Outcome after emergency surgery without angiography in patients with intracerebral haemorrhage after aneurysm rupture

TY - JOUR

T1 - Outcome after emergency surgery without angiography in patients with intracerebral haemorrhage after aneurysm rupture

AU - Bergdal, Ove

AU - Springborg, Jacob

AU - Hauerberg, John

AU - Eskesen, Vagn

AU - Poulsgaard, Lars

AU - Romner, Bertil

N1 - Keywords: Adult; Aged; Cerebral Angiography; Cerebral Arteries; Cerebral Hemorrhage; Cognition Disorders; Emergency Medical Services; Female; Humans; Male; Middle Aged; Neurosurgical Procedures; Outcome Assessment (Health Care); Postoperative Complications; Retrospective Studies; Subarachnoid Hemorrhage; Surgical Instruments; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vascular Surgical Procedures

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Patients with large intracerebral haematomas (ICH) from aneurysm rupture often present in a poor clinical condition and have a poor prognosis. Time delay for preoperative angiography might in some cases be unappealing. We evaluated the outcome after immediate haematoma removal and aneurysm occlusion without preoperative angiography. METHODS: We retrospectively identified 13 consecutive patients. We recorded clinical data and evaluated mortality and morbidity with the Glasgow Outcome Score (GOS) and Telephone Interview of Cognitive Status (TICS). FINDINGS: At follow up seven of thirteen patients had favourable outcome assessed by GOS. Three patients had severe disability and three patients died. None of the survived patients interviewed had impaired cognition. CONCLUSIONS: In patients presented in a critical state with aneurysmal ICH, emergency haematoma removal and aneurysm clipping without the delay for diagnostic angiography may be life saving and a satisfactory outcome can be accomplished.

AB - BACKGROUND: Patients with large intracerebral haematomas (ICH) from aneurysm rupture often present in a poor clinical condition and have a poor prognosis. Time delay for preoperative angiography might in some cases be unappealing. We evaluated the outcome after immediate haematoma removal and aneurysm occlusion without preoperative angiography. METHODS: We retrospectively identified 13 consecutive patients. We recorded clinical data and evaluated mortality and morbidity with the Glasgow Outcome Score (GOS) and Telephone Interview of Cognitive Status (TICS). FINDINGS: At follow up seven of thirteen patients had favourable outcome assessed by GOS. Three patients had severe disability and three patients died. None of the survived patients interviewed had impaired cognition. CONCLUSIONS: In patients presented in a critical state with aneurysmal ICH, emergency haematoma removal and aneurysm clipping without the delay for diagnostic angiography may be life saving and a satisfactory outcome can be accomplished.

U2 - 10.1007/s00701-009-0326-1

DO - 10.1007/s00701-009-0326-1

M3 - Journal article

C2 - 19387536

SN - 0001-6268

VL - 151

SP - 911

EP - 915

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

IS - 8

ER -