Clinical Features and Outcome in 1076 Patients with Ruptured Intracranial Saccular Aneurysms: A prospective consecutive study
作者:
RosenørnJarl,
EskesenVagn,
SchmidtKaare,
EspersenJens Ole,
HaaseJens,
HarmsenAage,
HeinOle,
KnudsenVerner,
MidholmSteen,
MarcussenErik,
RasmussenPeter,
RøndeFrits,
VoldbyBo,
HansenLise,
期刊:
British Journal of Neurosurgery
(Taylor Available online 1987)
卷期:
Volume 1,
issue 1
页码: 33-45
ISSN:0268-8697
年代: 1987
DOI:10.3109/02688698709034339
出版商: Taylor&Francis
关键词: Cerebral aneurysms;microsurgery;rebleeding;subarachnoid haemorrhage;vasospasm
数据来源: Taylor
摘要:
In a well-defined area, The Kingdom of Denmark, 1076 patients with ruptured intracranial aneurysms were admitted to the six Danish neurosurgical departments in a prospective consecutive study in the 5-year period 1978–1983. Follow-up examinations were accomplished 3 months and 2 years after the admission. A total of 674 women and 402 men with a median age of 49 years were included in the study. The localisation of the ruptured aneurysms were: internal carotid artery 285, anterior communicating artery and horizontal part of anterior cerebral artery 383, middle cerebral artery 291, basilar and vertebral arteries 83 and peripheral or other localisation 34. A significantly better outcome was seen in cases with internal carotid aneurysms compared to other localisations. 670 patients underwent operation. A highly significantly better outcome was found in operated versus non-operated patients in comparable clinical conditions. The advantage of microneurosurgery was well documented. Patients with vasospasm had a significantly worse outcome. Within the first 2 weeks a daily rebleeding rate from 0.2% to 2.1% was observed, and patients who rebled had a significantly worse outcome compared to patients, who did not rebleed. The overall outcome at 2-year follow-up was: normal 27.5%, mild dementia 15.8%, severe dementia 9.9%, vegetative 1.3% and mortality 45.5%.
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