[Early-mid-phase microsurgery for ruptured cerebral anterior circulating aneurysm]

Area of Science:

• Neurosurgery
• Vascular Neurology
• Surgical Innovation

Context:

• Ruptured cerebral aneurysms, particularly those in the anterior communicating artery, present a significant neurosurgical challenge.
• Subarachnoid hemorrhage (SAH) from these aneurysms requires timely and effective intervention to improve patient outcomes.
• Early surgical management aims to secure the aneurysm and prevent rebleeding, but optimal timing remains a subject of investigation.

Purpose:

• To evaluate the clinical strategy and efficacy of early-to-mid-phase microsurgical clipping for ruptured anterior communicating artery aneurysms.
• To assess patient outcomes using the Glasgow Outcome Scale (GOS) based on the timing of microsurgical intervention (within 3 days vs. 3-10 days).

Summary:

• A study of 75 patients with anterior communicating artery aneurysmal SAH treated with microsurgical clipping within 3 or 3-10 days post-rupture was conducted.
• Of 81 aneurysms, 77 were successfully clipped. Good outcomes (GOS 4-5) were achieved in 53 patients, with 4% mortality.
• Outcomes significantly differed based on Hunt and Hess grade (I-III vs. IV-V), but not between early (0-3 days) and mid-phase (3-10 days) surgery.

Impact:

• Early-to-mid-phase microsurgery is a feasible and effective strategy for managing ruptured anterior communicating artery aneurysms.
• The findings support prompt surgical intervention within the first 10 days post-rupture as a viable option.
• This study contributes to the understanding of optimal timing for surgical management in aneurysmal SAH.