Martindale B V, Garfield J
Br Med J. 1978 Feb 25;1(6111):465-6. doi: 10.1136/bmj.1.6111.465.
Out of 186 patients aged over 59 referred to a neurosurgical department after spontaneous subarachnoid haemorrhage, 143 underwent cerebral angiography; only 28 (15%) of the patients had surgery, of whom 16 were independent one year later. The doubtful benefit of surgery and the small proportion of patients who underwent surgery have economic and ethical implications; in particular, neurosurgical beds and neuroradiological facilities should not be occupied by such patients if this delays the admission of younger patients and those requiring investigation of intracranial space-occupying and spinal lesions.
在186例59岁以上自发性蛛网膜下腔出血后被转诊至神经外科的患者中，143例接受了脑血管造影；只有28例（15%）患者接受了手术，其中16例在一年后能够独立生活。手术的获益存疑以及接受手术的患者比例较小具有经济和伦理方面的影响；特别是，如果此类患者占用神经外科床位和神经放射设备会延迟年轻患者以及需要对颅内占位性病变和脊柱病变进行检查的患者入院，那么就不应让他们占用这些资源。
