Factors affecting outcome after surgery for intracranial aneurysm in Glasgow
1991; Taylor & Francis; Volume: 5; Issue: 6 Linguagem: Inglês
10.3109/02688699109002882
ISSN1360-046X
AutoresBill Taylor, Paul Harries, Ross Bullock,
Tópico(s)Cerebrovascular and Carotid Artery Diseases
ResumoAbstractTwo-hundred and ninety-five patients with angiographically demonstrated intracranial aneurysms presented to the Institute of Neurological Sciences, Glasgow over a 3-year period (1986–88). We have reviewed this group to assess the effect of changing patterns of management upon outcome. The overall mortality rate was 9.4%, and the surgical mortality rate was 4% in this selected series. Factors significantly associated with a poor outcome were: WFNS grades III-V on admission, presence of a haematoma on the first CT scan, delayed ischaemic deficit, and development of a post-operative haematoma. Seventy-six per cent of the patients who developed a delayed ischaemic deficit (nearly a third of those with recent subarachnoid haemorrhage) made a good recovery, in contrast to previous studies, and over two-thirds of those accepted in grades IV and V (28 patients) made a good recovery after surgery. Active management of patients in grades IV and V, and those with delayed ischaemia, together with prophylactic Nimodipine therapy and selective early surgery, offers the best prospect for further improvement in outcome after aneurysmal subarachnoid haemorrhage.Key Words: Subarachnoid haemorrhageaneurysm surgeryvasospasmoutcome
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