Overall management outcome of ruptured posterior fossa aneurysms.

Abstract:

:A study of the overall management of ruptured posterior fossa aneurysms was conducted over a 1-year period (1993) in five neurosurgical centers in Sweden, serving a population of 6.93 million people. Forty-nine cases were identified and treated. One-third of the patients were in the seventh or eighth decade of life. Good overall management outcomes at 6 months were achieved in 30 cases (61%). The overall mortality rate was 27%. Patients with Hunt and Hess Grades I and II had a good overall recovery rate of 87%. On admission, 69% of the patients were assigned Hunt and Hess Grades III to V. The impact on patient outcomes of the intraoperative difficulties encountered, especially in the basilar tip area, is stressed. The authors found that delayed operation is not warranted in most cases. Frequent devastating rebleeding was observed among patients not offered early aneurysm clipping and the operative results were not at significant variance between the early and late surgical groups. Only 50% of the patients scheduled for delayed surgery ultimately made a good recovery, whereas 72% of patients scheduled for early operation did so. The data demonstrate that overall management results with posterior fossa aneurysms, comparable to achievements with supratentorial lesions, are within the reach of modern strategies, even in centers not specializing in these problems.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Hillman J,Säveland H,Jakobsson KE,Edner G,Zygmunt S,Fridriksson S,Brandt L

doi

10.3171/jns.1996.85.1.0033

subject

Has Abstract

pub_date

1996-07-01 00:00:00

pages

33-8

issue

1

eissn

0022-3085

issn

1933-0693

journal_volume

85

pub_type

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