Medizinische Universität Graz - Research portal
Selected Publication:
Auer, LM.
Acute operation and preventive nimodipine improve outcome in patients with ruptured cerebral aneurysms.
Neurosurgery. 1984; 15(1):57-66
Doi: 10.1227/00006123-198407000-00011
(- Case Report)
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- Abstract:
- Sixty-five patients with ruptured aneurysms were operated upon within 48 to 72 hours after subarachnoid hemorrhage (SAH) and were treated with a regimen of intra- and postoperative nimodipine for the prevention of symptomatic vasospasm. The clinical grading (Hunt and Hess) was I to III in 49 patients and IV or V in 16. The SAH was mild in 15 patients, moderate in 27, and severe in 23; 12 patients harbored an intracerebral hematoma, and 6 had intraventricular bleeding. Acute hydrocephalus was observed on preoperative computed tomography (CT) in 19 patients. On CT 3 days postoperatively (i.e., Day 3-4 after SAH), 30 of 65 patients still had subarachnoid blood; however, severe symptomatic vasospasm as the deciding threatening event during the delayed postoperative period was not encountered in this series. Transient symptoms of ischemia were noted in 2 patients (3%) and were accompanied by angiographic spasm in 1. Irreversible neurological deficit occurred in 2 patients (3%); in 1 of these, it was a complication of postoperative control angiography. Of the patients preoperatively graded I or II, 96% had an excellent to fair outcome 6 months postoperatively, and 1 patient (4%) had died because of a surgical complication. Among patients preoperatively graded III or IV, 86% had an excellent to fair outcome, and the remaining 14% had a poor outcome. Shunt-dependent hydrocephalus developed in 7% of the patients. Acute surgical repair of ruptured cerebral aneurysms and preventive topical and intravenous administration of nimodipine reduce management complications and improve outcome; above all, ischemic lesions from symptomatic vasospasm are reduced to a minimum.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Female -
- Follow-Up Studies -
- Humans -
- Intracranial Aneurysm - complications
- Intraoperative Complications - prevention and control
- Ischemic Attack, Transient - prevention and control
- Middle Aged - prevention and control
- Nicotinic Acids - therapeutic use
- Nimodipine - therapeutic use
- Postoperative Complications - prevention and control
- Rupture, Spontaneous - prevention and control
- Subarachnoid Hemorrhage - therapy
- Time Factors - therapy