Ruptured intracranial aneurysms. Case morbidity and mortality

Area of Science:

• Neurosurgery
• Neurology
• Critical Care Medicine

Background:

• Ruptured intracranial aneurysms pose significant risks of rebleeding, neurological deficit, and death.
• Optimal management strategies are crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a comprehensive treatment regimen, including medical management and microsurgical intervention, on morbidity and mortality in ruptured intracranial aneurysms.

Main Methods:

• Review of 100 consecutive cases of ruptured intracranial aneurysms.
• Patients received bed rest, sedation, blood pressure control, anticonvulsants, and antifibrinolytic therapy (epsilon aminocaproic acid).
• Microsurgical intervention was performed under hypotensive anesthesia in 86 patients.

Main Results:

• Overall mortality was 15%.
• Surgical mortality was 8.1%, with 6.3% mortality in Grades 1-3 patients.
• Early rebleeding occurred in 11.8% of patients on the medical regimen.
• 60% of patients returned to prior activities; 25% had moderate neurological deficits.

Conclusions:

• Active medical management prior to microsurgical intervention improves overall outcomes for ruptured intracranial aneurysms.
• This integrated approach enhances patient survival and reduces long-term neurological deficits.