The Selection Of The Time And Outcome Of Surgery For Ruptured Intracranial Anterior Circulation Aneurysms With Patient's Hunt-Hess Grade I-Ⅲ

Objective To compare the effect of microsurgery for ruptured intracranial anterior circulation aneurysms with Hunt-Hess GradeⅠ-Ⅲduring different periods. and to evaluate the factors which may impact the selection of surgery time and factors which may impact the prognosis. Then to find an appropriate strategy.Methods A retrospective analysis of 145 patients with Hunt-Hess GradeⅠ-Ⅲbefore surgery after initial supratentorial aneurysmal subarachnoid haemorrhage. Divide the 145 patients into 4 groups according to the interval from the aneurysm broke to surgery:Early(0-2days), Intermediate(3-6days), Late(7-14days) and Delay(14-30days). Outcome at 3 months after discharged was assessed using Glasgow Outcome Scale(GOS). Analyzing sex, age, the size and the location of aneurysms, Hunt-Hess before surgery, GOS at 3 months after discharged with the time of surgery by the Logistic regression model. Then calculate and analyze the reasons for poor outcome after microsurgery.Results There was no difference in outcome among the 4 groups according to Glasgow Outcome Scale at 3 months after discharged. There is no relation between sex, age, the size or the location of aneurysms and the time of surgery. Group Intermediate's and Group Delay's Hunt-Hess is lower than Group Early's. The major reasons for poor outcome is vasospasm.Conclusions Ruptured intracranial anterior circulation aneurysms has similar effect of surgery in different time. Sex, age, the size or the location of aneurysms don't impact the selction of surgery time. Patients with lower Hunt-Hess should take surgery earlyer. Vasospasm are the main reason for poor outcome after surgery. So we suggest that active treatment should be taken in ruptured intracranial anterior circulation aneurysms.