Intracranial operation within seven days of aneurysmal subarachnoid hemorrhage. Results in 150 patients
H. P. Adams Jr, N. F. Kassell, G. A. Kongable and J. C. Torner
Department of Neurology, University of Iowa, Iowa City 52242.
We evaluated the results of intracranial operation in 150 consecutive
patients surgically treated within seven calendar days of aneurysmal
subarachnoid hemorrhage (SAH). Patients in all clinical grades, except
those who were moribund, were treated. Those with either anterior or
posterior circulation aneurysms were included. On follow-up assessment,
favorable outcomes were noted in 107 patients (71%), 17 had major
disabilities (11%), and 26 had died (17%). During hospitalization,
vasospasm was diagnosed in 63 patients (42%) and rebleeding occurred in 39
(25%). Operations were performed throughout the first week after SAH;
results of operation were similar on each day. A lower rate of good
recovery was observed among patients operatively treated four to seven days
after SAH than among those operated on earlier. The admitting neurologic
condition influenced outcome after early operation, but age did not have a
major impact. We find that aneurysm surgery can be performed within one
week of SAH with acceptable results, although there is room for
improvement.
