Acute surgery of cerebral aneurysms and prevention of symptomatic vasospasm

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Abstract
A treatment protocol for a controlled open study in patients with subarachnoid haemorrhage (SAH) from cerebral aneurysms is presented, applying acute surgery and pharmacological prevention of symptomatic vasospasm: In patients clinically graded I–III (Hunt and Hess), operation is performed within 48 to 72 hours. After aneurysm clipping, the calcium-antagonist Nimodipine is administered 1. topically during operation, 2. intravenously until day 14 after SAH, 3. perorally until day 21 after SAH. Preliminary results in the first 31 patients show no management mortality and no severe management morbidity. Severe symptomatic vasospasm has never occurred. At 3 months follow-up investigation in 27 of the 31 patients, 5 had minimal neurological deficit; all patients are fully resocialized, working in their previous professions.