Intracranial aneurysm with subarachnoid haemorrhage. Surgical results and long-term outcome in 100 cases.

The surgical results and long-term outcome in 100 consecutive cases of intracranial aneurysm with a subarachnoid haemorrhage are described. According to the modified Botterell classification of neurological status, 33 patients fell into grade I, 56 into grade II and 11 into grade III at the time of surgery. There were no deaths associated with the surgical procedure. Two patients were worse off immediately after the operation and 4 others developed delayed ischaemic deficits postoperatively owing to cerebrovascular spasm. Four of these 6 patients made a good recovery but the others remained in a vegetative state. One other patient died from a pulmonary embolism on the 9th postoperative day. A group of patients who had grade IV neurological status at some stage before the operation all tolerated surgery well once their condition had stabilized, and stood an even chance of making a full functional recovery by 3-6 months.