Factors affecting outcome after surgery for intracranial aneurysm in Glasgow

Bill Taylor, Paul Harries, Ross Bullock

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Two-hundred and ninety-five patients with angiographically demonstrated intracranial aneurysms presented to the Institute of Neurological Sciences, Glasgow over a 3-year period (1986-88). We have reviewed this group to assess the effect of changing patterns of management upon outcome. The overall mortality rate was 9.4% and the surgical mortality rate was 4% in this selected series. Factors significantly associated with a poor outcome were: WFNS grades III-V on admission, presence of a haematoma on the first CT scan, delayed ischaemic deficit, and development of a post-operative haematoma. Seventy-six per cent of the patients who developed a delayed ischaemic deficit (nearly a third of those with recent subarachnoid haemorrhage) made a good recovery, in contrast to previous studies, and over two-thirds of those accepted in grades IV and V (28 patients) made a good recovery after surgery. Active management of patients in grades IV and V, and those with delayed ischaemia, together with prophylactic Nimodipine therapy and selective early surgery, offers the best prospect for further improvement in outcome after aneurysmal subarachnoid haemorrhage.

Original languageEnglish (US)
Pages (from-to)591-600
Number of pages10
JournalBritish Journal of Neurosurgery
Volume5
Issue number6
DOIs
StatePublished - Jan 1 1991

Keywords

  • Aneurysm surgery
  • Outcome
  • Subarachnoid haemorrhage
  • Vasospasm

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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