Management of cerebral aneurysms: further facts and additional myths

In 1985 we reviewed 17 misconceptions or myths surrounding the treatment of aneurysmal subarachnoid hemorrhage that may contribute to the dismal outcome from these lesions. Since that time, significant new data, or facts, have become available regarding the influence of early aneurysm surgery on rebleeding, the efficacy of treatments for symptomatic arterial narrowing, improvements in surgical techniques such as temporary arterial clipping, and measures to protect the brain from ischemic injury. However, additional myths have become apparent which continue to limit our ability to improve the outcome of these patients. We review these facts and myths and discuss management of the patient with aneurysmal subarachnoid hemorrhage.