Skip to main content
  • Aneurysm treatment within 24 hours improves outcome in aneurysmal subarachnoid hemorrhage patients.

    Final Number:

    George KC Wong MD; Wai Sang Poon FRCS

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: : The timing of definitive aneurysm treatment (coiling or clipping) in acute aneurysm subarachnoid hemorrhage (aSAH) was a subject of controversy. Most vascular neurosurgeons agreed on early aneurysm treatment (within the first 72 hours). However, though practiced in some neurosurgical centers, whether ultra-early aneurysm treatment (within the first 24 hours) was beneficial remained debatable. We aimed to investigate whether ultra-early aneurysm treatment is associated with better outcome.

    Methods: Two-hundred and seventy-six (84%) patients had hemorrhage onset time and aneurysm treatment time available for analysis. P-values less than 0.05 were taken as statistically significant and P-values between 0.05 and 0.10 were considered to be a trend.

    Results: Ultra-early aneurysm treatment was associated with significantly better neurological outcome in mRS (mRS 0-1: OR 1.9 [95%CI 1.1 to 3.4], p=0.020), adjusted for age and admission WFNS grade. A reduction in clinical rebleeding was observed in poor grade patients undergoing ultra-early aneurysm treatment (9% vs 18%, p=0.159).

    Conclusions: Aneurysm treatment performed within the 24-hour window may be associated with better outcome and halved the clinical rebleeding risk in poor grade patients.

    Patient Care: The benefit of ultra-early aneurysm treatment should induce adequate resource allocation for provision of expert aneurysm treatment (embolization and clipping) in all neurosurgical centers.

    Learning Objectives: Aneurysm treatment as soon as feasible is beneficial to aneurysmal subarachnoid hemorrhage.

    References: Ultra-Early (within 24 Hours) Aneurysm Treatment After Subarachnoid Hemorrhage. Wong GK, Boet R, Ng SC, Chan M, Gin T, Zee B, Poon WS. World Neurosurg. 2011 Nov 1. [Epub ahead of print]

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy