Variation In Intracranial Pressue And Outcomes Between Early And Delayed Surgery In Severe Aneurysmal Subarachnoid Hemorrhage

Objective:There is no reliable evidence formulating the optimal timing of surgery for severe aneurysmal subarachnoid.This study aim to retrospectively evaluate in intracranial pressure and outcomes between early and delayed surgery groups.Method: Severe aneurysmal subarachnoid was defined as a Hunt-Hess scale of Ⅲ,ⅣorⅤupon admission.Seventy-three patients meeting the inclusion criteria were assigned into two treatment groups.The early surgery group received operation within 72 hours of ictus,and the non-early surgery group received operation after 72 hours of ictus.Intracranial press monitor was placed during surgery.Outcomes were assessed by modified Rankin score at discharge and 3months after ictus.Results: Of the 73 patients included in the study, 49(67%)underwent early surgery and 24(33%)underwent non-early surgery. Postoperative complications and length of hospital stay did not differ. Postoperative intracranial press in 3 days did not differ.During 4 to 7 days, there is a statistically significant difference.Early surgery group is higher than the other group.However outcomes were similar between the 2 groups.Conclusions:1. In Severe Aneurysmal Subarachnoid, although from the 4th to 7th days,Postoperative intracranial press of early surgery group is more refractory to manage,and high intracranial press will last longer. 2. There was no significant difference between early surgery group and non-early surgery.