Abstract
An analysis was made on 110 cases of no-direct operation for subarachnoid hemorrhage for comparison with 255 cases of direct operation for subarachnoid hemorrhage. In this study, analysis of the cases was made by incidence, sex, clinical grade on admission, neuroradiological findings, reasons for no-direct operation, outcome at 6 months after initial subarachnoid hemorrhage, cause of death, and long term follow-up results. No-direct operation cases were classified into the following three age groups, that is, Group A less than 60 of age, Group B 60-69 of age, and Group C 70 and over of age, for analysis by the foregoing parameters.
The mean age of the no-direct operation group was 62.9 years and that of the direct operation group was 57.2 years with the age being higher in the no-direct operation group. Clinical grades IV and V accounted for 58% of the no-direct operation group and for 15% of the direct operation group with the clinical conditions being poorer in the no-direct operation group. The subarachnoid clot volume and the incidence of subarachnoid hemorrhage associated with intracerebral hematoma were greater on computerized tomography in the no-direct operation group than in the direct operation group. The most predominant reason for no-direct operation was poor clinical condition on admission, followed by rebleeding and complications. Outcome at 6 months after initial subarachnoid hemorrhage showed a mortality rate of 77% in the no-direct operation group, indicating a very poor prognosis. However, of the 14 cases of no-direct operation due to unknown etiology, 13 cases were able to resume a normal life, showing a favorable prognosis for these cases.
