 individuals, the ruptured aneurysm originated from the anterior cerebral artery complex (ACA). In 39, it was located on the internal carotid artery segment (ICA), and, in 44 patients, the ruptured aneurysm arose from the middle cerebral artery (MCA). Ninety patients were in a favorable condition prior to surgery (within 72 h after hemorrhage), while 28 were either confused, had minor neurological deficit, or both (equivalent to Hunt-Hess neurological grade III). Twenty-two individuals were in poor condition. In addition, all patients received an intravenous infusion, with the calcium channel blocker nimodipine, during the critical period for symptomatic vasospasm or delayed ischemic deterioration. The overall success rate was 76% good neurological recoveries and the mortality was 5%. The success rate was 95% in the grade I patients, 87% in the grade II patients, 64% in the grade III patients, and 36% in the poor grade patients.


Intracranial Aneurysm Early Operation Cerebral Vasospasm Aneurysmal Subarachnoid Hemorrhage Symptomatic Vasospasm 
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Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Bengt Ljunggren
    • 1
  • Lennart Brandt
    • 1
  • Hans Säveland
    • 1
  1. 1.Department of NeurosurgeryUniversity HospitalLundSweden

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