抄録
Over the past six years we have treated 35 patients with ruptured posterior fossa aneurysms in the acute stage. Thirty-three of the 35 were operated on within four days after the last subarachnoid hemorrhage. Twenty-two patients were operated on within 24 hours. The six month follow-up outcome is excellent in 22 cases, good in four cases and seven patients died. We consider these results favorable (excellent or good) in 79% and unfavorable (poor or dead) in 21%. Compared with our 100 consecutive cases of patients with ruptured anterior aneurysms operated on in the acute stage, we have reached the following conclusions: 1. Early operation for ruptured posterior aneurysms may be more effective in improving the overall management outcome because these aneurysms tend to rebleed more easily during the first 24 hours after the initial SAH and the incident of symptomatic vasospasm is lower than in anterior aneurysms. 2. With recent advances in neurosurgical technique, these small aneurysms (<12mm) can be operated on safely as soon as possible after hemorrhage without specific regard to preoperative grade. But for large aneurysms, or aneurysms in older patients, operation should be performed at least 2-3 days after the hemorrhage.
