Microsurgery For Ruptured Cerebral Anterior Circulating Aneurysm

Objective To evaluate clinical strategy and effect of microsurgery for ruptured cerebral anterior circulating aneurysm.Methods One hundred-four patients presenting with anterior circulating aneurysmal subarachoid hemorrhage(SAH) underwent early-late-phase(within 3 days or after 10 days) microsurgical clipping at First Affiliated Hospital of Xinjiang Medical University between January 2002 and December 2005.Glasgow outcome scale(GOS) was conducted to evaluate patients outcomes.Results Of 126 intracranial aneurysms,121 lesions were clipped successfully.And five unruptured aneurysm,surgical clipping at the same time it is quite difficult,the only line ruptured aneurysm clipping operation,and postoperative follow-up study.After 15 cases of intracranial hematoma,13 cases of intracerebral hematoma,and two cases of subdural hematoma;21 cases of hydrocephalus,to ventriculo-peritoneal shunt eight cases; electrolyte disorder in 22 cases;seven cases of lung infection;oculomotor nerve palsy after three cases;hemiplegia or hemiplegia increase six cases;three cases of mental disorders;postoperative symptomatic cerebral vasospasm in 11 cases,improved significantly after treatment six cases,two cases of severe disability,death in 2 cases. Good outcome was achieved in 87 cases,mild disability in 11 cases,severe disability in 4 cases,and 2 patients died after surgery.The difference of GOS was statistically significant between patients in Hunt and Hess GradeⅠ～Ⅱand GradeⅢ～Ⅴ.However, there was no significant difference between early surgery and late surgery..In GradeⅢ～Ⅴthere was no significant difference in different surgical period.Conclusions There was no significant difference between early and late microsurgery for ruptured cerebral anterior circulating aneurysm.