Clinical Analysis and Surgical Results of Early, Intermediate, Delayed Operation in 100 Consecutive Aneurysmal Patients

ABSTRACT

We retrospectively reviewed 100 consecutive patients who were ruptured intracranial aneurysm and were operated on in the department of neurosurgery of Wallace Memorial Baptist Hospital from August 1984 to August 1988. The patients who were operated upon within the first 3 days of their most recent subarachnoid hemorrhage formed the early group, the patients operated upon with 4-7 days formed the intermediate group, after 8 days were considered as the delayed group. Early operation was performed in 30 patients, intermediate operation in 20 patients, and delayed operation in 50 patients. On the base of their clinical outcome, the patients were allocated to one of 4 outcome categories(good, fair, poor, death) at the time of their hospital discharge. The 80% favorable outcome estimated from early operation and 85% from intermediate operation and 90% from delayed operation. The mortality was estimated 13% from early operation and 0% from intermediate operation and 8% from the delayed operation. Each 4 cases of early, intermediate and delayed operation was needed shunt operation for hydrocephalus. In operative result, after 1987 was better than before 1987. In hypertensive patients, there was a tendency to observe poor prognosis than normotensive patients, especially with vasospasm.