Evaluation of results of surgical treatment in the patients with cerebral aneurysm

In this study, the purpose is to examine the surgical outcomes of the patients with cerebral aneurysms and make some contribution to the literature. Between 30.03.1998 and 12.12.2011, 286 patients with cerebral aneursym were operated in the Deparment of Neurosurgery of Gaziantep Medical Faculty. This series included both the patients with subarachnoid hemorrhage (n=238, 83.2 %) and incidental aneurysms (n=48, 16.8 %). The results of the surgical treatment in the 286 patients were evaluated retrospectively. In our study, female:male ratio was (172/114) 1.51 and the mean age was 50.56 (8-86). Of the 286 patients, 45 cases (15.73 %) were operated on due to multiple aneurysms. While aneurysm clipping procedures were performed in 268 cases, ECA-ICA bypass surgery was performed on 4 patients with complex aneurysms. Forty eigth of 286 (16.78 %) cases died in the early postopertive period. At the end of the sixth month, the rate of permanent neurological deficits was determined as 6,6 % (n=9). The causes of the mortality were rebleeding (n=8), septicemia secondary to pulmonary infection (n=4), acute myocardial infarction (n=3), brain edema (n=2), and ischemia after vasospasm (n=31). Clinical vasospasm occurred in 75 cases (26.22 %). 31 of these patients (41.3%) died. And in 21 cases (28 %), permanent neurological deficits developed. 8 of 12 cases with hypertension (66.6 %) died due to rebleeding after surgery and permanent neurological deficits occured in the remaining 4 cases (33.3 %). In conclusion, we observed that the presence of some important factors such as hypertension, rebleeding, vasospasm, and old age increase the rates of mortality and morbidity significantly (p=0,001).Key Words: Complication, Outcomes, Surgery, Cerebral Aneurysm.