caa a22 4500 477107044 CHVBK 20180405111556.0 cr unu---uuuuu 170330e19960901xx s 000 0 eng 10.1007/BF01412307 doi (NATIONALLICENCE)springer-10.1007/BF01412307 Early aneurysm surgery and dehydration therapy in patients with severe subarachnoid haemorrhage without ICH [Elektronische Daten] [S. Oda, M. Shimoda, O. Sato] Summary: We prospectively analysed treatment results in patients with severe subarachnoid haemorrhage (SAH) who underwent early aneurysm surgery, and were managed by dehydration therapy. We studied a total of 31 patients with poor-grade SAH including 18 in grade IV, and 13 in grade V according to the WFNS classification system. Patients who were older than 70 years of age, or those with an intracerebral haemorrhage or absent brainstem response were excluded from this study. At surgery, clot evacuation from the peribrainstem cisterns with/without external decompression was performed following obliteration of the aneurysmal neck. In the early postoperative period, patients were maintained in negative water balance using osmotic diuretics. When delayed ischaemic deficits had manifested themselves, the pulmonary wedge pressure and/or central venous pressure was immediately increased by the rapid injection of albumin until hypovolaemia reverted to normovolaemia with the continuous administration of dobutamine. The outcome at 3 months was good recovery in 16 (52%) patients, moderate disability in 3 (10%), severe disability in 5 (16%), a vegetative state in 1 (3%), and death in 6 (19%). We thought that early aneurysm surgery and postoperative dehydration therapy in the acute stages of brain oedema resulting from primary brain damage are effective in the treatment of patients with severe SAH but reversilbe primary brain damage. Springer-Verlag, 1996 Dehydration therapy nationallicence early surgery nationallicence patients management nationallicence severe subarachnoid haemorrhage nationallicence vasospasm nationallicence Oda S. Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan aut Shimoda M. Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan aut Sato O. Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan aut Acta Neurochirurgica Springer-Verlag 138/9(1996-09-01), 1050-1056 0001-6268 138:9<1050 1996 138 701 https://doi.org/10.1007/BF01412307 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01412307 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Oda S. Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Shimoda M. Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 700 1- Sato O. Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/9(1996-09-01), 1050-1056 0001-6268 138:9<1050 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer