Surgical treatment of complicated aneurismal subarachnoidal hemorrhage
Objective. Improvement of the surgical treatment results of aneurisms, complicated by intracranial hemorrhage.
Маterials and methods. Of 213 patients with subarachnoidal hemorrhage due to the cerebral aneurisms rupture in 121 (56.8%) a complicated course was observed. In all the patients a surgical treatment was conducted, doing the aneurism occlusion.
Results. In 68 (56%) patients a microsurgical clipping, and in 53 - еndovascular embolization was applied. Surgical interventions in 84.3% patients were performed during first two weeks. In some observations a combined and multi-staged surgical treatment was applied. Positive dynamics was obtained in 75 (61.9%) patients, including 59 (48.8%) patients with good functional result (degrees of disability 1 - 2 in accordance to Renkin modified scale). In 23 (19%) patients the result was unfavorable (degrees of disability 4-5), and 23 (19%) patients died.
Conclusion. A timely necessity have evolved for elaboration of the unified classification of complications for complications of aneurysmal intracranial hemorrhage, as well as studying of efficacy of various surgical methods of treatment and determination of the method selection criteria and the terms of the intervention performance depending on the intracranial hemorrhage type present.
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