caa a22 4500 477106552 CHVBK 20180405111555.0 cr unu---uuuuu 170330e19960101xx s 000 0 eng 10.1007/BF01411717 doi (NATIONALLICENCE)springer-10.1007/BF01411717 Study on early re-rupture of intracranial aneurysms [Elektronische Daten] [N. Aoyagi, I. Hayakawa] Summary: The prognosis of patients with early re-ruptured intracranial aneurysms is discouraging. We compared the data on patients suffering re-rupture before the onset of late vasospasm (Early-Re) with those suffering rebleeding thereafter (Late-Re). The operability in the Early-Re group was lower (p < 0.05) and the outcome less satisfactory than that of Late-Re group. Of the Early-Re patients, 83% had a re-rupture within 24 hours of the initial subarachnoid haemorrhage; moreover 46% of these experienced rebleeding within three hours of the initial bleeding. Cases in the Early-Re group tended to belong to Hunt-Hess grade III or IV on admission, of wide spread subarachnoid haemorrhage on CT and of "bump” type aneurysms on angiograms. Based on our experience we propose that early re-rupture may be attributable to the following factors: a gradual and progressive thinning of the wall of bump type aneurysms results in such a large laceration through the fundus of the aneurysm. Re-rupture may occur within a short period after the first rupture because the fibrin net covering the wide laceration cannot tolerate the slight increase in internal pressure within the aneurysmal dome. Therefore, in the patients of Hunt-Hess grade III or IV, conventional angiography, tight holding during CT examination and lumbar puncture, should be avoided during the first three hours after the first bleed. Although early direct operations on patients with high Hunt-Hess grades tend to produce an unsatisfactory outcome, we cannot help these patients with Early-Re without surgical treatment. Not only early direct operation but also first conservative treatment to control systolic blood pressure are very important in patients with Early-Re. Springer-Verlag, 1996 Early re-rupture nationallicence early surgery nationallicence intracranial aneurysm nationallicence Aoyagi N. Department of Neurosurgery, Tokyo Metropolitan Bukuto General Hospital and Tokyo Metropolitan Komagome General Hospital, Tokyo, Japan aut Hayakawa I. Department of Neurosurgery, Tokyo Metropolitan Bukuto General Hospital and Tokyo Metropolitan Komagome General Hospital, Tokyo, Japan aut Acta Neurochirurgica Springer-Verlag 138/1(1996-01-01), 12-18 0001-6268 138:1<12 1996 138 701 https://doi.org/10.1007/BF01411717 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01411717 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Aoyagi N. Department of Neurosurgery, Tokyo Metropolitan Bukuto General Hospital and Tokyo Metropolitan Komagome General Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Hayakawa I. Department of Neurosurgery, Tokyo Metropolitan Bukuto General Hospital and Tokyo Metropolitan Komagome General Hospital, Tokyo, Japan aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/1(1996-01-01), 12-18 0001-6268 138:1<12 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer