consecutive series of fifty-six patients with ruptured aneurysms were operated upon within 24 to 72 hours after subarachnoid hemorrhage (SAH). All operations were performed by the author.
;The clinical grading (Hunt and Hess) was I to II in 21, III in 11 and N to V in 24. In 24 pai6ent the internal carotid complex and in 18 it arose from the middle cerebral artery. The SAH as determined by computerized tomography was minor in 14, moderate in 5 and severe in 24. 15 patients habored intracranial hematomas (subdural, intracerebral or intraventricular hematoma). Of the patients preoperatively grade I or II, 86% had good neurological recovery, of the grade W patients good neurological recovery and of grade lV V 75% had died. The mortality of the grade I -II patients operated upon within 24 hours, 2448 hour and 72 hours were 11.1 %, nil , and. 133 % respectively. These results suggest that acute _surgical repair of the ruptured cerebral aneurysms within 3 day of the ruptures in the grade i to M, is useful in preventing recurrence of hemorrhage and vasospasm through the removal of the subarachnoid clot.
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