Current management of cerebral aneurysms: is it based on facts or myths?

The overall morbidity and mortality from aneurysmal subarachnoid hemorrhage have not changed significantly over the past 30 years in spite of great progress in surgical technology and diagnostic capabilities. Most series report major morbidity and mortality figures of approximately 60%. The reason for the currently poor prognosis is due, in part, to the sometimes devastating effect of the initial hemorrhage over which we have no control. Another reason for our inability to improve these dismal statistics may be that the currently accepted treatment regimens have proven to be ineffective. Eighteen misconceptions or "myths" surrounding the treatment of aneurysmal subarachnoid hemorrhage have been identified as factors that have largely determined the currently accepted, ineffective treatment protocols, and these are discussed.