Ultra-early surgery for severe intracranial aneurismal hemorrhage

Objective To discuss the possibility and therapeutic effect of ultra-early surgery for grade IV～V intraeranial aneurysms scored by Hunt-Hess grading system.Methods Thirteen cases suffered from intracranial aneurysms determined by 3D-CTA were treated by ultra-early surgery under general anesthesia within 24 hours(5 casses were treated within 6 hours and 8 Cases in 6-24 hours).Preoperative Hunt-Hess grade:10 cases were grade IV and 3 cases were grade V.The therapeutic effects were evaluated by Glasgow Outcome Score(COS).Results In operation,difficult dissection occurred in 6 cases,rupture of aneurysm occurred and temporary obstructions were performed in 4 Cases.After the clipping of aneurysms,there wei-e 3 cases underwent V-P shunt because of hydrocephalus,3 cases of pulmonary infection,2 cases of hypothalamus reaelion accompanied with hemorrhage in upper digestive tract and 1 case of frontal infarction.The therapeutic effects were good in 6 cases,worse in 5 cases,dead in 2 cases.Conclusions IThe ultra-early surgery could avoid early re-bleeding of intraeranial aneurysm and is suitable for intracranial aneurysrm of Hunl-Hess grade IV-V.The application of 3D-CTA could make it possible for using ultra-early surgery,and improve the therapeutic effect. Key words: Intracranial alleutysim;  Ultra-early;  Surgery