Related Experiment Videos
Early aneurysm surgery: a 7 year clinical practice report.
J M Gilsbach1, A G Harders, H R Eggert
1Department of Neurosurgery, University of Freiburg Medical School, Federal Republic of Germany.
Acta Neurochirurgica
|January 1, 1988
Summary
This study retrospectively analyzed 150 patients with intracranial aneurysms, finding that early surgical intervention and nimodipine improved outcomes. Improved results were seen with nimodipine, induced hypertension, and transcranial Doppler for vasospasm control.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Surgery
Background:
- Intracranial aneurysms pose significant risks, with early surgical intervention being a critical management strategy.
- Patient outcomes are influenced by aneurysm severity, hemorrhage classification, and the presence of intracerebral hematoma.
Purpose of the Study:
- To retrospectively evaluate the outcomes of 150 patients undergoing consecutive early-stage intracranial aneurysm surgery.
- To identify factors influencing patient recovery and complications, including surgical techniques and pharmacological interventions.
Main Methods:
- Retrospective analysis of 150 patients with 159 intracranial aneurysms operated on consecutively.
- Evaluation of patient grades (Hunt and Hess), hemorrhage severity (Fisher et al.), and complications such as vasospasm and hydrocephalus.
- Assessment of the impact of intraoperative cerebrospinal fluid (CSF) drainage, temporary clipping, nimodipine, induced hypertension, and transcranial Doppler (TCD) sonography.
Main Results:
- Seventy-nine percent of patients were in good preoperative condition (grades I-III).
- Immediate postoperative deterioration occurred in 13% of patients; delayed neurological deficits occurred in 11%.
- Nimodipine, induced hypertension, and TCD sonography were associated with improved results, particularly in managing vasospasm.
Conclusions:
- Early surgical management of intracranial aneurysms can yield favorable outcomes, especially in patients with good preoperative condition.
- Intraoperative CSF drainage is crucial, while postoperative drainage showed limited benefit for vasospasm and hydrocephalus.
- The introduction of nimodipine, induced hypertension, and TCD monitoring significantly improved patient outcomes and vasospasm management.