Long-term outcome of the management of ruptured intracranial aneurysm. Review of 328 consecutive patients treated over a period of 12 years.

From 1972 to 1984, 328 patients were admitted into the neurosurgical department for the treatment of a ruptured intracranial aneurysm, being clinically in grades 1 to 4. These patients were submitted to a deferred surgery protocol: 5.5% of the patients died before surgery, and 94.5% were actually operated upon. The follow-up was at least over 1 yr, and up to 14 yr (average 3 yr 8 months). The long-term result was evaluated according to both the physical status of the patients and their activity resumption (professional, familial and social). This long-term result was compared to the immediate results, which had been evaluated either at the time of discharge or a few months later: 25.9% of the 328 patients were 'lost to view', and 74.1% were 'followed-up' (including preoperative and operative death). The immediate results were: death 17.7%, poor 7.3%, fair 9.1%, good 66.2%. The long-term results were evaluated as follows: poor 7%, fair (independent but with emotional or psychological difficulties) 14.8%, good (fully independent) 55.1%. The long-term activity resumption (ability to work) was: normal 46.5%, lesser level of work 7.8%, unable to work 20.5%. Out of the patients with a good and fair immediate result, only 66.5% resumed their previous occupation: 21.2% of these patients did not resume their previous occupation due to psychological or emotional disturbances.