Background: The timing of surgery in patients suffering from subarachnoid hemorrhage grade IV and V according to Hunt and Hess, is still controversial. Several authors advocate early surgery for patients in poor clinical condition. Improved outcome and decreased mortality rates were reported. Others exclude patients in poor condition from early aneurysm surgery.
Methods: Forty grade IV aneurysm patients were admitted to our department. After ventriculostomy and cerebral angiography, 28 of them were operated on within 72 hours. The postoperative treatment included hypertensive, hypervolemic, hemodilutional therapy (triple-H therapy) and intensive monitoring (intracerebral pressure, blood pressure, hemodynamic parameters). The mean follow-up time was 6 months.
Results: Out of the 28 patients who underwent early surgery, 64% were in good health, 11% in poor health, 25% died; there were no survivors in a vegetative state. Twelve patients were treated conservatively; 50% died from infarction and rebleeding, before the operation was performed. Six underwent delayed aneurysm surgery after clinical improvement. In this group, 25% had good clinical outcome.
Conclusions: Our results favor an aggressive treatment of grade IV aneurysm patients by means of ventricular drainage, early surgery and triple-H therapy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0090-3019(96)00251-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treatment of saccular wide-neck intracranial aneurysm using Leo baby stent: a single-center experience based on 156 cases.
Neurosurg Rev
December 2024
Changhai Hospital, Navy Medical University, Shanghai, People's Republic of China.
To describe the mid-term safety and efficacy of Leo baby stent applied in saccular wide-neck intracranial aneurysms (IAs). 151 patients harboring 156 IAs treated with Leo baby stent from March 2021 to October 2023 were enrolled for further analysis. Among 156 IAs, 142 cases (91.
View Article and Find Full Text PDFOutcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation.
Pak J Med Sci
December 2024
Prof. Dr. Hafiz Abdul Majid, MBBS, FCPS(Neurosurgery), Department of Neurosurgery Unit-III, Punjab Institute of Neurosciences, Lahore, Pakistan.
Objectives: To evaluate the Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation.
Methods: A retrospective case series study was conducted at the Punjab Institute of Neurosciences, Lahore from August 2022 to July 2023. Seventy seven patients meeting the inclusion criteria of age group 20-65 years, ruptured saccular aneurysm of anterior circulation with or without lamina terminalis fenestration during clipping, were enrolled through non-probability convenience sampling.
Surgical outcome of clipping in anterior circulation aneurysms.
Pak J Med Sci
December 2024
Prof. Dr. Abdul Majid, MBBS, FCPS, MCPS, Head Department of Neurosurgery, Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.
Objective: To observe the outcome of surgical clipping in anterior circulation aneurysm in a modestly resourced hospital.
Methods: A retrospective cross-sectional study was conducted at Punjab Institute of Neurosciences Lahore, from August 2022 to July 2023. Seventy five patients meeting the inclusion criteria of age <65, saccular aneurysm of anterior circulation, and Hunt and Hess grade one or two were enrolled through non-probability convenience sampling.
Comparison of silent MRA and time-of-flight MRA in the depiction and grading of brain arteriovenous malformations.
Quant Imaging Med Surg
December 2024
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background: Preliminary small-sample studies suggest that silent magnetic resonance angiography (MRA) has an advantage over time-of-flight MRA (TOF MRA) in the characterization of brain arteriovenous malformation (BAVM), but did not examine whether the imaging performance of silent MRA was affected by the intrinsic features of BAVM or common clinical factors. This study sought to compare silent MRA and TOF MRA in terms of the visualization and grading of BAVMs in various clinical settings.
Methods: In total, 85 participants (50 males, 35 females; mean age: 33.
Hemodynamic relationship with angioarchitecture of cerebral arteriovenous malformation and changes after embolization: a pilot study by 4D flow MR.
Quant Imaging Med Surg
December 2024
Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Background: The hemodynamics of cerebral arteriovenous malformation (cAVM) is difficult to evaluate with conventional imaging or clinical grading. The aim of this study is to: (I) investigate the association between the angioarchitecture and hemodynamic parameters in cAVM based on 4-dimentional flow magnetic resonance (4D flow MR); (II) quantify flow changes during follow-up after embolization and explore the potential of flow-guided staged embolization.
Methods: Twenty-one patients with digital subtraction angiography (DSA)-diagnosed cAVM were prospectively enrolled in a tertiary hospital consecutively from April 2022 to January 2024 for a cohort study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!