RESUMEN
The aim of this study is to analyze the outcome of surgical clipping of the ruptured anterior circulation aneurysms with emphasis on the prognostic factors affecting this outcome. This is a retrospective study reviewing a database detailing all patients with ruptured anterior circulation aneurysm cases admitted in King Fahd Medical City from January 2006 - June 2007. Aneurysms were classified by location and size. Clinical condition was graded on admission according to classification of the World Federation of Neurological Surgeons [WFNS] grading. Outcomes were evaluated at discharge using the modified Rankin scale. Outcomes examined with overall rates of mortality, procedural complication and morbidity. Twenty-five patients, with 29 anterior circulation cerebral aneurysms underwent surgical clipping. According to WFNS, 15 patients were grade 1, 4 patients were grade 2, 4 patients were grade 3, and one patient was grade 4 and one patient was grade 5. Ten aneurysms [34.5%] were located in anterior communicating artery, 10 aneurysms [34.5%] in internal carotid artery segments, 5 aneurysms [17.2%] in anterior cerebral artery and 4 aneurysms [13.8%] in middle artery. The outcome according to Rankin score, 17 patients [68%] discharged with score 0, 3 patients [12%] with score 1, one patient [4%] with score 3, one patient [4%] with score 5 and 3 deaths [12%] score6. Surgical clipping is safe and reliable treatment of anterior circulation cerebral aneurysms. Clinical grade on admission is the most important determining factor for outcome