The Natural History of Patients with Intracranial Aneurysm after Rupture

Abstract

Publisher Summary One must firstly consider the implications of the title of this paper: Natural History. Consider this as the result of treatment by strict bed rest together with other supportive measures, but, excluding any therapy more specifically designed to reduce the risk of further haemorrhage. Unless otherwise stated the results are those measured six months after the presenting ictus. Of Patients: The data concerns patients in a trial in progress since 1958 in which treatment is randomly allocated. Excluded from this trial were patients with life threatening haematomas, inoperable lesions, or who died before angiography. With Aneurysms: All cases had aneurysms proven by angiography. In some cases of multiple aneurysms it was not possible either radiologically or clinically to be certain as to which lesion had ruptured. These patients were only included if the lesions could be treated by a single surgical procedure, either common carotid ligation or intracranial operation. After Rupture: All patients suffered subarachnoid haemorrhages within the eight weeks preceding admission as evidenced by clinical features and L. P. findings. The majority of patients were in fact admitted within 48 hours of the ictus. Patients suffering haemorrhage from an aneurysm are a heterogeneous group, so for any comparative purpose, one must introduce prognostic factors. Of these the most important is conscious level.