Patients with ruptured intracranial saccular aneurysms: clinical features and outcome according to the size.
In the prospective consecutive Danish Aneurysm Study 192 patients (19%) had a ruptured intracranial aneurysm (RA) with a maximum diameter < 5 mm (small). In 524 (51%) and 306 patients (30%) the size was 5-10 mm (medium) and 11-24 mm (large), respectively. More patients with large RA (35%) were unconscious more than 1 h after the bleeding and had more CT-visualized haematomas (49%) compared with the patients with small RA (28 and 34%) and medium RA (27 and 37%). After 2 years, more patients with small RA and medium RA had resumed their previous occupation (49 and 49%), regained a normal daily functional capacity (55%, 55%) and normal mental outcome (29 and 32%) compared with the patients with large RA (34, 44 and 23%). The mortality was 47, 39 and 51% for patients with small, medium and large RA, respectively. With also a very serious prognosis after rupture of aneurysms of 10 mm or less and even less than 5 mm we also recommend surgical treatment of unruptured aneurysms of these sizes.
University Clinics of Neurosurgery, Copenhagen County Hospital, Glostrup, Denmark.
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Eskesen
D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D003128:Coma / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology* / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed