CONSIDERABLE diversity of opinion exists concerning the management of subarachnoid hemorrhage and of its principal cause, ruptured intracranial aneurysms. Moreover, that the controversy transcends disciplinary boundaries is illustrated by the conclusions of McKissock et al. ~-35 that"the untreated appear to fare as well as those operated upon" and that "there can be no proof of the value of surgical treatment in this condition. ''3a Benson ~ concluded that if those patients who terminate fatally in the early danger period are excluded, "conservatively treated aneurysms and surgically treated aneurysms have nearly the same prognosis." Yet many reports 1,1~176 have emphasized the poor outlook offered by conservative management, and the advocates of surgical therapy are many. 5,9,14Ag,2a,25,31,as,42,45' 5~ Among the proponents of surgical therapy, however, the relative merits of different therapeutic approaches are contested. Direct attack, 39,42,52 as in clipping 9 or reinforcement 5~ of the lesion, is recommended by some, while others prefer indirect measures, 2,6,s,~6,2s,29,46 such as ligation of the carotid artery in the neck or "trapping" procedures. The timing of surgical intervention also evokes controversy. 12Ag,22,3~ Norl~n and Olivecrona 39 concluded that direct attack upon the lesion or ligation of the carotid artery in the neck was extremely dangerous during the acute phase of the illness and advised delay of surgical intervention until after the third week of the acute illness; Pool 42 recommended that direct surgical attack should be carried out between the 7th and 9th day after the initial hemor
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.