Results of surgery for aneurysmal subarachnoid haemorrhage in northern Norway: a retrospective study with special focus on timing of surgery in a rural area.
OBJECTIVE
This study reports data on time consumption before aneurysm surgery and the results of treatment in northern Norway.


METHODS
A total of 279 cases were identified and included in our analysis of time span from bleeding to arrival at our department. Fifty-one patients were treated conservatively, either because of bad clinical condition or because angiography revealed no aneurysm. The remaining 228 patients were operated and included in our analysis of outcome after early aneurysm surgery.


RESULTS
Among all 279 patients with aneurysmal subarachnoid haemorrhage (SAH), median time from ictus to arrival at the university hospital was 1 (0-30) day. Forty-one per cent arrived at the day of bleeding and 86% within the first 3 days after bleeding. Among the 228 patients who underwent surgical aneurysm repair, median time from bleeding to operation was 2 (0-33) days. Early aneurysm surgery (< 72 h) was performed in 146 patients (64%). Fifty patients (22%) underwent intermediate surgery (days 4-10) and 32 patients (14%) were operated later (day 11 or later). A significant association was found between Hunt and Hess (HH) grade and Glasgow Outcome Scale (GOS) score (P < 0.001).


CONCLUSIONS
Most patients suffering aneurysmal SAH in northern Norway undergo early aneurysm surgery and the outcome is comparable with that obtained in other Scandinavian centres. Initial Hunt and Hess grade is a major determinant for outcome in aneurysmal subarachnoid haemorrhage.
Egge
A
A
Department of Neurosurgery, University Hospital of Tromsø, Tromsø, Norway. arild.egge@rikshospitalet.no
Romner
B
B
Waterloo
K
K
Isaksen
J
J
Kloster
R
R
Ingebrigtsen
T
T
Trumpy
J H
JH
D000328:Adult; D000368:Aged; D017732:Air Ambulances / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D023261:Glasgow Outcome Scale / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D009664:Norway / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013997:Time Factors