Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Report on a Randomized Treatment Study

Abstract

Four selected treatments, namely, regulated bed rest, drug-induced hypotension, carotid ligation, and intracranial surgery, were randomly allocated with respect to location of the aneurysm and interval following last bleed. The objective of the Study was to answer the question. "What mode of treatment offers a patient with a single ruptured intracranial aneurysm during the previous three months the highest probability of optimal results with respect to survival. residual neurological deficit, capacity for self-care, and gainful employment? " Various treatments were suspended at specific intervals when a particular mode of therapy became inferior to the others. A group of 33 patients was disqualified after treatment was randomly allocated. The numbers of protocols remaining for analysis within each treatment category were 202 for regulated bed rest, 309 for drug-induced hypotension, 187 for carotid ligation, and 274 for intracranial surgery.