title: Aneurysmal subarachnoid haemorrhage: overall outcome and incidence of early recurrent haemorrhage despite a policy of acute stage operation.
abstract: A series of 480 patients who were alive upon admission following an aneurysmal subarachnoid haemorrhage (SAH) is reported. These patients represented 40% of the total Swedish incidence during a 3-year period. The three neurosurgical referral centres covering this population had a similar policy of early diagnosis and acute state surgery in all patients considered of having a potential to survive without permanent disabling cerebral malfunction. At 2-year follow up 45% showed a good neurological recovery, the morbidity was 25% and the mortality was 30%. Some more lives might have been saved with an improved ultra-early referral system since there were 21 initially good-to-fair risk patients (4% of the total SAH population) who rebled fatally before surgery and within 48 h. For comparison, in the Kingdom of Denmark, with a general policy of delayed operation, out of 1076 patients who were alive upon admission, 27.5% made a good recovery, while the morbidity was 27%, and the mortality was 45.5%.
authors.affiliation: Department of Neurosurgery, University Hospitals of Lund, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Ljunggren
authors.forename: H
authors.initials: H
authors.lastname: Fodstad
authors.forename: C
authors.initials: C
authors.lastname: von Essen
authors.forename: H
authors.initials: H
authors.lastname: Säveland
authors.forename: L
authors.initials: L
authors.lastname: Brandt
authors.forename: J
authors.initials: J
authors.lastname: Hillman
authors.forename: B
authors.initials: B
authors.lastname: Romner
authors.forename: G
authors.initials: G
authors.lastname: Algers
mesh_terms: D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000401:mortality* / Q000601:surgery