Early aneurysm surgery and dehydration therapy in patients with severe subarachnoid haemorrhage without ICH

1996 ◽  
Vol 138 (9) ◽  
pp. 1050-1056 ◽  
Author(s):  
S. Oda ◽  
M. Shimoda ◽  
O. Sato
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Aneurysm Surgery ◽  
Early Aneurysm Surgery ◽  
Dehydration Therapy

Prophylactic Hypervolemia without Calcium Channel Blockers in Early Aneurysm Surgery

Neurosurgery ◽  
1992 ◽  
Vol 30 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Michael D. Medlock ◽  
Scott C. Dulebohn ◽  
Patrick W. Elwood
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Channel Blockers ◽  
Aneurysm Surgery ◽  
Early Aneurysm Surgery

Reducing the risk of rebleeding before early aneurysm surgery: a possible role for antifibrinolytic therapy

1997 ◽  
Vol 86 (2) ◽  
pp. 220-225 ◽  
Author(s):  
Thomas J. Leipzig ◽  
Kathleen Redelman ◽  
Terry G. Horner
Keyword(s):  
Surgical Intervention ◽  
High Dose ◽  
Aneurysm Surgery ◽  
Recurrent Hemorrhage ◽  
Content Type ◽  
Early Aneurysm Surgery ◽  
Antifibrinolytic Therapy ◽  
Symptomatic Vasospasm ◽  
Early Surgical Intervention ◽  
Fine Print

✓ Previous studies on the initial nonoperative management of aneurysmal subarachnoid hemorrhage (SAH) demonstrated that antifibrinolytic therapy reduced the risk of rebleeding by approximately 50%; however, prolonged antifibrinolytic treatment was associated with an increase in the incidence of hydrocephalus and delayed ischemic deficit. When early surgical intervention became routine for ruptured aneurysms, the use of antifibrinolytic therapy diminished. However, early surgery is generally performed in the first several days after SAH and the risk of rebleeding remains until the aneurysm is obliterated. Based on a review of the literature, the authors formed two hypotheses: 1) the high-dose intravenous administration of epsilon-aminocaproic acid (EACA), an antifibrinolytic agent, might reduce the risk of recurrent hemorrhage in the interval between SAH and early surgical intervention, and 2) a short course of EACA might not produce the increase in complications previously associated with its prolonged administration. The use of preoperative high-dose EACA therapy was evaluated in 307 patients to determine its safety and efficacy in reducing the incidence of rebleeding before early aneurysm surgery. All patients were admitted within 3 days of their SAH and were classified as Hunt and Hess Grades I to III. Only four patients (1.3%) suffered a recurrent hemorrhage. This compares favorably to the rebleeding rate of 5.7% reported for the early surgery group in the International Cooperative Study on the Timing of Aneurysm Surgery. The incidence of hydrocephalus or symptomatic vasospasm was not unduly elevated in patients receiving preoperative EACA. Thirty-five patients (11.4%) needed temporary cerebrospinal fluid drainage during their hospitalization and, overall, 8.8% required a ventriculoperitoneal shunt. The mean age of the patients who required a shunt was nearly 10 years older than the general study population. Seventy-one patients (23%) developed symptomatic vasospasm and 8.1% suffered a stroke. This study indicates that a brief course of high-dose EACA is safe and may be beneficial in diminishing the risk of rebleeding in good-grade patients prior to early surgical intervention. Further investigation is planned based on these promising results.

One-year outcome in early aneurysm surgery: Prediction of outcome

1993 ◽  
Vol 123 (1-2) ◽  
pp. 25-32 ◽  
Author(s):  
M. M. Niskanen ◽  
J. A. Hernesniemi ◽  
M. P. Vapalahti ◽  
A. Kari
Keyword(s):  
Aneurysm Surgery ◽  
Prediction Of Outcome ◽  
Early Aneurysm Surgery ◽  
One Year

Shunt-dependent hydrocephalus after subarachnoid haemorrhage and aneurysm surgery: Timing of surgery is not a risk factor

1993 ◽  
Vol 123 (3-4) ◽  
pp. 118-124 ◽  
Author(s):  
A. Tapaninaho ◽  
J. Hernesniemi ◽  
M. Vapalahti ◽  
M. Niskanen ◽  
A. Kari ◽  
...  
Keyword(s):  
Risk Factor ◽  
Subarachnoid Haemorrhage ◽  
Timing Of Surgery ◽  
Aneurysm Surgery ◽  
Surgery Timing

One-year outcome in early aneurysm surgery: a 14 years experience

1993 ◽  
Vol 122 (1-2) ◽  
pp. 1-10 ◽  
Author(s):  
J. Hernesniemi ◽  
M. Vapalahti ◽  
M. Niskanen ◽  
A. Tapaninaho ◽  
A. Kari ◽  
...  
Keyword(s):  
Aneurysm Surgery ◽  
Early Aneurysm Surgery ◽  
One Year

scholarly journals Benefits of early aneurysm surgery: Southern Iran experience

2012 ◽  
Vol 3 (1) ◽  
pp. 156 ◽  
Author(s):  
Ali Razmkon ◽  
Juri Kivelev ◽  
Rossana Romani ◽  
Ehsan-Ali Alibai ◽  
Juha Hernesniemi ◽  
...  
Keyword(s):  
Aneurysm Surgery ◽  
Early Aneurysm Surgery ◽  
Southern Iran

PROTECTION FROM REBLEEDING BEFORE EARLY ANEURYSM SURGERY

2000 ◽  
Vol 11 (01) ◽  
pp. 3-16 ◽  
Author(s):  
Thomas Leipzig ◽  
Terry Horner ◽  
Troy Payner ◽  
Kathleen Redelman
Keyword(s):  
Aneurysm Surgery ◽  
Early Aneurysm Surgery
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