Kayama T, Yoshimoto T, Uchida K, Takaku A, Suzuki J
Tohoku J Exp Med. 1978 Oct;126(2):117-24. doi: 10.1620/tjem.126.117.
The results of our surgical treatment of 1,000 patients with intracranial saccular aneurysm were analyzed with special consideration for age, site of aneurysm, preoperative condition and operative timing. The results on discharge were as follows: 543 cases, excellent; 186, good; 117, fair; 93, poor; and 61, dead. About three-fourths of the cases except for 23 cases of vertebrobasilar aneurysm showed either excellent or good result. The mortality rate became worse with aging. The results fairly correlated with the preoperative grades by Hunt and Hess (1968), but the cases of Grade Ia were unexpectedly worse. The timing of operation influenced the mortality rate; especially, the cases operated within 3 to 7 days following the last subarachnoid hemorrhage bore poor results. Follow-up studies revealed that excellent and good cases increased and poor cases decreased. The mortality rate for each year decreased annually to 2% in 1975. This improvement may be attributed to the advancement in the operative management with supplementary procedures and in the treatment for cerebral angiospasms and general condition.
我们对1000例颅内囊状动脉瘤患者的外科治疗结果进行了分析，特别考虑了年龄、动脉瘤部位、术前状况和手术时机。出院时的结果如下：543例为优；186例为良；117例为中；93例为差；61例死亡。除23例椎基底动脉瘤外，约四分之三的病例结果为优或良。死亡率随年龄增长而升高。结果与Hunt和Hess（1968年）的术前分级有一定相关性，但Ia级病例的结果出人意料地较差。手术时机影响死亡率；特别是，在最后一次蛛网膜下腔出血后3至7天内进行手术的病例结果较差。随访研究显示，优和良的病例增加，差的病例减少。到1975年，每年的死亡率降至2%。这种改善可能归因于手术管理的进步，包括辅助手术、脑血管痉挛治疗和一般状况的改善。
