Jian-Qing He1, Jun-Hui Chen2, Jun Zhu1, Lei Chen1, Chun-Lei Zhang1, Li-Kun Yang1, Yu-Hai Wang1, Jun Zou3, Xu Hu1. 1. Department of Neurosurgery, 101 Hospital of PLA Wuxi 214044, China. 2. Department of Neurosurgery, Wuxi Clinical Medical School, Anhui Medical University, 101 Hospital of PLA Wuxi 214044, China. 3. Department of Otolaryngological, 92 Hospital of PLA Nanping 353000, China.
Abstract
OBJECTIVE: To explore the clinical effects of ultra-early microsurgery (< 24 hours) combined with extraventricular drainage for the treatment of poor-grade aneurysms. METHODS: A total of 60 patients with poor-grade aneurysms were randomly divided into a microsurgery combined with extraventricular drainage (MED) group and conventional microsurgery (M) group. The prognosis was comparatively studied for these 2 groups. RESULTS: All patients underwent a Glasgow Outcome Scale (GOS) assessment during a 6-month to 2-year follow-up. The excellent recovery (GOS, 4-5 points) rate for the MED group was 30% higher than that of the M group, while the poor recovery (GOS, 1-2 points) rate was 26.7% lower than that of the M group (P = 0.016). The incidence of acute brain swelling (26.7% vs 53.3%; P = 0.035), cerebral infarction (20% vs 46.7%; P = 0.025), and vasospasm (16.7% vs 40%; P = 0.045) for the MED group was significantly lower than that of the M group. CONCLUSIONS: For microsurgery combined with extraventricular drainage, the risk of cerebral infarction and vasospasm were significantly reduced for patients with poor-grade aneurysms, and the prognosis was better.
RCT Entities:
OBJECTIVE: To explore the clinical effects of ultra-early microsurgery (< 24 hours) combined with extraventricular drainage for the treatment of poor-grade aneurysms. METHODS: A total of 60 patients with poor-grade aneurysms were randomly divided into a microsurgery combined with extraventricular drainage (MED) group and conventional microsurgery (M) group. The prognosis was comparatively studied for these 2 groups. RESULTS: All patients underwent a Glasgow Outcome Scale (GOS) assessment during a 6-month to 2-year follow-up. The excellent recovery (GOS, 4-5 points) rate for the MED group was 30% higher than that of the M group, while the poor recovery (GOS, 1-2 points) rate was 26.7% lower than that of the M group (P = 0.016). The incidence of acute brain swelling (26.7% vs 53.3%; P = 0.035), cerebral infarction (20% vs 46.7%; P = 0.025), and vasospasm (16.7% vs 40%; P = 0.045) for the MED group was significantly lower than that of the M group. CONCLUSIONS: For microsurgery combined with extraventricular drainage, the risk of cerebral infarction and vasospasm were significantly reduced for patients with poor-grade aneurysms, and the prognosis was better.
Authors: D J Nieuwkamp; K de Gans; A Algra; K W Albrecht; S Boomstra; P J A M Brouwers; R J M Groen; J D M Metzemaekers; P C G Nijssen; Y B W E M Roos; C A F Tulleken; W P Vandertop; J van Gijn; P E Vos; G J E Rinkel Journal: Acta Neurochir (Wien) Date: 2005-06-16 Impact factor: 2.216
Authors: Andrew J Molyneux; Richard S C Kerr; Ly-Mee Yu; Mike Clarke; Mary Sneade; Julia A Yarnold; Peter Sandercock Journal: Lancet Date: 2005 Sep 3-9 Impact factor: 79.321