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"Ultraearly" aneurysm surgery

G Profeta1, R De Falco, L Profeta

  • 1Department of Emergency, Cardarelli Hospital, Naples, Italy.

Journal of Neurosurgical Sciences
|November 4, 1998
PubMed
Summary
This summary is machine-generated.

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Early surgical intervention for intracranial aneurysms within 72 hours of subarachnoid hemorrhage shows promising outcomes, particularly for patients operated on between 24-72 hours. Even "ultraearly" surgery within 24 hours yielded good results for select patients.

Area of Science:

  • Neurosurgery
  • Neurology
  • Vascular Surgery

Background:

  • Intracranial aneurysms pose significant risks, with timing of surgical intervention after subarachnoid hemorrhage being a critical factor.
  • Effective management strategies are crucial for improving patient outcomes and reducing morbidity.

Purpose of the Study:

  • To evaluate the impact of surgical timing on patient outcomes after intracranial aneurysm treatment.
  • To compare the results of early (<72 hours) versus delayed (>72 hours) surgical intervention.

Main Methods:

  • Retrospective analysis of 327 patients with intracranial aneurysms treated at Cardarelli Hospital.
  • Patients were categorized into early (<72 hours) and delayed (>72 hours) surgery groups.
  • Outcomes assessed using the Glasgow Outcome Scale (GOS) at discharge and 6 months, excluding poor clinical grades (IV-V Hunt and Hess).

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Main Results:

  • Patients operated on within 72 hours (Group II) showed favorable outcomes compared to those operated on after 72 hours (Group I).
  • The subgroup operated on between 24-72 hours (Group IIb) demonstrated the best results.
  • Even patients undergoing "ultraearly" surgery within 24 hours (Group IIa), including those in Hunt and Hess grade III, achieved good surgical results.

Conclusions:

  • Surgical intervention for intracranial aneurysms within 72 hours of subarachnoid hemorrhage is associated with positive outcomes.
  • Optimal timing appears to be between 24-72 hours, but early intervention, even within 24 hours, can be beneficial for carefully selected patients.
  • Further research into the nuances of surgical timing and patient selection is warranted.