[Preventive effect of intracisternal methylprednisolone on symptomatic vasospasm after aneurysmal subarachnoid...

A series of 103 patients with ruptured cerebral aneurysms were treated by intracranial irrigation, after aneurysmal clipping, with pH 8.0 Hartmann solution containing 1 mg/ml of methylprednisolone sodium succinate, during operation. Postoperatively, 5 ml/day of the solution was also injected until day 14, percutaneously through an Ommaya reservoir into the cisterns around the clipped aneurysm. Six (5.7%) of the 103 patients suffered symptomatic vasospasm postoperatively. The Glasgow Outcome Scale at discharge of all patients indicated good recovery, Moderately disabled, Severely disabled and Vegetative state in 74 (72%), 18 (17%), 9 (9%) and 2 (2%) patients respectively. As a complication, subdural effusion was noticed in 17 (17%) patients, without any influence on outcome at all.