Surgical management of ruptured cerebral aneurysms

ABSTRACT

In this study, 20 patients with subarachnoid hemorrhage due to ruptured cerebral aneurysms. 2 patients were at Grade I, 13 patients were at grade II, and 5 patients were at grade III. 19 patients had anterior circulation aneurysms and one patient had basilar bifurcation aneurysm. 1 patient was operated with early surgery 3 days after subarachnoid hemorrhage. 14 patients underwent microsurgical clipping of their ruptured aneurysms during the period 4th to 14th day [intermediate surgery], and 5 patients were operated after 14 days [late surgery]. The outcome in this series with a follow-up period from 2 months to 21/2 years was good in 14 patients. One patient developed postoperative stroke due to occlusion of the superior trunk of the middle cerebral artery with fair result. 5 patients died with a mortality of 25%. The mortality in 3 patients was considered a management rather than operative due to high clinical grade [grade III', with postoperative delayed ischemia due to vasospasm. Technical problems occurred in 2 patients