Neste estudo são analisadas as evoluções clínicas de 225 pacientes que apresentaram hemorragia subaracnóidea (HSA) por ruptura de aneurismas, atendidos no período de 1985 a 1990. A idade dos pacientes variou de 7 a 84 anos, com predomínio na faixa de 30 a 50 anos (60%). Quanto ao sexo, houve predomínio do feminino (62,2%). Quanto à localização dos aneurismas rotos, os pacientes distribuiram-se em: 75 na artéria carótida interna, 66 na comunicante anterior, 61 na cerebral média, 14 na circulação posterior, 1 na cerebral anterior distal; e 8 em localização não identificada. Quarenta e cinco pacientes (20%) apresentaram mais de um aneurisma. Quarenta e quatro pacientes foram submetidos a tratamento cirúrgico nas primeiras 72 horas após a HSA, 40 no período de 4 a 7 dias, 16 no período de 8 a 10 dias e 57 após o 10º dia. As evoluções clínicas dos pacientes estudados são analisadas, baseadas na época da cirurgia em relação à HSA.

The clinical course of patients with subarachnoid hemorrhage (SAH) due to rupture of cerebral aneurysm admitted during the last five years is analysed: 157 patients were treated by direct surgical approach of the aneurysm, 58 localized in the anterior communicating artery (ACoA), 48 in the internal ctarotid artery (ICA), 43 in the middle cerebral artery (MCA), and 8 in the posterior circulation. Fourty-four patients were operated on during the first 72 hours (early surgery), 40 during the 4th and 7th days, 16 during the 8th and the 10th, and 57 after the 10th (late surgery), According to main localizations, the outcome of patients with aneurysms in the ACoA was good in 79.1%, in the ICA in 69.7%, and in the MCA in 69.7%. Patients treated in Hunt & Hess grade I and II had both good results in 77.5%, grade HI patients had good results in 71.3%, and grade IV in 56.2%. According to timing of surgery good results were observed in 61.4% for patients submitted to early surgery, in 80% for patients treated during the 4th and 7th days, in 81.2% for patients treated during the 8th and the 10th days, and in 70.2% for that submitted to late surgery. The overall mortality was 14.6%. For grade I patients mortality was 6.4%, for grade, II was 12.2%, for grade III was 15.2%, for grade" IV was 25%, and all patients operated on in grade V died. Mortality for patients operated on during the first 72 hours was 29.5%, during the 4th and the 7th days was 15.0%, during the 8th and the 10th days was 6.2%, and after the 10th day was 8.7%. The mortality of non operated patients was 88.2%. The overall outcome for patients with aneurysm rupture was 52% and the overall mortality was 36.8%. Based on the results regarding the final clinical outcome early surgery for treatment of intracranial aneurysms was effective as late surgery, although