The Influence Of Surgical Timing On The Clinical Prognosis Of Patients With Aneurysmal Subarachnoid Hemorrhage

Object To investigate relationship between surgical timing and clinical prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH)。Methods From January 2006 to June 2009, 248 patients with aSAH in our department were retrospected, 117of which treated by clipping and 131 by coiling. According to preoperative Hunt-Hess Scale they were divided into two groups: gradesⅠ~Ⅲand gradesⅢ~Ⅴ. Based on the surgical timing, each group was divided into early surgery group (SAH<72h), intermediate surgery group (SAH 4d~14d) and postponed surgery group (SAH>14d). The prognosis of patients by Glasgow Outcome Scale(GOS) and the incidence rate of the cerebral vasospasm were statistically compared and evaluated between each group.Results Among 248 cases, 219 cases were in gradesⅠ~Ⅲ, 100 of which by clipping and 119 by coiling; 29 cases were in gradesⅢ~Ⅴ, 17 of which treated by clipping and 12 by coiling. For patients in gradesⅠ~Ⅲand gradesⅢ~Ⅴ, there were no statistically difference in GOS between the three surgery groups(P>0.05). For patients in gradesⅠ~Ⅲ, the incidence rate of the cerebral vasospasm in early surgery group and postponed surgery group were lower than that of intermediate surgery group(P<0.05). For patients in gradesⅢ~Ⅴ, there were no statistically difference in the incidence rate of the cerebral vasospasm between the three surgery groups (P>0.05).Conclusions There were no effects of surgical timing on the prognosis for patients in gradesⅠt oⅢ, but for preventing from re-rupture of aneurysm early operation should be done because of lower incidence rates of the cerebral vasospasm in early and postponed groups. For patients in gradesⅢ~Ⅴt here were no effects of surgical timing on the prognosis and the incidence rate of cerebral vasospasm.