Long term outcome after treatment of the ruptured intracranial aneurysm: 73 cases admitted from day 0 to day 3 after subarachnoid haemorrhage.

73 patients admitted from day 0 to day 3 (D0 to D3) after a subarachnoid haemorrhage and being in Hunt and Hess grades I to IV after aneurysm rupture, were studied. All admitted patients were operated upon. The timing of surgery was neither systematic early nor systematic late surgery, but modulated surgery. Patients in good grades (I and II) and under 50 years of age were operated on early. Patients in poor grade and over 50 years of age were operated late. Other patients were operated on preferably early if they were young, even in poor grade, or late if they were old even in good grade. The overall immediate outcome was: good and fair--85%, poor--4%, and death--11%. For those patients operated on early after SAH (D0-3) the good and fair outcome rate went up to 90%. The long term outcome was evaluated after 1 year (from 1 to 6 years, average 1 year 8 months). 97% of patients were available for follow-up. The long-term neurological outcome was identical to the immediate outcome. The resumption of activity was the criteria chosen to evaluate the long term outcome. The long term ability to work in 63 followed-up surviving patients was: normal activity--57%, reduced level of activity--16%, no resumption of activity--27%. This rate of activity resumption was not improved in patients operated on early. Among patients with a good long term neurological outcome, only 67% resumed their previous activity at the same level.(ABSTRACT TRUNCATED AT 250 WORDS)