Role of Microneurosurgery for Aneurysms of Brain: A Retrospective Study
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 3
Abstract
Background: Subarachnoid hemorrhage (SAH) from ruptured aneurysms carries a poor prognosis; half the patients die within 1 month of the hemorrhage; of the patients who survive longer than 1 month,40% remain dependent. Approximately 15% of patients with aneurismal SAH die before reaching the hospital. The initial and definitive management of ruptured cerebral aneurysm is evolving, with clipping and coiling being alternative treatments. Aim and Objective: To study the outcome of patients with aneurysmal subarachnoid hemorrhage who underwent surgery for clipping of aneurysm. Methods and Materials: This is the retrospective study conducted from January 2009 to December 2017, 105 patients were diagnosed as spontaneous subarachnoid hemorrhage resulting from ruptured cerebral aneurysms at Dept. of Neurosurgery, Tertiary Care Hospital, Ahmedabad. We have included the patients with ruptured cerebral aneurysms only, and excluded the patients without any treatment for aneurysms or incidentally found asymptomatic unruptured aneurysms. Neurological outcome was assessed using modified Rankin’s scale (mRS), and post-operative CTA. For use as the dichotomous variables, unfavorable and favorable outcomes were defined by mRS of 1-3 and 4-5, respectively. Results: In our study, most common age group affected is 41-60 years. Aneurysms are common in female sex as male to female ratio is 1:1.76. According to the criteria of size, 84.76% patients had aneurysm size of less than 10 mm. Anterior circulation aneurysms were present in 93.33% patients and posterior circulation aneurysms were present in 6.67% patients. Vasospasm was present in 76.19% patients detected radiologically. Multiple aneurysms were present in 7.6% patients. Intraoperative rupture was happened in 10 patients (9.52%), and 5 patients had expired. Post-operative complications were faced like rebleeding (2 patients), wound infection (5 patients), CSF leaf (5 patients), and diabetes insipidus in 12 patients, infarction in 13 patients and hydrocephalus in 22 patients. According to modified Rankins Scale, 75 patients (71.42%) were under Good category (0-2 mRS), 20 patients (19.04%) were under severely disabled category (3-5 mRS) and 10 patients (9.54%) were dead (mRS 6). Out of 105 patients, 10 patients had died in post-operative period.
Authors and Affiliations
Tushar V. Soni, Bhaumik T. Chudasama
Keywords
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- EP ID EP532020
- DOI 10.21276/ijmrp.2018.4.3.042
- Views 83
- Downloads 0
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