“Reattack” Following the Rupture of Intracranial Aneurysms

Hori Shigeaki, Mori Teruaki, Suzuki Jiro

doi:10.14878/scs1973.2.0_23

So-called reattacks after subarachnoid hemorrhage due to rupture of intracranial aneurysms were analyzed. Tohoku University, Division of Neurosurgery has experienced 709 aneurysm cases by the end of 1972, and 113 cases found in 1972 were carefully documented in regard to the reattacks for this study. The initial and subsequent reattacks were classified under the following criteria: 1) major bleeding, 2) moderate bleeding, 3) minor bleeding, and 4) cerebral infarction. In 62 cases out of the 113 cases, reattacks occurred up to four times at an interval ranging from a few hours to 16 years. Within one month after the initial subarachnoid hemorrhage, 66 reattacks occurred in 52 out of above 62 casse. Based on the analysis of these reattacks the following conclusions were drawn: 1. The reattacks tended to occur between the 2nd and the 14th day following the initial bleeding, the highest incidence being on the 7th day. 2. The reattack may be either rebleeding or infarction, however, the latter was more common within 14 days after the initial hemorrhage. 3. When the initial bleeding was major or moderate, the reattack due to rebleeding occurred within first 3 days or after 15 days after the initial hemorrhage. On the contrary, the reattack due to infarction occurred exclusively in between 4th and 14th days period (which is known as predilection period for cerebral vasospasm) after the initial hemorrhage. 4. When the initial subarachnoid hemorrhage was minor, the rebleeding occurred at any time in the subsequent days, while reattacks due to infarction tended to occur also in the 4-14th day period.

“Reattack” Following the Rupture of Intracranial Aneurysms

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