The Timing of Anterior Communicating Artery Aneurysm Surgery: Comparison of Outcome in Early Versus Intermediate Surgery

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Chung, Chun Kee; Han, Dae Hee
Issue Date
Seoul National University College of Medicine
Seoul J Med 1992;33(4):301-306
Anterior communicating artery aneurysmsEarly surgeryIntermediate surgeryVasospasmTiming of surgeryOutcome
The authors analyzed 47 cases of ruptured anterior communicating artery
aneurysms during the past three years that were clipped within 14 days after initial
hemorrhage, to study the influence of the timing of surgery on the development of
vasospasm-related complications. Twelve patients were operated within three days after
the onset of subarachnoid hemorrhage (SAH) (early group), and 35 patients were
operated 4-14 days after SAH (intermediate group). For the statistical analysis the
chi-square test with Yates' correction and Fisher's exact test were used. There were no
statistically significant differences between the early and the intermediate groups in (1)
the Hunt-Hess grade on admission and preoperatively, (2) the final outcome, (3) the
presence of associated diseases, or (4) the occurrence of angiographic vasospasm.
There was no difference in the preoperative medical management. The occurrence of
symptomatic vasospasm or infarct was not different in the early and intermediate
groups (p)0.10), nor was the occurrence of infarct in the anterior cerebral artery (ACA)
or non-ACA territory (p)0.10). Laterality of infarct was not related to laterality of surgical
approach in either the early or intermediate groups, nor in the whole group (p)
0.10). Hydrocephalus, rebleeding, and other complications were also not different in the
early and intermediate groups. The authors did not find any evidence that in patients
with ruptured anterior communicating artery aneurysms, the timing of surgery affects
the development of vasospasm-related complications.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 33 No.4 (1992)
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