Retrospective analysis of 162 consecutive cases of ruptured intracranial aneurysms. Total mortality and early surgery.

A retrospective analysis of 162 consecutive cases with ruptured intracranial aneurysm treated during the years 1979-1981 is presented. Total mortality was 33%. Eighty-four patients were in Botterell grades I-II and 62 were operated with a direct attack on the aneurysm. Thirty-eight were operated early with a mortality of 5% compared with 13% for those operated late. There was no difference in morbidity between the two groups. Of the patients operated with clipping, 66% made a "complete recovery" and 21% were classified as independent. Signs of delayed ischaemia were recorded in 42% of patients operated early as compared with 25% in the late surgery group. The frequency of rebleedings in the total material was 15%. Hospitalization time was significantly reduced in the early operated group. The importance of analysing the total management mortality and morbidity for evaluation and comparison between early and delayed surgery is discussed.