Research Of Surgical Timing For Ruptured Intracranial Aneurysms

Objective: To investigate the correlation between surgical timing and clinical prognosis.Methods: The data from 473 cases of ruptured intracranial aneurysm admitted in our hospital from Jan-2003 to Jul-2007 was retrospectively analyzed,of them, 382 were operated on and 5 died from rebleeding when waited for operation。The 387 patients were divided into group gradesⅠtoⅡ,group gradeⅢand group gradesⅣtoⅤaccording to Hunt&Hess grade when admitted.Each group was then divided into early surgery group(SAH<72h),intermediate surgery group(SAH4-10d) and late surgery group(SAH>11 d)based on the surgical timing.Those 5 case died from rebleeding and 3 case who were carried out emergency operation on in 4-10d after SAH because of rebleeding when waited for operation were putted in late surgery group. The GOS(Glasgow Outcome Scale) and the incidence rate of the main complications(symptomatic vasospasm and hydrocephalus) were statistically compared between the groups.Results: In patients of gradesⅠtoⅡ, There was no statistically difference in the rat of good outcomes and the incidence rate of symptomatic vasospasm and hydrocephalus among the three surgery groups. In patients of gradesⅢ, There was no statistically difference in rat of good outcomes among the three surgery groups. In patients of gradesⅣtoⅤ, the rat of good outcomes was significantly higher in in early surgery group than that in non-early surgery groupConclusions: Time of surgery was not matter cause of outcome in patients of gradesⅠtoⅢ. In patients of gradesⅣtoⅤ,early operation should be taken.