Related Experiment Video
Updated: Aug 9, 2026
11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Delayed surgery for ruptured intracranial aneurysms: a reappraisal
R S Maurice-Williams1, J P Wadley
1Department of Neurosurgery, Royal Free Hospital, London, UK.
British Journal of Neurosurgery
|April 1, 1997
Summary
Delayed surgery for ruptured brain aneurysms did not significantly impact patient outcomes. While some patients might have benefited from earlier intervention, overall results suggest timing is less critical than previously thought.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Surgery
Background:
- Delayed aneurysm surgery was once standard but is now uncommon.
- This study analyzes outcomes of a delayed surgery policy over 14 years.
Purpose of the Study:
- To analyze the outcome of delayed surgery for ruptured aneurysms.
- To evaluate the effect of surgical timing on patient management outcomes.
Main Methods:
- Analysis of 400 consecutive patients with ruptured aneurysms.
- Delayed surgery policy: generally 8-10 days or longer for unstable patients.
- Outcome assessment at 1 year using Glasgow Outcome Scale (GOS).
Main Results:
- 72% of patients underwent surgery, mostly after day 8.
- Overall, 68% achieved GOS Grade 1 (good recovery), 26% died.
- Operated patients had 88% GOS Grade 1 and 3.5% 30-day mortality.
Conclusions:
- Delayed surgery's effect on outcome is doubtful, aligning with Cooperative Study findings.
- Only a small number of deaths from rebleeding occurred in patients fit for earlier surgery.
- Non-hemorrhagic deterioration (NHD) was a significant factor, peaking within 10 days.
More Related Videos
Related Concept Videos
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...