Clinical Analysis of Aneurysmal Subarachnoid Hemorrhage

ABSTRACT

The authors analyzed 377 consecutive cases of aneurysmal subarachnoid hemorrhage admitted to the Department of Neurosurgery at Yonsei University Hospital from 1980 through 1984. The results of analysis were summarized as follows. 1) Mean age of the patients was 48.8 years. Aneurysmal SAH occured more frequently in female(201) than male(176). 2) Incidence of clinical vasospasm was 33.2%(125/377) and of rebleeding was 11.7%(44/377). 3) Surgery was done for 191 patients which accounts for 50.7% of all patients. Functional recovery was noted in 179 of these 191 surgically treated patients(93.7%). Operative mortality was 3.7%. 4) Conservative treatment was done for remaining 186 patients. Among them, 124 patients died or disabled 40 from initial insult, 59 from vasospasm, 25 from rebleeding. Aneurysm could not be found on angiography in 19 cases. Remaining 43 patients refused surgery. Despite of dramatic improvement of surgical treatment for ruptured intracranial aneurysms, overall mortality and morbidity for ruptured cerebral aneurysm still remain unchanged over the past two decades. As shown in this study, most of the management mortality and morbidity came from the patients who didn't or couldn't receive surgical treatment. The authors suggest several directions to improve overall management outcome in all aneurysmal patients.