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Ultra-early (within 24 hours) aneurysm treatment after subarachnoid hemorrhage.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wong, George Kwok Chu Boet, Ronald Ng, Stephanie Chi Ping Chan, Matthew Gin, Tony Zee, Benny Poon, Wai Sang
Description	Author Affiliation: Wong GK ( Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People's Republic of China. georgewong@surgery.cuhk.edu.hk)
Abstract	BACKGROUND: The timing of definitive aneurysm treatment (coiling or clipping) in acute aneurysm subarachnoid hemorrhage was a subject of controversy. Although most vascular neurosurgeons agreed on early aneurysm treatment (within the first 72 hours), whether ultra-early aneurysm treatment (within the first 24 hours) was beneficial remained debatable. We aimed to investigate whether ultra-early aneurysm treatment is associated with better neurological outcome in all patients or only good-grade patients or only poor-grade patients. METHODS: Two-hundred and seventy-six (84%) patients had hemorrhage onset time and aneurysm treatment time available for analysis. Values of P < 0.05 were taken as statistically significant, and P values between 0.05 and 0.10 were considered to be a trend. RESULTS: For the 96 poor-grade (World Federation of Neurological Surgeons grading scale 4 to 5) patients, there was a significant association between Short Form-36 mental scores and ultra-early aneurysm treatment (50 ± 10 vs. 46 ± 10, P = 0.019) and a trend toward association between ultra-early surgery and favorable neurological outcome (odds ratio 2.4 [95% confidence interval 1.0 to 6.0], P = 0.062). A reduction in clinical rebleeding (12% vs. 22%, P = 0.168) was observed in patients undergoing ultra-early aneurysm treatment. CONCLUSIONS: Aneurysm treatment performed within the 24-hour window may be associated with a better outcome and halve the clinical rebleeding risk in poor-grade aneurysmal subarachnoid hemorrhage patients.
File Format	HTM / HTML
ISSN	18788750
Issue Number	2
Volume Number	77
e-ISSN	18788769
Journal	World Neurosurgery
Language	English
Publisher	Elsevier
Publisher Date	2012-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Neurosurgery Intracranial Aneurysm Surgery Neurosurgical Procedures Subarachnoid Hemorrhage Aged Aneurysm, Ruptured Cerebral Angiography Confidence Intervals Female Humans Hypertension Complications Male Middle Aged Neuropsychological Tests Odds Ratio Prognosis Prospective Studies Recurrence Surgical Instruments Treatment Outcome Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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