| چکیده انگلیسی مقاله |
Introduction: Surgical intervention is a routine treatment in patients with Subarachnoid Hemorrhage (SAH). However influence of aneurysm surgery in the developing counties may be different than developed countries. Decision for surgical intervention in patients with Intracerebral Hemorrhage (ICH) is a subject of controversy. Methods and materials: Consecutive patients with SAH or ICH admitted in Ghaem hospital, Mashhad during 2005-2009 enrolled in a prospective clinical study. Diagnosis and work up of SAH and ICH was performed by neurologists. Decision for performing aneurysm surgery and evacuation of hematoma was made by neurosurgeons. All of the SAH or ICH patients received a standard conservative medical management. Frequency of complications and mortality was compared in medical and surgical groups of SAH patients. Results: 120 SAH patients (52% females) with mean age of 50.6±7 years were evaluated and 46.6% of them underwent aneurysm surgery. The effect of therapeutic type on mortality of SAH patients was not significant; X2=1.8, df=1, p=0.17. Difference in frequency of rebleeding in two therapeutic groups of our patients was not significant; X2=0.37, df=1, p=0.54. The influence of rebleeding in mortality of our patients was significant; X2=4.50, df=1, p=0.048. 193 ICH patients (52% females) with mean age of 61±3 years enrolled the study and 62.7% of them underwent surgery. Frequency of mortality was not significantly different in two therapeutic groups of ICH patients; X2=2.34, df=1, p=0.126. The influence of surgery on mortality of the ICH patients was not significant in lobar, putaminal, cerebellar and thalamic subtypes of our patients (X2=0.16, df=1, p=0.77), (X2=2.34, df=1, p=0.126), (X2=0.01, df=1, p=1) and (X2=3.09, df=1, p=0.08) respectively. Conclusion: Influence of aneurysm surgery in frequency of death is not significant in Iranian patients with SAH which could be due to delay in performance of surgery in Iranian neurovascular centers. Influence of surgery in frequency of death is not significant in our patients with ICH. Surgical intervention is not usefull in patients with lobar, putaminal and cerebellar hemorrhage and may be harmful in patients with thalamic hemorrhage. Keyword: MORTALITY, SUBARACHNOID, INTRACEREBRAL, SURGERY, HEMORRHAGE |
