Weir B, Aronyk K
Acta Neurochir (Wien). 1982;63(1-4):135-9. doi: 10.1007/BF01728865.
An analysis of all 197 consecutive cases of intracranial aneurysms treated by one of us (B. W.) was carried out. 82% were ruptured anterior circle aneurysms. 144 cases were analyzed with respect to post-operative and management mortality where patients were eligible for definitive clipping. Grade-time interactions on transfer to the neurosurgeon were considered. Early operation was not associated with significantly higher post-operative and management mortality. 116 cases clipped and discharged from hospital had longer follow-ups to see if earlier operation was associated with a poorer neurological and social outcome. This was not the case. We therefore believe that since the prime rationale for surgery following subarachnoid haemorrhage is the prevention of rebleeding and since this is more common immediately following the initial haemorrhage, early surgery is indicated whenever this is technically feasible. Since 1978, with a deliberate policy of trying to operate early, for all grades there has been a post-operative mortality of 3%, a case management mortality of 20% and 87% of patients operated upon have been able to go home.
我们对由其中一人（B.W.）治疗的连续197例颅内动脉瘤病例进行了分析。82%为破裂的前循环动脉瘤。对144例符合确定性夹闭条件的患者的术后及管理死亡率进行了分析。考虑了转至神经外科医生时的分级-时间相互作用。早期手术与显著更高的术后及管理死亡率无关。116例接受夹闭并出院的患者进行了更长时间的随访，以观察早期手术是否与较差的神经和社会结局相关。情况并非如此。因此，我们认为，由于蛛网膜下腔出血后手术的主要理由是预防再出血，且这在初次出血后立即更为常见，所以只要技术上可行，就应尽早手术。自1978年以来，由于刻意实行尽早手术的政策，所有分级患者的术后死亡率为3%，病例管理死亡率为20%，接受手术的患者中有87%能够回家。
