Journal article
The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: Surgical results
Journal of neurosurgery, Vol.73(1), pp.37-47
07/1990
DOI: 10.3171/jns.1990.73.1.0037
PMID: 2191091
Abstract
A prospective, observational clinical trial was conducted by the International Cooperative Study on the Timing of Aneurysm Surgery to determine the best time in relation to the hemorrhage for surgical treatment of ruptured intracranial aneurysms. Sixty-eight centers contributed 3521 patients in a 2 1/2-year period beginning in December, 1980. Analysis by a prespecified "planned" surgery interval demonstrated that there was no difference in early (0 to 3 days after the bleed) or late surgery (11 to 14 days). Outcome was worse if surgery was performed in the 7 to 10-day post-bleed interval. Surgical results were better for patients operated on after 10 days. Patients alert on admission fared best; however, alert patients had a mortality rate of 10% to 12% when undergoing surgery prior to Day 11 compared with 3% to 5% when surgery was performed after Day 10. Patients drowsy on admission had a 21% to 25% mortality rate when operated on up to Day 11 and 7% to 10% with surgery thereafter. Overall, early surgery was neither more hazardous nor beneficial than delayed surgery. The postoperative risk following early surgery is equivalent to the risk of rebleeding and vasospasm in patients waiting for delayed surgery.
Details
- Title: Subtitle
- The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: Surgical results
- Creators
- Neal F Kassell - Department of Neurological Surgery, University of Virginia Health Sciences Center, CharlottesvilleJames C TornerJohn A JaneE Clarke Haley JrHarold P Adams
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.73(1), pp.37-47
- DOI
- 10.3171/jns.1990.73.1.0037
- PMID
- 2191091
- NLM abbreviation
- J Neurosurg
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Publisher
- United States
- Grant note
- NS-15940 / NINDS NIH HHS
- Language
- English
- Date published
- 07/1990
- Academic Unit
- Neurology; Epidemiology; Iowa Neuroscience Institute; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983995003602771
Metrics
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