Timing of surgery for supratentorial aneurysmal subarachnoid haemorrhage: report of a prospective study

Journal of Neurology, Neurosurgery, and Psychiatry
N RossP J Kirkpatrick

Abstract

The debate on the timing of aneurysm surgery after subarachnoid haemorrhage (SAH) pivots on the balance of the temporal risk for fatal rebleeding versus the risk of surgical morbidity when operating early on an acutely injured brain. By following a strict management protocol for SAH, the hypothesis has been tested that in the modern arena of treatment for aneurysmal SAH the timing of surgery to secure supratentorial aneurysms does not affect surgical outcome. Over a 6 year period, patients admitted with a diagnosis of SAH to a regional neurosurgical unit have been prospectively studied. All have been on a management protocol in which early transfer and resuscitation has been followed regardless of age and clinical condition. Angiographic investigation and surgery have been pursued in those who have been able to at least flex to pain. A total of 1168 patients (60.7% female, mean age 54.3) with proved SAH were received on median day 1 (86.4% arrived within 3 days) of the ictus. Of these, 784 (67.1%) showed aneurysms on angiography and were prepared for surgery. Those who received surgery for a supratentorial aneurysm within 21 days of the ictus were included in the final analysis (n=550). Patients with an initial negative angiogr...Continue Reading

Citations

Jun 17, 2003·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Thomas VogelMarc Berthel
Jul 22, 2011·Stroke Research and Treatment·Kavian GhandehariAzadeh Afzalnia

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