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Vol. 13. Issue 5.
Pages 358-363 (January 2002)
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Vol. 13. Issue 5.
Pages 358-363 (January 2002)
La cirugía de los aneurismas grado 0. Análisis de 22 casos
Surgery of grade “0” aneurysms. Report of 22 cases
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E. Spagnuolo-Dondero
, A. Calvo-Rubal, P. Pereda-Casas, A. Tarigo-Morador
Servicio de Neurología y Neurocirugía. Hospital Maciel (Ministerio de Salud Pública). Montevideo. Uruguay
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Resumen

La hemorragia subaracnoidea por rotura de aneurismas continúa siendo, pese a los avances de la medicina, una enfermedad devastadora, con una mortalidad del 50% en relación con el sangrado inicial. Menos del 30% de los sobrevivientes retornan totalmente a sus tareas habituales.

Los autores presentan una serie de 22 pacientes con aneurismas grado “0”, operados en un período de 6 años, con una mortalidad del 0% y una morbilidad muy baja (menor al 5%).

Se analizan las características de los mismos y se efectúa una revisión bibliográfica, llegándose a la conclusión de que la mayoría de estos aneurismas se deben tratar, ya que los riesgos con cirugía son menores que los inherentes a los de la propia enfermedad, e incluso menores que con la terapia endovascular.

Se piensa que el progreso en el diagnóstico y en el tratamiento de estas malformaciones que no sangraron, logrará reducir la elevada cifra de morbilidad y mortalidad que actualmente presentan tras el sangrado.

Palabras clave:
Hemorragia subaracnoidea
Aneurismas grado“0”
Aneurismas incidentales
Cirugía
Summary

Subarachnoid hemorrhage secondary to aneurysms rupture is still a devastating disease, in spite of advances of medical and surgical management. Mortality remains about 50% at the initial event, and less of 30% of survivors recover their previous level. The authors present a series of 22 patients with grade “0”, aneurysms that had not bled, operated on during a six year period, with no mortality and a very low morbidity (less than 5%).

An analysis of the cases and a bibliographic revisión is made, concluding that most of those aneurysms should be treated, for the surgical risks are lower than those of the disease itself, and also lower than those of the endovascular therapy.

lt is believed that the advances in the diagnosis and treatment of unruptured aneurysms will reduce the high morbimortality they cause after the bleeding.

Key words:
Subarachnoid hemorrhage
Grade “0” aneurysms
Incidental aneurysm
Surgery

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