COOPERATIVE STUDY OF INTRACRANIAL ANEURYSMS AND SUBARACHNOID HEMORRHAGE Report on a Randomized Treatment Study

Graf, Carl J.; Nibbelink, Donald W.

doi:10.1161/01.str.5.4.557

Cited by 123 publications

(39 citation statements)

References 8 publications

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“…1,2 The American Heart Association (AHA) previously published "Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage." 3 Since then, considerable advances have been made in endovascular techniques, diagnostic methods, and surgical and perioperative management paradigms.…”

mentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Bederson¹,

Connolly²,

Batjer³

et al. 2009

Stroke

1,163

488

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mentioning

confidence: 99%

Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage

Bederson¹,

Connolly²,

Batjer³

et al. 2009

Stroke

1,163

488

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“…[3][4][5][6][7][8][9][10]21,41 The evidence for securing ruptured aneurysms with neurosurgical clipping or endovascular coiling to prevent rebleeding is sound, and there is evidence from the International Subarachnoid Hemorrhage Trial that endovascular coiling is the preferred method when both techniques are equally suited. 21,[31][32][33][34][42][43][44][45][46][47] Logically, therefore, it follows that securing the aneurysm with endovascular coiling or neurosurgical clipping in the for the ultra-early (coiling within 24 hours of SAH) and not ultra-early (coiling at Ͼ24 hours post-SAH) groups. The "outcome shift" toward better outcomes in the ultra-early group is statistically significant (Pϭ0.001) when tested with the Mantel-Haenszel test for linear association.…”

Section: Discussionmentioning

confidence: 99%

Does Treatment of Ruptured Intracranial Aneurysms Within 24 Hours Improve Clinical Outcome?

Phillips

Dowling

Yan

et al. 2011

Stroke

139

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Background and Purpose-The purpose of this study was to analyze whether treating ruptured intracranial aneurysms within 24 hours of subarachnoid hemorrhage improves clinical outcome. Methods-An 11-year database of consecutive ruptured intracranial aneurysms treated with endovascular coiling or craniotomy and clipping was analyzed. Outcome was measured by the modified Rankin Scale at 6 months. Our policy is to treat all cases within 24 hours of subarachnoid hemorrhage. Treatment delays are due to nonclinical logistical factors. Results-Two hundred thirty cases were coiled or clipped within 24 hours of subarachnoid hemorrhage and 229 at Ͼ24 hours.No difference in age, gender, smoking, family history of subarachnoid hemorrhage, aneurysm size, or aneurysm location was found between the groups. Poor World Federation of Neurological Surgeons clinical grade patients were overrepresented in the ultra-early group. Increasing age and higher World Federation of Neurological Surgeons clinical grade were predictors of poor outcome. Eight point zero percent of cases treated within 24 hours of subarachnoid hemorrhage (ultra-early) were dependent or dead at 6 months compared with 14.4% of those treated at Ͼ24 hours (delayed), a 44.0% relative risk reduction and a 6.4% absolute risk reduction (

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“…As many as 30,000 of North Americans suffer from SAH annually, accounting for 5 to 10 % of all stroke cases [1][2][3]. The mortality rate for SAH approaches 45 % at 30 days, and 10 to 15 % of cases are fatal before hospitalization [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%