Abstract
Two hundred and two patients with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms admitted to our clinic, of which 40 cases were observed without radical operations, and were investigated in this paper. Average age of this group was older than other group significantly. In the cases of over 70 years old, radical operation should be indicated properly. Aneurysms of vertebro-basilar system were found in 7 cases (15%). Vertebro-basilar aneurysms were not operated during acute stage, because many perforating arteries around basilar top aneurysm cannot be identified in the dense suba-rachnoid clot. However vertebral aneurysms, which do not have important perforating arteies around itself, will be operated during acute stage in the future.
In patients who were transfered to our clinic within 24 hours after the onset of the disease, several cases with no operative indication showed sevee CT grade, intracerebral hematomas and/or subdural hematomas. But in patients who were transfered over 24 hours after the onset of the disease, some cases were not indicated for the operation because of angiospasm on angiogram, though they showed mild SAH in CT scan or the patients were in good level of consciousness.
All patients of ruptured intracranial aneurysms should be transfered to the clinics in which neurosurgeons are available on full-time basis
