title: [Different treatments on the prognosis of poor-grade aneurysmal subarachnoid hemorrhage patients].
abstract: OBJECTIVE
  To compare the outcomes of surgical clipping, interventional treatment and conservative treatment of poor-grade aneurysm patients.
  
  
  METHODS
  A total of 119 patients of WFNS (World Federation of Neurosurgical Societies) grades IV (n=73) and V (n=46) from June 2004 from to December 2011 were analyzed. There were 51 males and 68 female with a mean age of 55.2 years (range: 32-77). The approaches included surgical clipping (n=57), interventional embolization (n=40) and conservative treatment (n=22). Their outcome were assessed with a 3-month follow-up according to the Glasgow outcome score (GOS).
  
  
  RESULTS
  In surgical clipping group, the prognoses were excellent (5-4 points, n=22), poor prognosis (3-2 points, n=30) and death (1 point, n=5); excellent (n=26), poor (n=1) and death (n=13) in interventional embolization group; excellent (n=0), poor (n=3) and death (n=19) in conservative treatment. The excellent outcome of interventional embolism was better than those of surgical clipping and conservative treatment (P<0.05), but it had higher mortality than surgical clipping (P<0.05). In conservative treatment group, mortality was significantly higher than the first two groups (P<0.05).
  
  
  CONCLUSIONS
  For patients of grade IV, surgical clipping and interventional embolization may be selected; for those of grade V, interventional embolization can be used as a first choice; for those of grade IV/V with large intracerebral hematoma (hematoma volume>30 ml), surgical clipping is preferred.
authors: Department of Neurosurgery, Second Hospital of Shandong University, Jinan 250033, China.
authors: Xuan
authors: X
authors: Ding
authors: Zhi-gang
authors: ZG
authors: Wang
authors: Cheng-wei
authors: CW
authors: Wang
authors: Yi-hua
authors: YH
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome