CEREBRAL ANEURYSM CHARACTERISTICS AND SURGICAL OUTCOMES

Abstract

Background Intracranial aneurysms (IAs) represent life-threatening neurosurgical emergencies. This study aims to provide a comprehensive analysis of 346 patients with 416 IAs treated using microsurgical clipping between 2016/2022, focusing on demographic characteristics, aneurysm features, and surgical outcomes. Methods This retrospective study involved patients from the National Institute of Neurology and Neurovascular Diseases in Bucharest, Romania. Variables examined included aneurysm localization, diameter, neck dimensions, rupture status, and postoperative complications. The study employed statistical analysis using Python and adhered to the Declaration of Helsinki principles (2013). Results - Patient Demographics: 346 patientsaa: mean age over 30 years. A gender discrepancy was noted, with a higher prevalence of IAs in females (3:1 ratio). - Aneurysm Characteristics: Anterior communicating artery and middle cerebral artery (246 cases, 71% of total). Diameters ranged from 2-12.5 mm in 323 cases (93.3%), with neck dimensions primarily between 1-5 mm in 292 cases (84.4%). - Rupture and Complications: A substantial prevalence of ruptured aneurysms was observed in 309 patients (89.3%). Hemorrhage was noted in 312 cases (90.1%), and 101 patients (29.2%) experienced vasospasm. The Fisher score distribution highlighted severity, with 142 cases (41%) at score 3. - Surgical Outcomes: The Glasgow Outcome Scale (GOS) indicated favorable results in 261 patients (75.4%), while 84 patients (24.3%) succumbed postoperatively, with 70 patients (20.2%) due to neurological causes. Postoperative complications included 25 reoperations (7.2%) and 71 cases of osteomyelitis (20.5%). - Predictive Factors: Significant risk factors included arterial hypertension (mostly grade II), atherosclerosis, obesity, and diabetes, influencing both intraoperative phases and postoperative infection rates. Conclusion The study underscores the critical nature of timely surgical intervention in IA cases, particularly for ruptured aneurysms. The findings emphasize the need for tailored, multidisciplinary treatment strategies and ongoing research to improve surgical protocols and patient outcomes. The comprehensive analysis of preoperative, intraoperative, and postoperative variables provides valuable insights into managing intracranial aneurysms, highlighting the complexities and challenges in treating this condition.

Keywords

• intracranial aneurysm
• microsurgical clipping
• subarahnoidal haemorrhage
• outcome