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Ruptured intracranial aneurysms: has the incidence of early rebleeding been over-estimated?

Authors
Journal
Journal of Neurology Neurosurgery & Psychiatry
0022-3050
Publisher
BMJ
Publication Date
Keywords
  • Research Article
Disciplines
  • Medicine

Abstract

Of 110 consecutive patients with ruptured intracranial aneurysms, 49 underwent delayed neurological deterioration, involving 57 episodes in all. During the first three weeks after the presenting haemorrhage less than a third of these episodes were due to confirmed rebleeding. Rebleeding episodes were found to have a "flat" distribution in time during this period, but episodes of non-haemorrhagic deterioration "peaked" between days 4-12. This peak coincides with the peak for rebleeding which was described in earlier studies on aneurysms, and it is suggested that confusion between non-haemorrhagic deterioration and rebleeding may have led to a significant over-estimate of the incidence of early rebleeding with important implications for the optimum timing of surgical intervention. Images

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