Clinical Outcome Of Emergency Surgical Aneurysm Clipping For Hunt And Hess Grade ? And ? Aneurysmal Subarachnoid Hemorrhage

BACKGROUND: Aneurysmal subarachnoid hemorrhage is one of the common neurological condition that warrants emergency treatment.Hunt & Hess grading system is routinely used for the initial assessment and is prognosis predictor of patients with subarachnoid hemorrhage.Usually,a poor Hunt & Hess i.e.grade ?,? aSAH is associated with not so good clinical presentation at hospital admission assuming for poor prognosis,and,it is even supposed to have higher mortality following higher disability rates.For these instigates,such patients are often treated with endovascular coiling or merely left for conservative therapies because of financial constraint.The efficacy of surgical clipping for poor grade aneurysmal subarachnoid hemorrhage still remains controversial.The present study aims to investigate the clinical outcome following emergency surgical aneurysm clipping for Hunt & Hess grade ?,? subarachnoid hemorrhage.OBJECT?E: To investigate the clinical outcome following emergency surgical aneurysm clipping for Hunt & Hess grade ?,? subarachnoid hemorrhage.METHODS: Patients those admitted to our hospital from Jan 2015 to Jan 2017 were included and evaluated retrospectively,according to the inclusion criteria.Follow-up was carried out after 6-months following emergency aneurysmal clipping.The Glasgow outcome scale(GOS)was applied for post-operative evaluation.RESULTS: A total of 42 patients(male/female ratio of 19:23,mean age of 62.64 years)suffering from Hunt & Hess grade ?,? aneurysmal subarachnoid hemorrhage were included in the study.After evaluation at 6-months follow up: Total 23 patients(54.76%)were reported good outcome with GOS score of 4 & 5,19 patients(45.23%)were reported unfavorable outcome(GOS score of 2 & 3),3 of them were dead(GOS score of 1).CONCLUSION: Hunt & Hess grading system is an important tool for the prognosis of patients with aneurysmal subarachnoid hemorrhage.Individualized preoperative assessment,appropriate operative strategy and intensive postoperative management are critical for the reduction of perioperative complications.We conclude that: surgical clipping showed overall positive outcomes for Hunt & Hess ?,? aneurysmal subarachnoid hemorrhage.Emergency Surgical treatment maybe a good option for such patients rather than merely left without treatment out of financial constraints due to likelihood of poor outcome.