Document Detail

Patients with supratentorial aneurysmal subarachnoid hemorrhage during the intermediate period: waiting or actively treating.
MedLine Citation:
PMID:  19922395     Owner:  NLM     Status:  MEDLINE    
Perhaps the most difficult practical decision for neurosurgeons these days is whether to secure aneurysms during the intermediate period (4-10 days) after aneurysmal subarachnoid hemorrhage (SAH). We retrospectively reviewed a series of 115 patients with a Hunt-Hess grade I-III upon admission who were admitted 4-10 days after initial supratentorial aneurysmal SAH. Patients who underwent active treatment in the intermediate period were assigned to the intermediate group (n = 49) while those who accepted delayed obliteration of a ruptured aneurysm (11-30 days) were assigned to the late group (n = 66). The demographic characteristics, size and site of aneurysms, and clinical conditions were well balanced in the two groups. There was no difference in outcome between the two groups according to the Glasgow Outcome Scale (GOS) at discharge or a six-month follow-up. Rebleeding before aneurysms obliteration was the leading factor resulting in poor outcome. In conclusion, for patients with supratentorial aneurysmal SAH who were in good clinical condition upon admission, active treatment during the intermediate period offered a good chance of a favorable outcome. An even larger number of patients from randomized clinical trials might be necessary to draw more reliable conclusions.
Ying Tong; Jun Gu; Wei-Jian Fan; Jian-Bo Yu; Jian-Wei Pan; Shu Wan; Yong-Qing Zhou; Xiu-Jue Zheng; Ren-Ya Zhan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of neuroscience     Volume:  119     ISSN:  1563-5279     ISO Abbreviation:  Int. J. Neurosci.     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0270707     Medline TA:  Int J Neurosci     Country:  England    
Other Details:
Languages:  eng     Pagination:  1956-67     Citation Subset:  IM    
Department of Neurosurgery, The First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, P.R. China.
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MeSH Terms
Aneurysm, Ruptured / etiology*,  physiopathology
Angiography, Digital Subtraction
Cerebral Revascularization / methods*
Follow-Up Studies
Glasgow Outcome Scale
Middle Aged
Postoperative Complications / physiopathology*
Retrospective Studies
Severity of Illness Index
Subarachnoid Hemorrhage / pathology,  radiography,  surgery*
Time Factors
Treatment Outcome

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