Early management of aneurysmal subarachnoid hemorrhage

Neurosurgery. 1982 Sep;11(3):412-8. doi: 10.1227/00006123-198209000-00013.


The Lund Clinic serves a population of 1.46 million inhabitants. During the calendar year 1981, 72 patients presented with a ruptured supratentorial aneurysm, diagnosed either at angiography or at autopsy. Upon admission, 60% of the patients were in good condition and 40% were in poor condition. Eighty-three per cent were admitted within 72 hours after the subarachnoid hemorrhage (SAH). In the total series, 50% made a good recovery; the overall management morbidity was 19% and the management mortality was 31%. Thirty-one patients in Grades I-III underwent early operation (43% of the total series), with a favorable outcome in 74% and 7% mortality. Of the 35 patients who were admitted early and in good condition, 71% made a good recovery, and the management mortality was 9%. These figures may be compared to the 51% favorable outcome and 27% mortality reported from the Cooperative Aneurysm Study with late operation. In the early operation cases, the incidence of significant arterial narrowing at postoperative angiography performed on Day 9 +/- 2 after SAH was 30% and the incidence of permanent neurological deficits of delayed onset was 10%. Two of the early operation patients developed permanent symptomatic hydrocephalus.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carotid Artery Diseases / complications
  • Carotid Artery, Internal
  • Cerebral Arterial Diseases / complications
  • Circle of Willis
  • Female
  • Humans
  • Intracranial Aneurysm / complications
  • Ischemic Attack, Transient / complications
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Subarachnoid Hemorrhage / complications
  • Subarachnoid Hemorrhage / surgery*
  • Time Factors