The analysis of treatment results of brain aneurysms rupture
Introduction. The problem of surgical treatment of brain aneurysms is unsolved, and results of treatment don’t satisfy neurosurgical community. The indications and terms of surgery performing are most discussed.
Purpose. To determine main causes of unfavorable outcomes of surgical treatment of patients with brain aneurysms rupture on the base of analysis of our own clinical experience.
Materials and methods. The results of treatment of 1099 patients with ruptured brain aneurysms were analyzed. 99 patients died without surgery. Microsurgical approach was used in 706 patients, endovascular — in 294.
Results. The cause of death of 50% patients who died without surgery was brain aneurysms re-rupture. Postoperative lethality was 9.0% after microsurgical technique use, and 9.2% — after endovascular one. Lethality when using both methods differed significantly depending on terms after brain aneurysm rupture.Conclusion. In the acute period of brain aneurysm rupture (1–3 days) the surgery has to be performed just in patients without clinical signs of angiospasm. Lethality after endovascular surgery in this period is 2.5 times lower than after microsurgical operations.
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