Outcome after emergency surgery without angiography in patients with intracerebral haemorrhage after aneurysm rupture.
BACKGROUND
Patients with large intracerebral haematomas (ICH) from aneurysm rupture often present in a poor clinical condition and have a poor prognosis. Time delay for preoperative angiography might in some cases be unappealing. We evaluated the outcome after immediate haematoma removal and aneurysm occlusion without preoperative angiography.


METHODS
We retrospectively identified 13 consecutive patients. We recorded clinical data and evaluated mortality and morbidity with the Glasgow Outcome Score (GOS) and Telephone Interview of Cognitive Status (TICS).


RESULTS
At follow up seven of thirteen patients had favourable outcome assessed by GOS. Three patients had severe disability and three patients died. None of the survived patients interviewed had impaired cognition.


CONCLUSIONS
In patients presented in a critical state with aneurysmal ICH, emergency haematoma removal and aneurysm clipping without the delay for diagnostic angiography may be life saving and a satisfactory outcome can be accomplished.
Bergdal
Ove
O
The Neurocenter, Neurosurgical Section 2092, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 8, 2100 Copenhagen Ø, Denmark. dr.bergdal@gmail.com
Springborg
Jacob
J
Hauerberg
John
J
Eskesen
Vagn
V
Poulsgaard
Lars
L
Romner
Bertil
B
D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003072:Cognition Disorders / Q000453:epidemiology; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013525:Surgical Instruments / Q000592:standards; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*