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The author evaluates in a retrospective study a group of 148 patients with subarachnoidal haemorrhage, focused on the cause of death. A sufficient angiographic examination was made in 68 patients. The source of haemorrhage was detected in this group in 68.6%, in 66 patients an aneurysm was detected, only in two patients an arteriovenous malformation. Fifty-one patients were operated. The operation was delayed after stabilization of the patients, on average to the 36.8 day after the haemorrhage. Twenty per cent of the patients died. The most frequent cause of death were general systemic complications which accounted for 50% of the general mortality. In some instances there was a confirmed or probable participation of vasospasm. The other most frequent cause of death was a vasospasm with ischaemic cerebral changes and a 20% ratio in the death rate. A relapse of haemorrhage accounted also for 20% of the deaths. From the assessed data ensues the necessity to devote a greater effort to prevention and treatment of general complications and vasospasms in addition to hitherto relatively successful pharmacological of relapses of haemorrhage by antifibrinolytics. An important part of this prevention and treatment will be early diagnosis and early surgical treatment of vascular malformations.
The author evaluates in a retrospective study a group of 148 patients with subarachnoidal haemorrhage, focused on the cause of death. A sufficient angiographic examination was made in 68 patients. The source of haemorrhage was detected in this group in 68.6%, in 66 patients an aneurysm was detected, only in two patients an arteriovenous malformation. Fifty-one patients were operated. The operation was delayed after stabilization of the patients, on average to the 36.8 day after the haemorrhage. Twenty per cent of the patients died. The most frequent cause of death were general systemic complications which accounted for 50% of the general mortality. In some instances there was a confirmed or probable participation of vasospasm. The other most frequent cause of death was a vasospasm with ischaemic cerebral changes and a 20% ratio in the death rate. A relapse of haemorrhage accounted also for 20% of the deaths. From the assessed data ensues the necessity to devote a greater effort to prevention and treatment of general complications and vasospasms in addition to hitherto relatively successful pharmacological of relapses of haemorrhage by antifibrinolytics. An important part of this prevention and treatment will be early diagnosis and early surgical treatment of vascular malformations.