Intracranial aneurysms. A review

Intracranial aneurysms are common, and their rupture carries a grave prognosis. There is no effective way of preventing the development of intracranial aneurysms, but noninvasive means of detection are becoming increasingly practical and, at present, should be used routinely--at least in populations at high risk. SAH is frequently preceded by warning signs that, when recognized by the primary care or the emergency room physician, can lead to prompt and safe surgical intervention. About half the patients who suffer a major rupture either die or remain in poor condition as a result of the hemorrhage. In the rest, surgical intervention has become safer and very effective in preventing subsequent hemorrhage, which occurs in about 50% of patients if the aneurysm is left untreated. Since early surgery should be at least considered in the majority of these patients and since the early treatment of a patient after SAH is so specialized, it appears prudent to manage patients with SAH in units where the necessary neurological and neurosurgical specialized intensive care is available.