• Acta neurochirurgica · Aug 2009

    Outcome after emergency surgery without angiography in patients with intracerebral haemorrhage after aneurysm rupture.

    • Ove Bergdal, Jacob Springborg, John Hauerberg, Vagn Eskesen, Lars Poulsgaard, and Bertil Romner.
    • The Neurocenter, Neurosurgical Section 2092, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 8, 2100 Copenhagen Ø, Denmark. dr.bergdal@gmail.com
    • Acta Neurochir (Wien). 2009 Aug 1;151(8):911-5.

    BackgroundPatients with large intracerebral haematomas (ICH) from aneurysm rupture often present in a poor clinical condition and have a poor prognosis. Time delay for preoperative angiography might in some cases be unappealing. We evaluated the outcome after immediate haematoma removal and aneurysm occlusion without preoperative angiography.MethodsWe retrospectively identified 13 consecutive patients. We recorded clinical data and evaluated mortality and morbidity with the Glasgow Outcome Score (GOS) and Telephone Interview of Cognitive Status (TICS).FindingsAt follow up seven of thirteen patients had favourable outcome assessed by GOS. Three patients had severe disability and three patients died. None of the survived patients interviewed had impaired cognition.ConclusionsIn patients presented in a critical state with aneurysmal ICH, emergency haematoma removal and aneurysm clipping without the delay for diagnostic angiography may be life saving and a satisfactory outcome can be accomplished.

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