Early operations for ruptured intracranial aneurysms. Comparative study with computed tomography.

The authors have analyzed the correlation between the results of early operation for ruptured intracranial aneurysms (45 cases) and CT scan (54 cases) performed within the second week after subarachnoid haemorrhage (SAH). There was a good correlation between the results of early operation within one week after the haemorrhage and CT findings. Surgical results were closely correlated to the incidence of vasospasm in our cases. All cases with symptomatic vasospasm showed bilateral high density in the cistern or ventricles on CT scan performed within three days after initial bleeding. For the cases within 24 hours after haemorrhage, surgical operation is recommended as early as possible, including removal of blood clots in the basal cistern and Sylvian fissure, and ventriculo-cisternal drainage for improvement of cerebrospinal fluid (CSF) circulation. On the other hand, the cases in which operations were performed during the second to seventh days and where CT scan revealed bilateral high density in the cistern or ventricles resulted in poor outcome or death.