[Bleeding cerebral aneurysm: indication and timing of angiography and surgery].

Recent experience with cerebral aneurysms suggests that it is unadvisable to abide by the principle that angiography should be delayed for 7-10 days and surgery still longer. There is no hard and fast rule for the timing of angiography and surgery: this must be determined in the light of the clinical condition. The following guideline may prove of help: in cases of slight hemorrhage, angiography with 24 h and operation within the first few days. In suspected intracranial hematoma, emergency angiography and surgery are of course mandatory. Surgical intervention, but not angiography, should be delayed in severe bleeding with lasting disturbance of consciousness, neurologic deficit and markedly bloody cerebrospinal fluid. The prognosis can be improved by rapid diagnosis, proper selection and early operation.