Early surgery of hemorrhaging aneurysms of brain blood vessels

Comprehension of the natural course of the aneurisms on the blood vessels of the brain has imposed the need for timely surgical treatment. The comfort of delayed surgery, due to the high risk of the rupture had to be overlooked. Early surgery, within the first three days from the rupture of the aneurysm, has a double role--it prevents rupture, but considerably decreases the risk of complications caused by subarachnoid hemorrhage, vasospasm and hydrocephalus. We present the results of the surgical treatment of 710 patients operated during the period from year 1994 until 1996. We point out that the treatment of patients was conducted in conditions that were not standard, due to sanctions. During operations at our disposal most of the time was only one clip and a limited quantity of drugs for the perioperative treatment. Our results show that compulsory candidates for early surgery are small patients in good clinical grading, without associated illnesses. Patients without clinical and angiographic signs of vasospasm may also be operated in the intermediary term. Patients with massive intracerebral hematoma caused by the rupture of the aneurysm who are in a coma should be urgently operated.