Post K D, Flamm E S, Goodgold A, Ransohoff J
J Neurosurg. 1977 Mar;46(3):290-5. doi: 10.3171/jns.1977.46.3.0290.
The authors review 100 consecutive cases of ruptured intracranial aneurysms to assess the overall morbidity and mortality. Patients were placed on a regimen of bed rest, sedation, control of blood pressure, anticonvulsants, and antifibrinolytic therapy. Surgery was performed on 86 patients with hypotensive anesthesia and microsurgical techniques. The incidence of early rebleeding while on epsilon aminocaproic acid and control of blood pressure was 11.8%. The overall surgical mortality was 8.1%, and the surgical mortality of patients in Grades 1, 2, and 3 was 6.3%. Of the 100 patients, 60 were able to return to their prior activities, and 25 had moderate neurological deficits that required limitation of their activities. The total case mortality was 15%. The evidence presented indicates that the regimen of active medical treatment before microsurgical intervention has improved the overall case morbidity and mortality, as well as the chance for long-term survival.
作者回顾了100例连续性颅内动脉瘤破裂病例，以评估总体发病率和死亡率。患者接受了卧床休息、镇静、血压控制、抗惊厥药物和抗纤维蛋白溶解治疗的方案。86例患者采用低血压麻醉和显微外科技术进行了手术。在使用氨甲环酸和血压控制期间，早期再出血的发生率为11.8%。总体手术死亡率为8.1%，1、2和3级患者的手术死亡率为6.3%。100例患者中，60例能够恢复到之前的活动水平，25例有中度神经功能缺损，需要限制活动。总病例死亡率为15%。所提供的证据表明，显微外科干预前的积极药物治疗方案改善了总体病例的发病率和死亡率，以及长期生存的机会。
