PDF herunterladen
CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(03): 525-530
DOI: 10.4103/ajns.AJNS_13_21
Original Article

Factors influencing 1-year functional outcome after surgery in aneurysmal subarachnoid hemorrhage patients: A single-center series

I-sorn Phoominaonin
Department of Surgery, Neurosurgery Unit, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
,
Somkiat Wongsuriyanan
Department of Surgery, Neurosurgery Unit, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Objective: The objective of the study was to evaluate the outcome and related factors in patients with aneurysmal subarachnoid hemorrhage (aSAH). Materials and Methods: Clinical data of 221 patients who were diagnosed with spontaneous SAH due to ruptured intracranial aneurysm and surgically treated at Vajira Hospital between January 2013 and May 2016 were retrospectively reviewed. Patient and aneurysm characteristics, clinical status at presentation, treatment, and status at discharge and 1 year after discharge were recorded. Outcomes 1 year after surgery were assessed using the Glasgow Outcome Scale (GOS). Patients were divided into two groups according to the GOS score: the favorable outcome group (GOS scores 4 and 5) and unfavorable outcome group (GOS scores 1–3). Results: Among the 221 study patients, 158 were classified in the favorable outcome group and 63 in the unfavorable outcome group. Patient age, Hunt and Hess grade, aneurysm size, use of Vitamin C solution irrigation in the subarachnoid space, and GOS score 1 year after surgery significantly differed between the two groups. Conclusions: Numerous factors analyzed in this study were significantly associated with 1-year outcome in surgically treated aSAH patients, including subarachnoid Vitamin C irrigation. Further study of subarachnoid Vitamin C irrigation is warranted.

Key-words:

Aneurysm clipping - aneurysm trapping - aneurysmal subarachnoid hemorrhage - ruptured intracranial aneurysm

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 12. Januar 2021

Angenommen: 16. März 2021

Artikel online veröffentlicht:
16. August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Haley EC Jr., Kassell NF, Torner JC. The international cooperative study on the timing of aneurysm surgery. The North American experience. Stroke 1992;23:205-14.
  • 2 Le Roux PD, Elliot JP, Newell DW, Grady MS, Winn HR. The incidence of surgical complications is similar in good and poor grade patients undergoing repair of ruptured anterior circulation aneurysms: A retrospective review of 355 patients. Neurosurgery 1996;38:887-93.
  • 3 Zaidi HA, Montoure A, Elhadi A, Nakaji P, McDougall CG, Albuquerque FC, et al. Long-term functional outcomes and predictors of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms in the BRAT trial: Revisiting the clip vs. coil debate. Neurosurgery 2015;76:608-13.
  • 4 Mavaddat N, Sahakian BJ, Hutchinson PJ, Kirkpatrick PJ. Cognition following subarachnoid hemorrhage from anterior communicating artery aneurysm: Relation to timing of surgery. J Neurosurg 1999;91:402-7.
  • 5 Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet 1975;1:480-4.
  • 6 Wilson JT, Pettigrew LE, Teasdale GM. Structured interviews for the Glasgow outcome scale and the extended Glasgow outcome scale: Guidelines for their use. J Neurotrauma 1998;15:573-85.
  • 7 Jaja BN, Cusimano MD, Etminan N, Hanggi D, Hasan D, Ilodigwe D, et al. Clinical prediction models for aneurysmal subarachnoid hemorrhage: A systematic review. Neurocrit Care 2013;18:143-53.
  • 8 Hütter BO, Kreitschmann-Andermahr I, Gilsbach JM. Health-related quality of life after aneurysmal subarachnoid hemorrhage: Impacts of bleeding severity, computerized tomography findings, surgery, vasospasm, and neurological grade. J Neurosurg 2001;94:241-51.
  • 9 Pegoli M, Mandrekar J, Rabinstein AA, Lanzino G. Predictors of excellent functional outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg 2015;122:414-8.
  • 10 Springer MV, Schmidt JM, Wartenberg KE, Frontera JA, Badjatia N, Mayer SA. Predictors of global cognitive impairment 1 year after subarachnoid hemorrhage. Neurosurgery 2009;65:1043-50.
  • 11 Sheldon S, Macdonald RL, Cusimano M, Spears J, Schweizer TA. Long-term consequences of subarachnoid hemorrhage: Examining working memory. J Neurol Sci 2013;332:145-7.
  • 12 Al-Khindi T, Macdonald RL, Schweizer TA. Decision-making deficits persist after aneurysmal subarachnoid hemorrhage. Neuropsychology 2014;28:68-74.
  • 13 Schuss P, Hadjiathanasiou A, Borger V, Wispel C, Vatter H, Güresir E. Poor-grade aneurysmal subarachnoid hemorrhage: Factors influencing functional outcome--A single-center series. World Neurosurg 2016;85:125-9.
  • 14 Jaja BN, Lingsma H, Steyerberg EW, Schweizer TA, Thorpe KE, Macdonald RL, et al. Neuroimaging characteristics of ruptured aneurysm as predictors of outcome after aneurysmal subarachnoid hemorrhage: Pooled analyses of the SAHIT cohort. J Neurosurg 2016;124:1703-11.
  • 15 Stienen MN, Smoll NR, Weisshaupt R, Fandino J, Hildebrandt G, Studerus-Germann A, et al. Delayed cerebral ischemia predicts neurocognitive impairment following aneurysmal subarachnoid hemorrhage. World Neurosurg 2014;82:e599-605.
  • 16 Jabbarli R, Reinhard M, Niesen WD, Roelz R, Shah M, Kaier K, et al. Predictors and impact of early cerebral infarction after aneurysmal subarachnoid hemorrhage. Eur J Neurol 2015;22:941-7.
  • 17 Kawakami M, Kodama N, Toda N. Suppression of the cerebral vasospastic actions of oxyhemoglobin by ascorbic acid. Neurosurgery 1991;28:33-9.
  • 18 Kodama N, Matsumoto M, Sasaki T, Konno Y, Sato T. Cisternal irrigation therapy with urokinase and ascorbic acid for prevention of vasospasm. Acta Neurochir Suppl 2001;77:171-4.
  • 19 Kodama N, Sasaki T, Kawakami M, Sato M, Asari J. Cisternal irrigation therapy with urokinase and ascorbic acid for prevention of vasospasm after aneurysmal subarachnoid hemorrhage. Outcome in 217 patients. Surg Neurol 2000;53:110-7.