Nishijima Y, Yoshimoro T, Kaneko U, Sakurai Y, Suzuki J
No To Shinkei. 1978 Feb;30(2):181-7.
The is no doubt that radical surgery has been successful in preserving the lives of patients with ruptured aneurysms. On the other hand, no matter how successful we have been we cannot and must not forget the patients who died without undergoing surgery. Therefore, we investigated from clinical course, laboratory work, including angiography and autopsy, 38 cases who died during hospitalization in order to elucidate the causes of death in the natural course and to find the possibilities of minnimizing the number of non-operative fatalies. We classified the causes of death into 3 groups: intracranial hemmatomas, brain ischemia due to vasospasm, and aggravation of the general condition. From the study, it was concluded that most of the lives could have been saved, if appropriate diagnosis and treatment had been made as soon as possible after the initial hemorrhage.
毫无疑问，根治性手术在挽救动脉瘤破裂患者的生命方面取得了成功。另一方面，无论我们多么成功，我们都不能也绝不能忘记那些未经手术就死亡的患者。因此，我们从临床病程、实验室检查（包括血管造影和尸检）对38例住院期间死亡的病例进行了调查，以阐明自然病程中的死亡原因，并找出将非手术死亡人数降至最低的可能性。我们将死亡原因分为3组：颅内血肿、血管痉挛导致的脑缺血和全身状况恶化。从这项研究得出的结论是，如果在初次出血后尽快进行适当的诊断和治疗，大多数生命本可以挽救。
