Aslan Javed Munir, Habib Ullah Khan, Khurshid Ali Bangash.
Surgical Outcome of Anterior Circulation Cerebral Aneurysm Surgery, a Review of 52 Cases.
Pak J Neuro Surg Jan ;15(1):24-7.

Objective: To assess the variables contributing to surgical outcome after anterior circulation cerebral aneurysm clipping.Design: Descriptive study.Place and duration of study: Combined Military Hospital Rawalpindi from Jan 2006 to Dec 2010.Material and Methods: A total of 52 cases were included in the study who underwent surgical clipping of anterior circulation cerebral aneurysm at neurosurgical centre CMH Rawalpindi from Jan 2006 to Dec 2010. Data collection was done using non-probability convenient sampling. Both male and female were included in the study. Patients with multiple, unruptured and those of posterior circulation aneurysms were excluded from the study. Patients were divided in two groups. The first group was operated in less than three weeks time after subarachnoid haemorrhage while the second group was operated after three weeks. CT angiography was used for the diagnosis of aneurysms. Postoperatively obliteration of the aneurysms was confirmed radiologically three weeks after the procedure. Postoperative results were compared for each group.Results: Between Jan 2006 and Dec 2010, 52 patients harbouring anterior circulation cerebral aneurysms were selected for the study. Mean age was 48.35 years. 72% were males while 28% females. Overall the patients operated in first group had a combined morbidity of 7% while second group patients had a combined morbidity of 3.6%. Patients less than 50 years of age with aneurysm size of less than 10 mm and Hunt and Hess grade of 1 and 2 had a morbidity of 2.4%. Patients more than 50 years of age with aneurysm size of more than 10 mm and Hunt and Hess grade of 3 had a morbidity of 8%. Only one patient in second group died in the postoperative period due to hypostatic pneumonia.Conclusion: Age of the patient, size of the aneurysm, Hunt and Hess grade and the timing of surgery are independent predictors of surgical outcome in anterior circulation cerebral aneurysm surgery.

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