Abstract
The appropriate time to perform surgery for posterior circulation aneurysms is debated. Controversy exists secondary to the lack of information regarding the overall management and outcome, as well as difficulties with their surgical treatment and infrequent occurrence. The present study examines the results of 46 patients with ruptured vertebro-basilar aneurysms treated with a delayed surgical protocol. Twenty-four were Hunt-Hess grade I/II on admission, 13 were grade III, and 9 grade IV/V. Nineteen patients (40%) (4 grade I/II, 6 grade III, and the 9 grade IV/V on admission) died before meeting the required conditions for surgery. Causes of death were vasospasm (8 cases), direct effect of the initial bleeding (7 cases), and rebleeding (4 cases). Surgical results were excellent/good in 87% of the patients. Surgical mortality was 8% (2 out of 24). In this study, despite encouraging surgical results, overall mortality was disappointingly high. We suggest that as more experience is gained in treating vertebrobasilar aneurysms, early surgery should be performed in selected cases. Early surgery is prophylactic for rebleeding and allows for more aggressive treatment of cerebral vasospasm.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 5-8 |
| Number of pages | 4 |
| Journal | Acta Neurochirurgica |
| Volume | 125 |
| Issue number | 1-4 |
| DOIs | |
| State | Published - Mar 1993 |
| Externally published | Yes |
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Keywords
- delayed surgery
- early surgery
- subarachnoid haemorrhage
- timing of surgery
- Vertebrobasilar aneurysms
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
Vertebro-basilar aneurysms : Does delayed surgery represent the best surgical strategy? / Lanzino, G.; Andreoli, A.; Limoni, P.; Tognetti, F.; Testa, C.
In: Acta Neurochirurgica, Vol. 125, No. 1-4, 03.1993, p. 5-8.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vertebro-basilar aneurysms
T2 - Does delayed surgery represent the best surgical strategy?
AU - Lanzino, G.
AU - Andreoli, A.
AU - Limoni, P.
AU - Tognetti, F.
AU - Testa, C.
PY - 1993/3
Y1 - 1993/3
N2 - The appropriate time to perform surgery for posterior circulation aneurysms is debated. Controversy exists secondary to the lack of information regarding the overall management and outcome, as well as difficulties with their surgical treatment and infrequent occurrence. The present study examines the results of 46 patients with ruptured vertebro-basilar aneurysms treated with a delayed surgical protocol. Twenty-four were Hunt-Hess grade I/II on admission, 13 were grade III, and 9 grade IV/V. Nineteen patients (40%) (4 grade I/II, 6 grade III, and the 9 grade IV/V on admission) died before meeting the required conditions for surgery. Causes of death were vasospasm (8 cases), direct effect of the initial bleeding (7 cases), and rebleeding (4 cases). Surgical results were excellent/good in 87% of the patients. Surgical mortality was 8% (2 out of 24). In this study, despite encouraging surgical results, overall mortality was disappointingly high. We suggest that as more experience is gained in treating vertebrobasilar aneurysms, early surgery should be performed in selected cases. Early surgery is prophylactic for rebleeding and allows for more aggressive treatment of cerebral vasospasm.
AB - The appropriate time to perform surgery for posterior circulation aneurysms is debated. Controversy exists secondary to the lack of information regarding the overall management and outcome, as well as difficulties with their surgical treatment and infrequent occurrence. The present study examines the results of 46 patients with ruptured vertebro-basilar aneurysms treated with a delayed surgical protocol. Twenty-four were Hunt-Hess grade I/II on admission, 13 were grade III, and 9 grade IV/V. Nineteen patients (40%) (4 grade I/II, 6 grade III, and the 9 grade IV/V on admission) died before meeting the required conditions for surgery. Causes of death were vasospasm (8 cases), direct effect of the initial bleeding (7 cases), and rebleeding (4 cases). Surgical results were excellent/good in 87% of the patients. Surgical mortality was 8% (2 out of 24). In this study, despite encouraging surgical results, overall mortality was disappointingly high. We suggest that as more experience is gained in treating vertebrobasilar aneurysms, early surgery should be performed in selected cases. Early surgery is prophylactic for rebleeding and allows for more aggressive treatment of cerebral vasospasm.
KW - delayed surgery
KW - early surgery
KW - subarachnoid haemorrhage
KW - timing of surgery
KW - Vertebrobasilar aneurysms
UR - http://www.scopus.com/inward/record.url?scp=0027762722&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027762722&partnerID=8YFLogxK
U2 - 10.1007/BF01401820
DO - 10.1007/BF01401820
M3 - Article
VL - 125
SP - 5
EP - 8
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
SN - 0001-6268
IS - 1-4
ER -