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Evaluation of dead cases of ruptured intracranial aneurysms with special reference to a comparison between patients with early operations and unoperated cases.

The authors have analysed dead cases of ruptured intracranial aneurysms. This analysis included 270 patients with ruptured intracranial aneurysms, admitted to Mito National Hospital over an 8 yr period. Of the 98 patients who had surgery within 48 h after SAH, 17 cases died (mortality rate 17.3%); 7 deaths were due to massive haemorrhage, 5 due to vasospasm and 5 to other causes. Analysis of the causes of death in the non-surgical group (62 cases) disclosed that massive haemorrhage was the most common (29 cases), followed by rerupture after admission (14 cases), vasospasm (7 cases) and miscellaneous cases (5 cases). The possibility of improving the mortality rate in the early surgical group and the non-surgical group is discussed.