Timing of surgery for intracerebral hematomas due to aneurysm rupture.
Timing of surgery for intracerebral hematomas due to aneurysm rupture.
复制标题
动脉瘤破裂导致脑内血肿的手术时机。
DOI：
10.3171/jns.1983.58.4.0476
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发表时间：
1983
影响因子：
4.1
通讯作者：
D. M
中科院分区：
文献类型：
--
作者：
B. Wheelock;B. Weir;Reginald Watts;G. Mohr;Moe Khan;Michael Hunter;D. Fewer;G. Ferguson;F. Durity;D. Cochrane;B. Benoit;D. M
由动脉瘤破裂引起的✓脑内血肿并不罕见，现在可以通过计算机断层扫描轻松而准确地诊断出来。作者从11个医学中心收集了132个这样的病例。在这些患者中，38%的人在出院前死亡。78%的患者在动脉瘤破裂后第0天或第1天住进神经外科；其中15%的患者未手术死亡，28%的患者手术后死亡，57%的患者手术后存活。患有高血压、神经学评分较差、有脑疝迹象或有较大血栓的患者死亡率会增加。如果患者活过了最初的几天，并且没有脑突出，手术的时机并不是很重要，尽管早期手术的发病率有降低的趋势。这是真的，尽管早期的手术是在最初病情较重的患者组上进行的。脑缺血恶化和...
✓ Intracerebral hematomas (ICH) from aneurysm rupture are not rare and can now be diagnosed easily and accurately by computerized tomography. The authors have collected 132 such cases from 11 medical centers. Of these patients, 38% died prior to discharge from the hospital. Seventy-eight percent of cases were admitted to the neurosurgical services on Day 0 or 1 after rupture of the aneurysm; of these patients, 15% died without surgery, 28% had surgery and died postoperatively, and 57% were operated on and survived. Mortality rates were increased in patients who were hypertensive, had poor neurological grades, showed evidence of brain herniation, or had larger clots. If the patient lived beyond the first few days and did not have brain herniation, the timing of surgery was not of great consequence, although there was a tendency toward lower morbidity in earlier surgery. This was true despite the fact that earlier operations were carried out on an initially sicker group of patients. Ischemic deterioration a...