Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm

Background and Aim: This study aimed to present the results of early and delayed operation on patients with ruptured brain aneurysms. In addition to comparing the results and rates of morbidity and mortality in the surgical procedure and identifying the effective factors, this study aimed to provide...

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Main Authors: Babak Alijani, Mohamadreza Emamhadi, Shahrokh Yosefzadeh Chabok, Seyfollah Jafari, Amin Naseri
Format: Article
Language:English
Published: Guilan University of Medical Sciences 2018-07-01
Series:Iranian Journal of Neurosurgery
Subjects:
Online Access:http://irjns.org/browse.php?a_code=A-10-193-1&slc_lang=en&sid=1
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author Babak Alijani
Mohamadreza Emamhadi
Shahrokh Yosefzadeh Chabok
Seyfollah Jafari
Amin Naseri
author_facet Babak Alijani
Mohamadreza Emamhadi
Shahrokh Yosefzadeh Chabok
Seyfollah Jafari
Amin Naseri
author_sort Babak Alijani
collection DOAJ
description Background and Aim: This study aimed to present the results of early and delayed operation on patients with ruptured brain aneurysms. In addition to comparing the results and rates of morbidity and mortality in the surgical procedure and identifying the effective factors, this study aimed to provide methods to improve the treatment of brain aneurysm. Methods and Materials/Patients: This was a retrospective study on 60 patients with a definitive diagnosis of brain aneurysm admitted to Neurosurgery Ward of Poursina Hospital, Rasht, Iran from 2009 to 2013.  Results: 7(11.7%) patients on the first 3 days and 37(61.7%) patients on the days 4-14 and 16(26.7%) after 2 weeks and selectively underwent surgery. In total, 11.7% of patients died and 15% developed severe complications. In the group underwent surgery on the first 3 days, 2(28.5%) patients died and 2 experienced severe complications. In the second group (in 4-14 days), 4(10.8%) patients died and 5(13.5%) suffered from severe complications, and in the group (16 patients) with delayed surgeries, 1(6.2%) patient died and 2(12.5%) suffered from severe complications. Neurological grading and operation time were important factors in complications and mortality of patients. Conclusion: This study showed that Hunt and Hess neurological grading score has a direct relationship with increased morbidity and mortality rates, while delayed operation is associated with a reduction in morbidity and mortality. Given the complications of early aneurysm surgery (during the first 3 days) compared with delayed surgery, and also most of these patients die due to vasospasm or recurrent hemorrhage before the onset of a delayed phase, performing early surgery in these patients requires further evaluation. According to this study, the reduction of each episode of occlusion with temporary clipping will result in fewer complications.
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spelling doaj.art-020bd0c6815449ceabda57c80bb2ea8d2022-12-21T21:09:09ZengGuilan University of Medical SciencesIranian Journal of Neurosurgery2423-64972423-68292018-07-01427582Surgical Protocol and Outcome of 60 Cases With Intracranial AneurysmBabak Alijani0Mohamadreza Emamhadi1Shahrokh Yosefzadeh Chabok2Seyfollah Jafari3Amin Naseri4 Associate Professor of Neurosurgery, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Associate Professor of Neurosurgery, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Associate Professor of Neurosurgery, Guilan Road Trauma Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Associate Professor of Neurosurgery, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Associate Professor of Neurosurgery, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Background and Aim: This study aimed to present the results of early and delayed operation on patients with ruptured brain aneurysms. In addition to comparing the results and rates of morbidity and mortality in the surgical procedure and identifying the effective factors, this study aimed to provide methods to improve the treatment of brain aneurysm. Methods and Materials/Patients: This was a retrospective study on 60 patients with a definitive diagnosis of brain aneurysm admitted to Neurosurgery Ward of Poursina Hospital, Rasht, Iran from 2009 to 2013.  Results: 7(11.7%) patients on the first 3 days and 37(61.7%) patients on the days 4-14 and 16(26.7%) after 2 weeks and selectively underwent surgery. In total, 11.7% of patients died and 15% developed severe complications. In the group underwent surgery on the first 3 days, 2(28.5%) patients died and 2 experienced severe complications. In the second group (in 4-14 days), 4(10.8%) patients died and 5(13.5%) suffered from severe complications, and in the group (16 patients) with delayed surgeries, 1(6.2%) patient died and 2(12.5%) suffered from severe complications. Neurological grading and operation time were important factors in complications and mortality of patients. Conclusion: This study showed that Hunt and Hess neurological grading score has a direct relationship with increased morbidity and mortality rates, while delayed operation is associated with a reduction in morbidity and mortality. Given the complications of early aneurysm surgery (during the first 3 days) compared with delayed surgery, and also most of these patients die due to vasospasm or recurrent hemorrhage before the onset of a delayed phase, performing early surgery in these patients requires further evaluation. According to this study, the reduction of each episode of occlusion with temporary clipping will result in fewer complications.http://irjns.org/browse.php?a_code=A-10-193-1&slc_lang=en&sid=1CerebralAneurysmEarly surgerySurgical treatmentResults
spellingShingle Babak Alijani
Mohamadreza Emamhadi
Shahrokh Yosefzadeh Chabok
Seyfollah Jafari
Amin Naseri
Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm
Iranian Journal of Neurosurgery
Cerebral
Aneurysm
Early surgery
Surgical treatment
Results
title Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm
title_full Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm
title_fullStr Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm
title_full_unstemmed Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm
title_short Surgical Protocol and Outcome of 60 Cases With Intracranial Aneurysm
title_sort surgical protocol and outcome of 60 cases with intracranial aneurysm
topic Cerebral
Aneurysm
Early surgery
Surgical treatment
Results
url http://irjns.org/browse.php?a_code=A-10-193-1&slc_lang=en&sid=1
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AT shahrokhyosefzadehchabok surgicalprotocolandoutcomeof60caseswithintracranialaneurysm
AT seyfollahjafari surgicalprotocolandoutcomeof60caseswithintracranialaneurysm
AT aminnaseri surgicalprotocolandoutcomeof60caseswithintracranialaneurysm