Aneurysmal rebleeding : factors associated with clinical outcome in the rebleeding patients.
OBJECTIVE
Aneurysmal rebleeding is a major cause of death and disability. The aim of this study is to investigate the incidence of rebleeding, and the factors related with patient's outcome.


METHODS
During a period of 12 years, from September 1995 to August 2007, 492 consecutive patients with aneurysmal subarachnoid hemorrhage (SAH) underwent surgery at our institution. We reviewed the patient's clinical records, radiologic findings, and possible factors inducing rebleeding. Also, we statistically analyzed various factors between favorable outcome group (FG) and unfavorable outcome group (UG) in the rebleeding patients.


RESULTS
Rebleeding occurred in 38 (7.7%) of 492 patients. Male gender, location of aneurysm (anterior communicating artery) were statistically significant between rebleeding group and non-rebleeding group (p = 0.01 and p = 0.04, respectively). Rebleeding occurred in 26 patients (74.3%) within 2 hours from initial attack. There were no statistically significant factors between FG and UG. However, time interval between initial SAH to rebleeding was shorter in the UG compared to FG (FG = 28.71 hrs, UG = 2.9 hrs).


CONCLUSIONS
Rebleeding occurs more frequently in the earlier period after initial SAH. Thus, careful management in the earlier period after SAH and early obliteration of aneurysm will be necessary.
Cha
Ki Chul
KC
Department of Neurosurgery, Eulji University School of Medicine Eulji General Hospital, Seoul, Korea.
Kim
Jae Hoon
JH
Kang
Hee In
HI
Moon
Byung Gwan
BG
Lee
Seung Jin
SJ
Kim
Joo Seung
JS
Aneurysm; Outcome; Rebleeding; Subarachnoid hemorrhage