Prognostic factors of ruptured middle cerebral artery aneurysms treated with surgical clipping

Main Article Content

Samer S. Hoz
Saja A. Albanaa
Ali M. Neamah
Farah W. Abdulmohsin
Zahraa Al-Sharshahi

Abstract

Background: Spontaneous subarachnoid haemorrhage is an emergent condition that leads to profound morbidity and mortality. It is mainly caused by a ruptured intracranial aneurysm. Herein we described the relationship of different factors and their impact on the outcome of patients who underwent a surgical clipping exclusively to the ruptured middle cerebral artery aneurysm.


Methods: We retrospectively analyzed the medical records of patients admitted to the Neurosurgery Teaching Hospital (NTH) in Baghdad for the period between January 2017-April 2019 of patients who underwent microsurgical clipping for ruptured middle cerebral artery aneurysm. Demographic, clinical, radiological and surgical data were extracted. A univariate analysis was used to illustrate the relationship between the variables and outcome which was assessed using the five scores of the Glasgow Outcome Scale where patients were dichotomized into two groups; favourable (IV + V) and unfavourable (I, II, III).


Results: Within this cohort, a total of 50 patients were studied and the analysis revealed that 92% (N=46) had a favourable outcome and 8% (N=4) had an unfavourable outcome at discharge. The in-hospital mortality was 6%(N=3). Factors that were significantly associated with poor outcome were giant aneurysms, the presence of other unruptured aneurysms, post-operative clinical vasospasm, presence of contralateral weakness, lower pre/post-operative Glasgow coma scores, higher Hunt and Hess, World Federation of Neurosurgical Societies (WFNS) and modified-WFNS grades.


Conclusion:  The factors with a significant impact on the outcome of patients with surgically clipped ruptured middle cerebral artery aneurysms were GCS, WFNS, m-WFNS, H&H, contralateral muscle weakness, size of the aneurysm, presence of other unruptured aneurysms and clinical vasospasm.

Article Details

How to Cite
Hoz, S. S. ., Albanaa, S. A. ., Neamah, A. M. ., Abdulmohsin, F. W. ., & Al-Sharshahi, Z. . (2020). Prognostic factors of ruptured middle cerebral artery aneurysms treated with surgical clipping. Romanian Neurosurgery, 34(2), 245-253. https://doi.org/10.33962/roneuro-2020-037
Section
Articles
Author Biographies

Samer S. Hoz

Neurosurgeon, Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq

Saja A. Albanaa

Medical student, College of Medicine, Baghdad University, Baghdad, Iraq

Ali M. Neamah

Medical student, College of Medicine, Baghdad University, Baghdad, Iraq

Farah W. Abdulmohsin

Medical student, College of Medicine, Baghdad University, Baghdad, Iraq

Zahraa Al-Sharshahi

MB, BCh BAO (NUI, RCSI), LRCP & SI, Royal College of Surgeons in Ireland (Alumnus), Dublin, Ireland