Abstract
Whether to treat bleeding aneurysms surgically or by endovascular occlusion is a frequent subject of debate between neurosurgeons and radiologists. The aim was to take a general position on when to apply which method through the overview of the results that have been achieved so far. However, each patient must be seen as an individual in order for the right decision to be made. A prospective study of 336 patients who were treated at the Clinic of Neurosurgery in Nis for a ruptured aneurysm in the period between January 2007 and December 2010 has been conducted. Hunt-Hess grading system was used and the patients who were treated were those with grade I, II and III. Out of 336 bleeding aneurysms, embolization was used to treat 154 of them, whereas 282 patients underwent operative treatment. Embolization was a method of choice when dealing with aneurysms in the basilar flow, as well as in the initial segment of the carotid flow. Better results were obtained in patients treated, either surgically or endovascularly, 72 hours after the bleeding.
Highlights
A sudden headache followed by nausea and vomiting is usually caused by subarachnoid hemorrhage (SAH) caused by aneurysm rupture on the blood vessels of the brain
It was found that the aneurysms on the carotid artery and the basilar artery were embolized significantly more often than operated on (χ2 = 52.927; p < 0.001 and χ2 = 61.405; p < 0.001, respectively) (Table 1)
There was a significant difference in patient gradation according to the Hunt-Hesse scale relative to the method of treatment of an aneurysm (χ2 = 13.51; p < 0.001)
Summary
A sudden headache followed by nausea and vomiting is usually caused by subarachnoid hemorrhage (SAH) caused by aneurysm rupture on the blood vessels of the brain. Intracranial aneurysms represent localized extensions of structurally altered walls of blood vessels of the brain that, with their rupture, lead to blood flowing into the subarachnoidal area. It may be accompanied by minor hemorrhage "warning laic" or severe intracranial hemorrhage, which is accompanied by loss of conscience and neurological deficits. The defini tive confirmation of the presence of an aneurysmal change in the blood vessels of the brain is made by a CT-angio, MR-angio scan and digital subtraction angiography.
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