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Pan Arab Journal of Neurosurgery. 2004; 8 (2): 28-34
in English | IMEMR | ID: emr-68148


We reviewed the ruptured cerebral aneurysm treatment in Fujita Health University Hospital with multimodalities of treatment. Form 1996 to 2002, cerebral aneurysms were treated by two methods: direct microsurgical clipping and endovascular coiling. Both were selected based on definite guidelines of clinico-radiological criteria as follows: endovascular therapy comprised of GDC embolisation and CSF washout with UK or TPA performed in cases with Hunt and Kosnik grade 4 [GCS 7,8], and grade 5 [without hydrocephalus or intracranial haemorrhage], age > 70 years, subacute stage [4-14 days of vasospasm], basilar aneurysm and peripheral MCA/PCA aneurysms. Microsurgical clipping with drainage procedure was performed in cases with Hunt and Kosnik grade 0-3, grade 4 [GCS 9-12], age less than 70 years, grade 5 with hydrocephalus or intracerebral haematoma and acute stage [0-3 days after bleed]. The patient's outcome was measured using Glasgow Outcome Score [GOS] at the time of discharge. In our series of severe [poor grade] SAH cases, 120 cases underwent clipping and 59 cases underwent coiling. Though they accounted for 37.8% and 48% of total SAH cases respectively, the outcome was satisfactory. In each treatment modality, a favourable outcome [good recovery/moderate disability] was found in 75.4% of clipping cases and 55.2% of coiling cases clipping had a better outcome than coiling in cases of acute severe SAH in our series and is in contrast to ISAT results

Humans , Treatment Outcome , Aneurysm, Ruptured , Intracranial Aneurysm/complications