Clinical features and outcome in 1076 patients with ruptured intracranial saccular aneurysms: a prospective consecutive study.
In a well-defined area, The Kingdom of Denmark, 1076 patients with ruptured intracranial aneurysms were admitted to the six Danish neurosurgical departments in a prospective consecutive study in the 5-year period 1978-1983. Follow-up examinations were accomplished 3 months and 2 years after the admission. A total of 674 women and 402 men with a median age of 49 years were included in the study. The localisation of the ruptured aneurysms were: internal carotid artery 285, anterior communicating artery and horizontal part of anterior cerebral artery 383, middle cerebral artery 291, basilar and vertebral arteries 83 and peripheral or other localisation 34. A significantly better outcome was seen in cases with internal carotid aneurysms compared to other localisations. 670 patients underwent operation. A highly significantly better outcome was found in operated versus non-operated patients in comparable clinical conditions. The advantage of microneurosurgery was well documented. Patients with vasospasm had a significantly worse outcome. Within the first 2 weeks a daily rebleeding rate from 0.2% to 2.1% was observed, and patients who rebled had a significantly worse outcome compared to patients, who did not rebleed. The overall outcome at 2-year follow-up was: normal 27.5%, mild dementia 15.8%, severe dementia 9.9%, vegetative 1.3% and mortality 45.5%.
Rosenørn
J
J
University Clinic of Neurosurgery, Copenhagen County Hospital, Glostrup, Denmark.
Eskesen
V
V
Schmidt
K
K
Espersen
J O
JO
Haase
J
J
Harmsen
A
A
Hein
O
O
Knudsen
V
V
Midholm
S
S
Marcussen
E
E
D003718:Denmark; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D012422:Rupture, Spontaneous