Strategies in management of ruptured aneurysms--own experiences with various therapeutical procedures in severe SAH
Gräwe, A.; Meier, U.; Molsen, H.P.
Neurologia i Neurochirurgia Polska 34(6 Suppl): 15-20
2000
ISSN/ISBN: 0028-3843 PMID: 11452850 Document Number: 520611
A retrospective analysis of 58 patients with spontaneous SAH was conducted. 33 patients suffered on severe SAH, clinical grading IV and V (Hunt, Hess). 11 died without treatment due to decerebrate rigidity. 22 patients were treated, 16 underwent a clipping procedure and 6 were selected for endovascular coilembolization. A total of 14 SAH were associated with intracerebral, intraventricular or subdural hemorrhages. In fact of these in 10 patients first an evacuation of the haematoma or a ventricular drainage was necessary, two times combined with a decompressive craniectomy. In 4 patients the removal of haematoma was combined with clipping of aneurysm in one operation. After occlusion of aneurysm decompressive craniectomy was required in 3 patients, an evacuation of an intracerebral bleeding in 1 patient. 6 patients needed a permanent shunting system. The outcome according the Glasgow Outcome Score was: 4 died (GOS1), 12 were severely disabled (GOS3) and 6 were moderately disabled (GOS4).