[Evaluation of treatment results in patients operated for aneurysm]

The evaluation of the surgical results in patients operated on for intracranial aneurysms is still controversial, since a satisfactory method able to provide complete informations and ease to use is not still available. The more often used evaluation criteria provide standardized patterns, but the excessive simplifications affect the reliability of the final evaluation. Therefore, I suggest a brand new scale called Clinical Social Emotional Evaluation (CESE), based upon the following domains: neurological evaluation, psychomotor autonomy, return to prior job, behavioural and affective disorders, social reintegration and occurrence of seizures. In order to validate this scale, 190 patients operated on for intracranial aneurysms were assessed. Different scales provided different results. In detail, the number of the "best results" according to CESE was smaller (48%) when compared to the number provided by GOS (80%) and Rankin (62%). Nevertheless, the smaller amount of good results does not imply an overall worsening of the outcome. It is due to the different selection criteria employed by the diverse scales. Indeed, CESE selects groups of patients very homogeneously, whilst other scales include much more heterogeneous subjects. Thus, CESE would prove it-self to be a reliable, accurate and easy to use evaluation scale.