[Outcomes of early surgery combined with anti-vasospasm agents treat ruptured cranial aneurysms: an analysis of 127 cases].
OBJECTIVE
Retrospective study on 127 cases of early microsurgery combined with antivasospasm agents for treatment of subarachnoid hemorrhage after the rupture of intracranial aneurysm. To evaluate the microsurgery for early-stage (3 days) of ruptured aneurysm.


METHODS
127 cases of subarachnoid hemorrhage after the rupture of intracranial aneurysm were diagnosed by MRI and CTA. Patients underwent early microsurgical clipping of intracranial aneurysm followed by antivasospasm agents treatment were retrospectively analyzed for their clinical manifestation, characteristics of imaging presentation, the curative effects and experiences of different operative approaches, surgical methods and techniques, pharmaceutical treatment and other integrated management.


RESULTS
In all 127 cases, organized blood clot accompanied with subarachnoid hemorrhage and cerebral vasospasm surrounding the ruptured aneurysm was found in the course of surgical probing, among which 21 aneurysms ruptured during the operation; according to the GOS, 109 cases were cured or free of symptom, 23 cases got a transient hemiparalysis or aggravation of hemiparalysis, among which 18 cases were free of symptom, 9 were slight disability, 6 were severe disability, 3 cases die when discharged.


CONCLUSIONS
Early operation could prevent second-time rupture effectively, lower the death rate, and at the same time lower the occurrence of cerebral vasospasm and the succeeding damage caused. Cerebral vasospasm is still the serious complication of subarachnoid hemorrhage of ruptured aneurysm and inappropriate management would cause critical consequences. Antivasospasm agents used postoperative could help preventing cerebral vasospasm and maintaining function.
Yang
Jun
J
Department of Neurosurgery, Capital Medical University, Beijing 100038, China.
Lin
Rui-sheng
RS
Li
Zhi-qiang
ZQ
Qi
Jian-fa
JF
Ma
Shun-chang
SC
Liang
Ji-jun
JJ
Cun
En-hao
EH
Ren
Ming
M
Yu
Chun-jiang
CJ
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged