Vertebro-basilar aneurysms: Does delayed surgery represent the best surgical strategy?

G. Lanzino, A. Andreoli, P. Limoni, F. Tognetti, C. Testa

Research output: Contribution to journalArticle

10 Scopus citations

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 languageEnglish (US)
Pages (from-to)5-8
Number of pages4
JournalActa Neurochirurgica
Volume125
Issue number1-4
DOIs
StatePublished - Mar 1 1993

Keywords

  • Vertebrobasilar aneurysms
  • delayed surgery
  • early surgery
  • subarachnoid haemorrhage
  • timing of surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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