Early Surgical Treatment For Ruptured Cerebral Aneurysm

PurposeTo investigate the possibility of early surgical treatment for ruptured cerebral aneurysm with CTA.Method102 cases of spontaneous subarachnoid hemorrhage from 2006.6 to 2007.12 were diagonsised,who were all emergency patients. Some paitients were performed early surgical clipping with CTA. ResultsThere were 79 cases of intracranial aneurysm found with CTA in 102 patients. Nothing was found in 23cases with CTA first, then rechecked by DSA, found 3 aneurysms.No aneurysm was found in other 20 cases.5 cases have two aneurysms.There were 87 intracranial aneurysms found in 102 patients. 65 cases were performed operation in early time . 3 cases have two aneurysms.Of 68 intracranial aneurysms, 65 lesions were clipped successfully and 3 were wrapped.Three-dimensional CT angiography with volume rendering well demonstrated aneurysms and provided useful information including their site, shape, size and the spatial relationship to the surrounding vessels and bone structures . Follow up three to six months, good recovery was achieved in 51 cases, mild and moderated disability in 6 cases and severe disability in 2 cases. 4 cases remained in a vegetative state and 2 died. ConclusionThree dimensional CT angiography with volume rendering is a rapid , reliable ,and relative noninvasive diagnostic tool for intracranial aneurysms.It can delineate the aneurismal morphology in detail, and it can provide enough information for making decisions and planning microsurgical clipping in emergency.Early clipping can reduce the risk of re-bleeding and relieve the secondary cerebral vasospasm, thus decreasing the mortality and improving the prognosis. It is completely feasible that early surgical treatment for ruptured cerebral aneurysm with CTA.