بررسي نتايج اعمال جراحي انجام شده بر روي 85 بيمار مبتلا به آنورسيم اينتراكرانيال در بيمارستان شهداي تجريش طي سالهاي 1381-1371

Outcome of surgical treatment of 85 patients with intracranial aneurysm in shohada tajrish hospital ( -2001)

Background: Intracranial aneurysms are potentially fatal but curable neurologic disorders that usually present with catastrophic clinical picture due to suharachnoid hemorrhage. Successful diagnosis and treatment of this disorder has become possible owing to numerous developments in practice of neurosurgery during the last century including development of microsurgical techniques, progress in neuroanesthesiology and improvement in pre and post operative managements and special cares. Materials and methods: Clinical course and outcome of surgical treatment of intracranial aneurysms have been reviewed in 85 cases between 1991-2001.The survey includes demographic data as well as signs and symptoms, location of the aneurysms, surgical approaches and postoperative complications. Results: Ninety aneurysms in 85 patients have been reviewed with male to female ratio as 3.1.The mean age of the patients was 46.2±15.4 y. Twenty seven of the aneurysms were located in anterior communicating artery territory, 22 in posterior communicating artery, 20 in middle cerebral artery and 18 in other branches. Fifty five percent of our patients were in Hunt & Hess grade 1, 38% in grade 2, 9% in grade 3 and grade 4 &5 1% each. Early surgery was performed on 8 patients and late surgery on 59 cases.18 patients were operated during vasospasm phase. Neurological complications occurred in 52% and medical problems in 28%. Postoperative mortality reached 18% in our cases. Conclusion: Surgical outcome was clearly worse in patients operated during vasospasm period but no significant difference was observed between early and late surgery.