Treatment of intracerebral hematomas caused by aneurysm rupture: coil placement followed by clot evacuation.
OBJECTIVE
The aim of this study was to evaluate the efficacy of a treatment combination of coil embolization and clot evacuation in patients presenting with an intracerebral hematoma (ICH) caused by the rupture of an aneurysm.


METHODS
Twenty-seven patients were prospectively recruited in this study between 1996 and 2000. Endovascular treatment of the putative ruptured aneurysm was performed as soon as practical after diagnosis and before surgical evacuation of the ICH. The Glasgow Outcome Scale (GOS) was used during follow up. Despite admission World Federation of Neurosurgical Societies grades of IV or V in 25 patients (92%), 13 (48%) recovered well with GOS scores of 1 or 2, whereas six patients (21%) died.


CONCLUSIONS
The combined result of a favorable outcome in 48% of the patients and a mortality rate of 21% indicates that this treatment may be a valuable alternative for this patient group and warrants further study.
Niemann
David B
DB
Department of Neurosurgery, Radcliffe Infirmary, Oxford, United Kingdom.
Wills
Andrew D
AD
Maartens
Nicholas F
NF
Kerr
Richard S C
RS
Byrne
James V
JV
Molyneux
Andrew J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D004322:Drainage / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D023261:Glasgow Outcome Scale; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed