Extensive evacuation of subarachnoid clot for prevention of vasospasm--effective or not?

The effect of subarachnoid haematoma (clot) evacuation for the prevention of vasospasm (VS) in the acute state was studied using 62 ruptured IC and MC aneurysm cases. Extensive clot evacuation within 48 hours after the onset did not prevent the development of VS but reduced the severity of VS, especially in the main trunks of the cerebral arteries (IC, M1, M2, A1). But excessive clot evaluation applied to the angry, swollen brain in the acute stage worsened the brain swelling and sometimes formed an intracerebral haematoma due to brain compression. The extent of the clot evacuation should be determined by preoperative CT findings and the brain's condition during the operation.