Abstract
A score table has been derived from 138 cases of intracranial aneurysm whereby the timing of the operation can be determined in each patient. Among the factors that were considered to influence on the fatal rebleeding, sex, age, location of aneurysm, frequency of the episode of bleeding (static factors), cerebrospinal fluid pressure, level of consciousness, angiospasm, angiographical signs of hematoma, and blood pressure (dynamic factors) were compared between non rebleeding group and rebleeding group in 48 cases of ruptured intracranial aneurysm which were transferred to our service within 2 weeks after the recent episode of bleeding.
We evaluate the state of each patient according to the score table. A patient calculated the total score more than 13 is presumed to rebleed within 1 to 5 days following admission, on the other hand, a patient calculated the total score less than 9 is expected little chance of rebleeding under careful management. The former should be operated as soon as possible and the latter could be operated after improving the unfavourable factors. The case calculated between 10 and 12 should be observed carefully on dynamic factor (blood pressure, etc.) until the patient was classified the former or the latter. The validity of the score table has been demonstrated in illustrated cases. This is a preliminary study and further evaluation with a larger series will be required to validate this socre table.
