Clinical Analysis of Aneurysmal Subarachnoid Hemorrhage Patients with Vasospasm on Admission

Abstract

Objective: The purpose of this preliminary study is to evaluate the influence of the treatment time(early surgery versus delay surgery) on outcome in a series of 14 patients with the aneurysmal subarachnoid hemorrhage presenting clinical and angiographic vasospasm on admission. Methods: The authors have reviewed retrospectively the clinical characteristics of 14 patients presenting vasospasm at admission among 430 patients admitted from January 1998 to December 2001. The patients were divided into two groups based on their preoperative time : in 7 days (early treated group) : over 7 days from the hemorrhage(delayed treated group). Results: There were no clinical differences between the two groups in age and sex distribution, preoperative Hunt-Hess scale and Fisher grade except anterior communicating artery aneurysm predominance in delayed treated group. The early treated group had a better outcome than the delayed treated group by Glasgow Outcome Scale(p<0.05) : 6 good recovery in early treated group(100%, n=6) versus 3 good recovery, 3 moderate Disability, 1 severe disability and 1 death in delayed treated group(n=8). The latter group had high complication rates such as a hemiparesis, meningitis and hydrocephalus(n=6, 78%) Conclusion: The early treated group has a good outcome in spite of vasospasm period by early medical treatment for vasospasm. The authors suggest that active early treatment regardless of vasospasm would be one of the treatment choice which contribute to improve the clinical result for subarachnoid hemorrhage presenting vasospasm.