破裂脳動脈瘤の早期手術

概要

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The total number of the intracranial aneurysms experienced in our clinic was 434 cases until the end of December, 1970. In these cases, 385 cases were performed the intracranial direct operation and the surgical mortality rate during hospitalization was 7.8%. A series of 107 cases as early operation cases, which direct operation was performed within 21 days after the episode of SAH were picked up. The surgical mortality rate in early operation was definitively worse than in delayed operation, especially within 7 days. However, the period of operation was not the direct factor related to the operative result. As to the operative results, the most important factor was the progress of state of patients consciousness. Age, blood pressure, site of aneurysms, motor disturbance, cranial nerve disorder and preoperative vasospasm were not so important factors for the result of early surgical operation. However, meningeal irritation and frequency of rupture of aneurysms were important factors. Finally, as a policy for the management of ruptured intracranial aneurysms, we emphasize that the early direct operation for the intracranial aneurysms should be done positively, if the state of patients' consciousness is not in coma, or in a down hill course.
The Japanese Society on Surgery for Cerebral Strokeの論文