Management and surgical treatment of ruptured intracranial aneurysms.

The advantages, methods and results of surgical intracranial obliteration of aneurysms in conjunction with the use of intracranial or neck ligation of arteries were studied in 177 patients made up of the following groups: (a) internal carotid aneurysms-48, (b) anterior cerebral-anterior communicating-37, (c) middle cerebral-20, (b) basilar-two, (e) posterior cerebral-one. The overall mortality rate was 23%. Following conservative treatment, 69 patients with subarachnoid hemorrhage without demonstrated aneurysms had a mortality rate of 30%. In this seven-year study the value of team work involving a second neurosurgeon, well-trained nursing personnel and expert anesthetists was amply demonstrated.