Outcome of Microsurgical Clipping of Ruptured Anterior Circulation Aneurysms

  • MUHAMMAD JAHANGIR KHAN Department of Neurosurgery, Postgraduate Medical Institute, Lahore General Hospital, Lahore
  • MUHAMMAD HAMMAD NASIR Department of Neurosurgery, Postgraduate Medical Institute, Lahore General Hospital, Lahore
  • SIKANDAR ALI Department of Neurosurgery, Postgraduate Medical Institute, Lahore General Hospital, Lahore
  • SARFRAZ KHAN Khyber Medical University, Kohat Institute of Medical Sciences, Kohat
  • MUHAMMAD WAQAS Department of Neurosurgery, Postgraduate Medical Institute, Lahore General Hospital, Lahore
  • ZUBAIR AHMED KHAN Department of Neurosurgery, Postgraduate Medical Institute, Lahore General Hospital, Lahore
Keywords: Aneurysms, complications, subarachnoid hemorrhage

Abstract

Objective: The objective of the study was to analyze the operative outcome of microsurgical clipping in Ruptured Anterior Circulation Aneurysms.
Materials and Methods: Twenty patients with Ruptured Anterior Circulation aneurysms were treated with surgical clipping. All the patients were evaluated pre-operatively according to Hunt & Hess and WFNS grading scales. Patients with grade I, II, and III were operated. All the aneurysms were clipped through Pterional approach under General anesthesia and Yasargil Aneurysm clips of appropriate sizes were used in each patient. Outcome was analyzed according to Glasgow Outcome Scale at the end of six months of follow up in each patient.
Results: In this series of twenty cases, the mean patient age was 49 years. Lesion location included, the ACA/A. Com 55% (n = 11), the Middle Cerebral artery 25% (n = 5), P. Com 15% (n = 3), Ophthalmic artery 5% (n = 1). Sex distribution, female 55% (n = 11) and male 45% (n = 9). Per-operative complications, rupture of aneurysm 20% (n = 4), and damage to perforating branches of MCA 5% (n = 1). 
Conclusions: Surgical clipping still is the most efficient treatment of Ruptured Anterior Circulation aneurysm at the beginning of the new millennium. Anterior Communicating Artery is the commonest location of aneurysms. Major determinants of outcome are Hunt & Hess, WFNS grades on admission and the age of the patient.

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Published
2019-12-28
Section
Original Article