A study of outcome of surgical management of ruptured intracranial aneurysms

Zafar Ahmed H., Paresh Sodhiya


Background: The present study is a retrospective analysis of collected data of consecutive cases with ruptured intracranial aneurysms treated at two centres. The clinical outcome and associated complications were graded using the modified Rankins scale.

Methods: A total of 48 patients of ruptured intracranial aneurysms were managed between January 2014 and August 2017. All forty eight patients underwent clipping. All the 48 patients who were consequently treated with surgery for intracranial aneurysm were analysed.

Results: Of the total of 48 patients, Six patients died in the post-operative period while the remaining 42 patients were available for a minimum followup of 6 months duration. the post operatives outcomes matched the presenting Hunt and Hess grade in 80% patients.

Conclusions: Surgical outcome of ICA Aneurysm is generally good. Poor results are mainly related to poor aneurysm grade, atherosclerotic intracranial carotid artery, and severe vasospasm. ACOM aneurysm in spite of being very common the outcome of patients with ACOM aneurysms remains not so good. In patients with MCA aneurysm the post-operative outcome is significantly better if surgery is undertaken earlier.


Intracranial Aneurysms, Outcome of clipping ruptured aneurysms

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Heur GG, Lawton M, Winn HR, LeRoux P. Surgical approaches to intracranial aneurysms. In Winn HR, Berger MS, Dacey RG Jr editors. Youmans Neurological Surgery. Sixth edition. Philadelphia, Elsevier Saunders;3801-23.

Cameron G, McDougall, Albuquerque FC. Endovascular coiling of intracranial aneurysms: supporting evidence. In Winn HR, Berger MS, Dacey RG Jr editors. Youmans Neurological Surgery. Sixth edition. Philadelphia, Elsevier Saunders;3924-8.

Dion JE, Mathis JM, Vineula F. Endovascular treatment of cervicocerebral aneurysms In Wilkins RH, Rengachary SS editors. Neurosurgery. Second edition. McGraw -Hill;2383-404.

RP sengupta, Pande A. Anterior communicating aneurysms In Tandon PN, Ramamurthy R editors; Ramamurthi and Tandons Textbook of Neurosurgery. Third Edition, New Delhi, Jaypee. 958-76.

Mathuriya SN, Pathak A, Gupta V, Grover VK. Middle cerebral artery aneurysms In Prakash Narain Tandon, Ravi Ramamurthy editors; Ramamurthi & Tandons Textbook of Neurosurgery. Third Edition. New Delhi, Jaypee. 979-95.

Ducruet AF, Conolly Jr.ES. Microsurgery of distal anterior cerebral aneurysms In Winn RH, Berger MS, Dacey Jr RG. editors. Youmans Neurological Surgery, Sixth edition. Philadelphia, Elsevier Saunders. 3853-61.

Dashti R, Hernesniemi J, Lehto H, Niemelä M, Lehecka M, Rinne J, et al. Microneurosurgical management of proximal anterior cerebral artery aneurysms. Surg Neurol. 2007;68(4):366-77.

Czepko R, Libionka W, Lopatka P. Characteristics andsurgery of aneurysms of the proximal (A1) segment of the anterior cerebral artery. J Neurosurg Sci. 2005;49(3):85-95.

Handa J, Nakasu Y, Matsuda M, Kyoshima K. Aneurysms of the proximal anterior cerebral artery. Surg Neurol. 1984;22(5):486-90.

Hino A, Fujimoto M, Iwamoto Y, Oka H, Echigo T. Surgery of proximal anterior cerebral artery aneurysms. Acta Neurochir (Wien). 2002;144(12):1291-6.

Lee JM, Joo SP, Kim TS, Go EJ, Choi HY, Seo BR. Surgical management of anterior cerebral artery aneurysms of the proximal (A1) segment. World Neurosurg. 2010;74(4-5):478-82.

Suzuki M, Onuma T, Sakurai Y, Mizoi K, Ogawa A, Yoshimoto T. Aneurysms arising from the proximal (A1) segment of the anterior cerebral artery. A study of 38 cases. J Neurosurg. 1992;76(3):455-8.