The International Cooperative Studyon the Timing of Aneurysm Surgery

Part 1: Overall management results

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✓ The International Cooperative Study on the Timing of Aneurysm Surgery evaluated the results of surgical and medical management in 3521 patients between December, 1980, and July, 1983. At admission, 75% of patients were in good neurological condition and surgery was performed in 83%. At the 6-month evaluation, 26% of the patients had died and 58% exhibited a complete recovery. Vasospasm and rebleeding were the leading causes of morbidity and mortality in addition to the initial bleed. Predictors for mortality included the patient's decreased level of consciousness and increased age, thickness of the subarachnoid hemorrhage clot on computerized tomography, elevated blood pressure, preexisting medical illnesses, and basilar aneurysms. The results presented here document the status of management in the 1980's.

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Address reprint requests to: Neal F. Kassell, M.D., Department of Neurological Surgery, University of Virginia Health Sciences Center, Box 180, Charlottesville, Virginia 22908.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Graph showing distribution of patients by age and sex.

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    Graph showing distribution of preexisting hypertension by age.

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    Graph showing average (of three recordings) of systolic and diastolic blood pressure on day of admission stratified by age.

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    Graph showing distribution of number of patients by day of surgery.

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    Graph showing rate of mortality by time of treatment in the study period.

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    Graphs showing overall and surgical good recovery rates (left) and overall and surgical mortality rates (right) ranked by center.

  • View in gallery

    Graphs showing overall good recovery rates (left) and overall mortality rates (right) by center ranked from low to high.

  • View in gallery

    Graphs showing surgical good recovery rates (left) and surgical mortality rates (right) by center ranked from low to high.

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