The Early to Emergency Surgery on the Deteriorating Aneurysms

Hamm, In Suk; Park, Yeun Mook; Kim, Seung Lae

Abstract

The decision of proper time for operation on ruptured aneurysm is a very important tactic of treatment, because of the following major complications after subarachnoid hemorrhage. Recently it is widely accepted opinion that the ruptured aneurysm should receive an early operation for lower mortality and morbidity by preventing possible complications after subarachnoid hemorrhage such as rebleeding, symptomatic vasospasm and even hydrocephalus. Since 1985, we applied early to emergency surgery to the clinically deteriorating or non improving patients after aneurysm rupture and delayed surgery to the ameliorating patients who were placed under close observation. The early to emergency surgery on poor risk patient was performed within 48 hours after recent subarachnoid hemorrhage and delayed surgery was done after 2 weeks. Of the selective 95 poor-condition patients admitted to Kyungpook National University Hospital over the past 4 years from 1984, 60 got early surgeries and 35 delayed surgeries. Among the 60 patients in the early group, 22 patients with considerable intracranial hemorrhage were exempted from this comparative study. A few cases of vertebrobasilar aneurysms were not included in this paper for a little value in significance. In this prospective study, we evaluated the results of early and delayed surgeries of poor risk patients through clinical analyses and comparison, and we could gain better results from early surgeries.