Blood clot evacuation in aneurysm surgery in the acute stage (arguments pro and con).

In a series of 122 consecutive patients operated on by the senior author for rupture of an aneurysm the pterional approach was used in all but a few cases. A microsurgical technique was invariably utilized from opening to closing of the dura. Nearly half of our patients underwent surgery within the first week after subarachnoid haemorrhage (SAH). In the majority of cases operated on in the acute stage, a sizable subarachnoid blood clot was evacuated, mostly from the basal cisterns. The authors present their own experience in the field to show the superiority of the technically more demanding surgery carried out within the first days following SAH over other therapeutic procedures.