Results of surgical treatment of patients with ruptured anterior communicating artery aneurysms

Abstract

Anterior communicating artery aneurysms (AComA) are the most common type of intracranial aneurysms, accounting for approximately 35 % of all ruptured intracranial aneurysms. The aim of this study was to evaluate the results of surgical treatment of patients with ruptured AComA aneurysms. Materials and methods. The study included 98 patients who underwent surgical treatment for ruptured AComA aneurysms between 2008 and 2019 at the Uzhhorod Regional Center of Neurosurgery and Neurology and CNE “Сity Hospital of Emergency and Urgent Medical Care” of Zaporizhzhia City Council. The mean age of the patients was 47.8 ± 11.0 years, and 51.0 % were female. Results. Upon admission to the hospital, 69.3 % of patients with ruptured AComA aneurysms were conscious. The level of consciousness was influenced by the presence and size of an intracerebral hematoma, the severity of intraventricular blood circulation due to its presence, and the prevalence of angiospasm. Aneurysms of average size (6–15 mm according to the classification of G. Yasargil, 1984) were found in 44.9 % of cases. Postoperative mortality was 11.2 %. Postoperative vasospasm was the most common complication, occurring in 51.0 % of the patients. A good outcome in accordance with the modified Rankin Scale (mRS) was achieved in 66.3 % of the patients. Conclusions. Surgical treatment remains an effective treatment for ruptured AComA aneurysms, with favorable outcomes, which depend on age, serious condition of the patient, level of consciousness, re-rupture of the aneurysm, timing of the surgical operation, presence and size of intracerebral hematoma, presence and intensity of intraventricular hemorrhage, presence and intensity of angiospasm.

Keywords

• acomа aneurysm
• ruptured aneurysm
• surgical treatment
• prognostic factors
• postoperative complications