Publish in this journal
Journal Information

Congress

Congress content
Congress
XXIII Congreso Nacional de la Sociedad Española de Neurocirugía
Salamanca, 14-17 May 2019
List of sessions
Communication
13. VASCULAR
Full Text

C0089 - RISK FACTORS FOR UNFAVORABLE OUTCOMES AND SHORT-TERM OUTCOME IN PATIENTS WITH RUPTURED PERICALLOSAL ARTERY ANEURYSMS

V. Krylov, V. Dashyan, I. Grigoriev, V. Lukianchikov and I. Senko

Sklifosovsky Research Institute of Emergency Care, Moscow, Russia.

Objectives: To assess the short-term outcomes and identify risk factors of unfavorable outcomes in patients with ruptured pericallosal artery aneurysms (PerAA).

Methods: We analyzed the outcomes of 61 patients with ruptured PerAA (39 females and 22 males, mean age: 47 years) that were treated with microsurgery. Forty-four patients (72.1%) had a single PerAA, and 17 (27.9%) had multiple aneurysms (most commonly middle cerebral artery aneurysms). The Hunt-Hess (HH) grade was grade I in four patients (6.5%), grade II in 28 (46%), grade III in 23 (38%), and grade IV in six patients (9.5%). Various levels of depression of consciousness were observed in 20 patients (33%). Seven (12%), 13 (21%), five (38%), and 36 patients (59%) patients had Fisher scale grades of 1, 2, 3, and 4, respectively. In most cases (70.5%), PerAAs were located on the A3 segment, followed by the A2 in 28% and A4-A5 in 1.6%. Rebleeding was observed in nine patients (15%) and vasospasm in 19 (31%). Microsurgical clipping was performed in 52 patients (85%) and trapping of the aneurysm in nine (15%).

Results: Treatment results were assessed using the Glasgow Outcome Scale (GOS). At discharge, 33 (54.1%), nine (14.7%), six (9.9%), and 13 patients (21.3%) were rated as GOS5, GOS4, GOS3, and GOS1, respectively. Statistically significant (p < 0.05) risk factors for unfavorable outcomes were found to be: HH grades IV-V, a Glasgow Coma Scale score of < 12 upon admission, intracerebral hemorrhage of > 20 cm3, rebleeding, vasospasm, and early operation (in the first 72 h of rupture).

Conclusions: Early operation is preferable for patients without vasospasm and patients with HH grade I-III. In patients who present with HH grade IV-V on admission, early operation can be performed in selective cases with respect to the identified risk factors.

Idiomas
Neurocirugía (English edition)

Subscribe to our newsletter

es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.