Prognosis of ultra-early microsurgery combined with extraventricular drainage in patients with poor-grade aneurysms.

OBJECTIVE To explore the clinical effects of ultra-early microsurgery (< 24 hours) combined with extraventricular drainage for the treatment of poor-grade aneurysms. METHODS A total of 60 patients with poor-grade aneurysms were randomly divided into a microsurgery combined with extraventricular drainage (MED) group and conventional microsurgery (M) group. The prognosis was comparatively studied for these 2 groups. RESULTS All patients underwent a Glasgow Outcome Scale (GOS) assessment during a 6-month to 2-year follow-up. The excellent recovery (GOS, 4-5 points) rate for the MED group was 30% higher than that of the M group, while the poor recovery (GOS, 1-2 points) rate was 26.7% lower than that of the M group (P = 0.016). The incidence of acute brain swelling (26.7% vs 53.3%; P = 0.035), cerebral infarction (20% vs 46.7%; P = 0.025), and vasospasm (16.7% vs 40%; P = 0.045) for the MED group was significantly lower than that of the M group. CONCLUSIONS For microsurgery combined with extraventricular drainage, the risk of cerebral infarction and vasospasm were significantly reduced for patients with poor-grade aneurysms, and the prognosis was better.