Seiler R W
Schweiz Med Wochenschr. 1983 Feb 12;113(6):202-7.
The morbidity and mortality in 100 consecutive patients, almost all admitted within one week after a proven subarachnoid hemorrhage, were investigated in a prospective study. An aneurysm was demonstrated by angiography or autopsy in 76 patients, while in 24 patients the cerebral panangiography was normal. 13.1% of the patients with a proven aneurysm died within 48 hours of the hemorrhage as a consequence of a massive initial bleeding, 23.6% died from preoperative rebleeding or brain infarcts due to cerebral vascular spasms, 2.6% from direct operative complications and 2.6% from brain infarcts due to postoperative cerebral vascular spasms. The total case mortality was 41.9%. This high mortality was due to massive initial hemorrhage, early rebleedings and in particular to pre- and postoperative brain infarcts due to cerebral vascular spasms. The prognosis can only be improved significantly by early diagnosis and admission and effective prophylaxis and therapy of the vasospasm, but not by further perfecting of surgical technique.
在一项前瞻性研究中，对100例连续患者的发病率和死亡率进行了调查，这些患者几乎都是在确诊蛛网膜下腔出血后一周内入院的。76例患者通过血管造影或尸检发现有动脉瘤，而24例患者的全脑血管造影结果正常。13.1%确诊有动脉瘤的患者在出血后48小时内死于大量初始出血，23.6%死于术前再出血或因脑血管痉挛导致的脑梗死，2.6%死于直接手术并发症，2.6%死于术后脑血管痉挛导致的脑梗死。总病例死亡率为41.9%。这种高死亡率是由于大量初始出血、早期再出血，特别是由于脑血管痉挛导致的术前和术后脑梗死。只有通过早期诊断和入院以及对血管痉挛进行有效的预防和治疗，才能显著改善预后，而不是通过进一步完善手术技术。
