Comparison of late and early stage surgery for ruptured intracranial aneurysms

Surgical indications and timing in serious cases (Hunt and Hess grades 4 and 5) of intracranial aneurysms were investigated. The outcomes in early surgery were compared to the clinical courses of cases intended for late surgery. The survival rate of early surgery patients was 64.4%, better than the total of improved (28.3%) and survived (6.5%) patients for late surgery. There were 28.8% good outcomes in the early surgery group, compared to 2.2% in those treated late. Both of these figures are statistically significant. We consider that early surgery is indicated for serious cases, but not for grade 5 patients with hematoma.