Retrospective analysis of 162 consecutive cases of ruptured intracranial aneurysms. Total mortality and early surgery

1984 ◽  
Vol 70 (1-2) ◽  
pp. 31-41 ◽  
Author(s):  
H. G. Bolander ◽  
H. Kourtopoulos ◽  
K. A. West
Keyword(s):  
Retrospective Analysis ◽  
Intracranial Aneurysms ◽  
Total Mortality ◽  
Early Surgery ◽  
Ruptured Intracranial Aneurysms

scholarly journals Early Surgery for Ruptured Intracranial Aneurysms associated with Neurogenic Pulmonary Edema

1988 ◽  
Vol 28 (11) ◽  
pp. 1107-1112 ◽  
Author(s):  
Takeshi KONDOH ◽  
Keiichi KUWAMURA ◽  
Masaru MIYATA ◽  
Junichi IKEGAKI
Keyword(s):  
Pulmonary Edema ◽  
Intracranial Aneurysms ◽  
Early Surgery ◽  
Neurogenic Pulmonary Edema ◽  
Ruptured Intracranial Aneurysms

Considerations in early surgery on good-risk patients with ruptured intracranial aneurysms

1982 ◽  
Vol 56 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Herman Hugenholtz ◽  
Robert G. Elgie
Keyword(s):  
Intracranial Pressure ◽  
Retrospective Analysis ◽  
Intracranial Aneurysms ◽  
Early Operation ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Risk Patients ◽  
Ruptured Intracranial Aneurysms ◽  
Good Risk ◽  
Fine Print

✓ A retrospective analysis of 100 consecutive patients with proven ruptured intracranial aneurysms, classified as Botterell Grades I to III on admission, was carried out to evaluate the efficacy of early operation. Surgical and management mortality/morbidity rates were lower for cases in which a single hemorrhage was operated on within 48 hours than when surgery was delayed for 7 days or more. Surgical and management mortality/morbidity rates were worse in good-risk patients treated surgically between the 3rd and 7th days following a hemorrhage, reflecting the increased incidence of postoperative vasospasm and raised intracranial pressure encountered at surgery during this interval.

The International Cooperative Study on the Timing of Aneurysm Surgery

1990 ◽  
Vol 73 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Neal F. Kassell ◽  
James C. Torner ◽  
John A. Jane ◽  
E. Clarke Haley ◽  
Harold P. Adams ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Intracranial Aneurysms ◽  
Early Surgery ◽  
Surgical Results ◽  
Aneurysm Surgery ◽  
Cooperative Study ◽  
Content Type ◽  
Delayed Surgery ◽  
Postoperative Risk ◽  
Ruptured Intracranial Aneurysms

✓ A prospective, observational clinical trial was conducted by the International Cooperative Study on the Timing of Aneurysm Surgery to determine the best time in relation to the hemorrhage for surgical treatment of ruptured intracranial aneurysms. Sixty-eight centers contributed 3521 patients in a 2½-year period beginning in December, 1980. Analysis by a prespecified “planned” surgery interval demonstrated that there was no difference in early (0 to 3 days after the bleed) or late surgery (11 to 14 days). Outcome was worse if surgery was performed in the 7 to 10-day post-bleed interval. Surgical results were better for patients operated on after 10 days. Patients alert on admission fared best; however, alert patients had a mortality rate of 10% to 12% when undergoing surgery prior to Day 11 compared with 3% to 5% when surgery was performed after Day 10. Patients drowsy on admission had a 21% to 25% mortality rate when operated on up to Day 11 and 7% to 10% with surgery thereafter. Overall, early surgery was neither more hazardous nor beneficial than delayed surgery. The postoperative risk following early surgery is equivalent to the risk of rebleeding and vasospasm in patients waiting for delayed surgery.

scholarly journals Causes of Poor Results of Early Surgery for Ruptured Intracranial Aneurysms in Elderly Patients

1988 ◽  
Vol 28 (12) ◽  
pp. 1157-1162 ◽  
Author(s):  
Akifumi SUZUKI ◽  
Nobuyuki YASUI ◽  
Hiromu HADEISHI ◽  
Ichiro SAYAMA ◽  
Ken ASAKURA ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Intracranial Aneurysms ◽  
Early Surgery ◽  
Ruptured Intracranial Aneurysms

scholarly journals Early Surgery in Elderly Patients with Ruptured Intracranial Aneurysms

1990 ◽  
Vol 30 (2) ◽  
pp. 95-99 ◽  
Author(s):  
Akifumi SUZUKI ◽  
Nobuyuki YASUI ◽  
Hiromu HADEISHI ◽  
Makoto MIZUNO ◽  
Takeo ABUMIYA ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Intracranial Aneurysms ◽  
Early Surgery ◽  
Ruptured Intracranial Aneurysms ◽  
Surgery In Elderly

scholarly journals Evaluating the safety of early surgery for ruptured intracranial aneurysms in patients with long-term aspirin use: a propensity score matching study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Maogui Li ◽  
Shuzhe Yang ◽  
Qingyuan Liu ◽  
Rui Guo ◽  
Jun Wu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Intracranial Aneurysms ◽  
Postoperative Hospital Stay ◽  
Early Surgery ◽  
Intraoperative Blood Loss ◽  
Microsurgical Clipping ◽  
Hemorrhagic Events ◽  
Ruptured Intracranial Aneurysms ◽  
Aspirin Group

Abstract Background Early microsurgical clipping is recommended for ruptured intracranial aneurysms to prevent rebleeding. However, dilemma frequently occurs when managing patients with current acetylsalicylic acid (aspirin) use. This study aimed to examine whether aspirin use was associated with worse outcomes after early surgery for aneurysmal subarachnoid hemorrhage (aSAH). Methods We retrieved a consecutive series of 215 patients undergoing early microsurgical clipping within 72 h after aneurysmal rupture from 2012 to 2018 in the neurosurgery department of Beijing Tiantan Hospital. The medical records of each case were reviewed. Twenty-one patients had a history of long-term aspirin use before the onset of aSAH, and 194 patients did not. To reduce confounding bias, propensity score matching (PSM) was performed to balance some characteristics of the two groups. The intraoperative blood loss, postoperative hemorrhagic events, postoperative hospital stay, and functional outcome at discharge were compared between aspirin and non-aspirin group. Results We matched all the 21 patients in aspirin group with 42 patients in non-aspirin group (1:2). Potential confounding factors were corrected between the two groups by PSM. No hospital mortality occurred after surgery. No significant differences were found in intraoperative blood loss (P = 0.540), postoperative hemorrhagic events (P > 0.999), postoperative hospital stay (P = 0.715), as well as functional outcome at discharge (P = 0.332) between the two groups. Conclusions Our preliminary results showed that long-term low-dose aspirin use was not associated with worse outcomes. Early surgery can be safe for ruptured intracranial aneurysms in patients with long-term aspirin use.

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