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Journal of Korean Neurosurgical Society 1994;23(10): 1150-1156.
Surgery of Cerebral Aneurysms in Comatose Patients.
Hae Kon Choi, Han Kyu Kim, Yong Soon Hwang, Jae Gon Moon, Hwa Dong Lee
Department of Neurosurgery, Kosin University, Pusan, Korea.
ABSTRACT
Neurological grade on admission is an important prognostic factor for aneurysmal patients. The decision for operation in comatose patients with ruptured aneurysm is difficult and remains controversial. Recent literatures tend to emphasize the benefit of operative treatment for these patients because of the higher mortality of the patients who were managed conservatively. We performed early surgery in ten comatose aneurysmal patients combining lumbar drainage, intravenous and cisternal nimodipine therapy, and intermittent brain retraction. Among these ten patients, four showed survival over three months. We suggest that early surgery with aggressive postoperative management should be considered in comatose aneurysmal rupture patients for life-saving.
Key Words: Aneurysms; Comatose patient; Early surgery; Clinical outcome; Prognostic
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