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Intracranial aneurysm with subarachnoid haemorrhage. Surgical results and long-term outcome in 100 cases
Insights
This study on 100 intracranial aneurysm patients with subarachnoid hemorrhage found surgery had no direct deaths. Post-operative complications occurred, but many patients achieved good recovery, highlighting surgical safety and outcome potential.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Surgery
Background:
- Subarachnoid hemorrhage (SAH) from intracranial aneurysms is a critical condition.
- Surgical intervention is a primary treatment modality for these aneurysms.
- Assessing surgical outcomes and long-term prognosis is vital for patient management.
Purpose of the Study:
- To describe the surgical results and long-term outcomes.
- To evaluate the safety and efficacy of surgical treatment for intracranial aneurysms with SAH.
- To correlate preoperative neurological status with surgical outcomes.
Main Methods:
- Retrospective analysis of 100 consecutive cases of intracranial aneurysm with SAH.
- Classification of patients using the modified Botterell scale for neurological status.
- Documentation of surgical outcomes, complications, and long-term follow-up.
Main Results:
- No intraoperative deaths occurred in 100 cases.
- Postoperative complications included delayed ischemic deficits in 4 patients due to cerebrovascular spasm.
- Patients with initially poorer neurological status (grade IV) tolerated surgery well after stabilization, with a 50% chance of full functional recovery.
Conclusions:
- Surgical treatment for intracranial aneurysms with SAH is associated with low mortality.
- Cerebrovascular spasm is a significant postoperative complication requiring management.
- Early surgical intervention, even in patients with initially compromised neurological status, can lead to favorable long-term functional recovery.
Abstract:
The surgical results and long-term outcome in 100 consecutive cases of intracranial aneurysm with a subarachnoid haemorrhage are described. According to the modified Botterell classification of neurological status, 33 patients fell into grade I, 56 into grade II and 11 into grade III at the time of surgery. There were no deaths associated with the surgical procedure. Two patients were worse off immediately after the operation and 4 others developed delayed ischaemic deficits postoperatively owing to cerebrovascular spasm. Four of these 6 patients made a good recovery but the others remained in a vegetative state. One other patient died from a pulmonary embolism on the 9th postoperative day. A group of patients who had grade IV neurological status at some stage before the operation all tolerated surgery well once their condition had stabilized, and stood an even chance of making a full functional recovery by 3-6 months.