Rebleeding of ruptured intracranial aneurysms in the acute stage.
We analyzed early aneurysmal rebleeding in 150 consecutive patients who suffered an aneurysmal subarachnoid hemorrhage (SAH) and who were admitted within 6 hours of the initial SAH. Of these patients, 33 patients rebled. The first rebleed occurred within 24 hours in 29 patients, among whom 23 cases rebled within 6 hours. The rebleeding rate within 6 hours after the initial SAH was not related to age or sex of the patient; blood pressure on admission; size, shape, or site of aneurysm; or presence or absence of intracerebral hematoma or intraventricular hemorrhage on computed tomography (CT) scan. The patients' clinical condition and SAH on CT scan were graded I-V. Evaluation of rebleeding of those patients with grade V was difficult. In examining the rebleeding rate in grades I-IV, the higher the grade, the greater the rebleeding. Rebleeding developed during angiography conducted within 6 hours from the initial SAH in four cases. This is approximately twofold higher than the rebleeding rate within 6 hours for the total series. It is concluded that rebleeding in the acute stage is predominant within 6 hours from the initial SAH and that this rebleeding rate is higher the more severe the initial SAH is.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002533:Cerebral Angiography / Q000009:adverse effects; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012306:Risk; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed