Surgical Risk as Related to Time of Intervention in the Repair of Intracranial Aneurysms

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It is generally agreed that the surgical risk in intracranial aneurysm is closely related to the patient's condition at the time of surgery, as well as to other factors such as age, associated disease, and the location of the aneurysm. Many criteria have been proposed1,2,5 for the determination of surgical risk; some are based upon whether or not the patient is “conscious,” others upon the number of days that have passed since the last hemorrhage, and still others upon the patient's age. We have felt that the intensity of the meningeal inflammatory reaction, the

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    Time between hemorrhage and surgery for Grade I, II, and III patients. The vertical bars represent the number of cases operated on each post-bleeding day (measured from the last known hemorrhage) for those cases that had bled. The grading was done at the time of operation. Note the number of cases operated within the first week, and within the first three weeks in each grade. Delay in surgery in Grades I and II beyond the first day or two was usually incurred prior to admission to our institutions.

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    Classification of patients by grade at admission, at surgery for all surgical procedures, and at surgery for intracranial ligation alone. The mortality for each classification is shown as a black wedge.

References

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