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Article
November 10, 1978

Medical News

JAMA. 1978;240(20):2135-2144. doi:10.1001/jama.1978.03290200013001

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Abstract

Emerging trend: new therapy for ruptured intracranial aneurysms  After several decades of assessing various medical and surgical treatments for subarachnoid hemorrhage due to ruptured intracranial aneurysm (RIA), neurologists and neurosurgeons may be approaching a consensus.It now appears that the best results in most cases can be achieved by early medical management with hypotensive and antifibrinolytic drugs followed by microsurgical clipping of the aneurysm whenever possible.This two-step approach to RIA is based on the natural history of the condition. Studies have shown that of the approximately 15,000 people who survive an RIA each year, 40% to 50% will die of a fatal rebleeding episode in the ensuing two weeks to three months if treated only with bed rest and sedation.The most recent evaluation of long-term prospects for conservatively managed patients was carried out by John A. Jane, MD, PhD, of Atkinson Morley's Hospital, Wimbledon, England, and colleagues

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