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October 1988

Intracranial Operation Within Seven Days of Aneurysmal Subarachnoid Hemorrhage: Results in 150 Patients

Author Affiliations

From the Department of Neurology, Division of Cerebrovascular Diseases (Dr Adams), and the Department of Surgery, Division of Neurosurgery (Drs Kassell and Torner and Ms Kongable), University of Iowa, Iowa City. Drs Kassell and Torner and Ms Kongable are now with the Department of Neurological Surgery, University of Virginia, Charlottesville.

Arch Neurol. 1988;45(10):1065-1069. doi:10.1001/archneur.1988.00520340019004

• 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.

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