Results of microsurgical treatment of arterial brain aneurysms in the acute rupture period

Abstract

Objective – to find out the causes of adverse effects of microsurgical exclusion of arterial aneurysms during the acute rupture period.Materials and methods. The results of 41 microsurgical exclusions of arterial aneurysms in the first two days after the rupture were analyzed. There were 17 men and 24 women. The age of patients was from 32 to 78 years, the average age was 50 years. Neurological status, the severity of the Hunt–Hess condition, and the level of consciousness on the Glasgow com scale were assessed. The Glasgow Scale was used to evaluate the quality of life of surviving patients.Results. After surgery, 12 (29.2 %) patients died. A statistically significant dependence of mortality have been established by the Hunt–Hess scale, the level of consciousness on the Glasgow scale, the prevalence of angiospasm according to cerebral angiography and the presence of ischemia according to spiral computed tomography. The severity of subarachnoid hemorrhage according to Fisher and angiospasm according to transcranial dopplerography, although they affect the mortality and outcome of surgery, but not statistically significant.Conclusion. Given the high mortality rate after microsurgical operations in the acute period of arterial aneurysms rupture the indications for their conduct should be more balanced. It should be taken into account the presence of adverse predictors.