Introduction: Prevalence of intracranial aneurysms is estimated to be from 1% to 5% of population,
most of them are small and located in the anterior circulation. The real danger is
when an aneurysm ruptures, leading to a subarachnoid hemorrhage (SAH). SAH is a catastrophic
event with a mortality rate of 25% to 50%. Permanent disability occurs in nearly 50%
of the survivors. Fifteen percent of patients expire before reaching the hospital
and 25% die within 24 h. The purpose of our study is to report the clinicoradiological
data and outcome of microsurgical clipping of ruptured anterior circulation aneurysms
in our center. Materials and Methods: This study included ruptured anterior circulation aneurysms admitted to tertiary
care hospital in northern India from January 2018 to June 2020. The final outcome
of patients was analyzed with Glasgow Outcome Score (GOS) at the time of discharge
from the hospital. Results: A total of 53 patients with ruptured anterior circulation aneurysm underwent microsurgical
clipping comprising 25 (47.2%) males and 28 (52.8%) females. The mean neck size of
all aneurysms was 3.43 ± 1.66 mm. The mean hospital stay was longer in patients having
preoperative intraventricular hemorrhage (IVH) (35.96 ± 27.27 days) and postoperative
complications (43.36 ± 29.76 days) compared to patients who did not have IVH (21.10
± 15.47 days) and postoperative complications (18 ± 6.54 days). P value was ≤0.05.
Patients with preoperative hydrocephalus had GOS 3.44 ± 1.20 at discharge compared
to nonhydrocephalus who had GOS 4.32 ± 1.07 (P = 0.009). Patients with Intracerebral
Hemorrhage (ICH) and non-ICH had GOS 3.31 ± 1.38 and 4.28 ± 1.01, respectively (P
= 0.009). Conclusion: Poor outcome at the time of discharge after the surgical treatment of anterior circulation
aneurysms was associated with poor world federation of neurological surgeons grade
on admission, presence of IVH, hydrocephalus, intracerebral hemorrhage, and postoperative
cerebral infarcts.
Key-words:
Aneurysm - clipping - infarct - outcome - world federation of neurological surgeons