Surgical treatment and clinical outcome of patients with intracranial posterior circulation poor-grade aneurysms / 中国医师进修杂志

ABSTRACT

Objective To investigate the surgical treatment and clinical outcome of patients with intracranial posterior circulation poor-grade aneurysms. Methods The clinical data of 35 patients with intracranial posterior circulation poor-grade aneurysms were collected. Seventeen patients were World Federation of Neurosurgical Societies (WFNS) grade IV and 18 patients were WFNS grade V. Twenty- nine patients were definitively treated with open microsurgery treatment(2 patients) and endovascular treatment (27 patients). Six patients received conservative treatment, including 4 patients only receiving external ventricular drainage to decrease intracranial pressure and 2 patients only receiving medical treatment. The nerve function were evaluated by Glasgow outcome scale (GOS) at discharge from hospital and 1 and 12 months after operation. Results In the patients who received conservative treatment, 5 patients were dead in hospital, and 1 patient got good outcome after 12 months. In the patients who received surgical treatment, at discharge from hospital good outcome were achieved in 15 patients (51.7%), poor outcome in 9 patients (31.0%), and death happened in 5 patients (17.2%). At 1 month after operation, good outcomes were achieved in 14 patients (48.3%), poor outcome in 9 patients (31.0%), and death happened in 6 patients (20.7%). At 12 months after operation, good outcome were achieved in 18 patients (62.1%), poor outcome in 5 patients (17.2%), and death happened in 6 patients (20.7%). Conclusions Patients with posterior circulation poor-grade aneurysms have better prognosis after positive surgical treatment.