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Outcome, Prognostic Factors, and Follow-Up Results After Subarachnoid Hemorrhage from Pericallosal Artery Aneurysms.
- Source :
-
World neurosurgery [World Neurosurg] 2017 Mar; Vol. 99, pp. 566-571. Date of Electronic Publication: 2016 Dec 27. - Publication Year :
- 2017
-
Abstract
- Objective: Pericallosal artery aneurysms (PAAs) are usually rare (2%-5%), and treatment is challenging for both surgical and endovascular modalities. We performed this analysis to determine the outcome and prognostic factors after subarachnoidal hemorrhage (SAH) caused by ruptured PAAs.<br />Methods: A total of 32 patients with ruptured PAA were admitted to our hospital between 1999 and 2014, added to our prospective database, and analyzed retrospectively. Outcome was measured based on the modified Rankin Scale (mRS) at 6 months after ictus (favorable mRS score, 0-2 vs. unfavorable mRS score, 3-6).<br />Results: Only 16 (50%) patients had a good clinical status at admission (World Federation of Neurological Surgeons Grading System [WFNS] grades I-III), whereas 12 patients (37.5%) were comatose (WFNS grade V). In 18 patients (56%), intracerebral hemorrhage was confirmed, in 18 patients (56%) cerebrospinal fluid drainage was required immediately after admission, and in 5 cases (16%) decompressive craniectomy was performed. There were 17 patients (53.1%) who achieved a favorable outcome (mRS score 0-2) at follow-up. Unfavorable outcome was associated with smoking, cerebral infarction, and worse admission status after multiple logistic regression analysis.<br />Conclusions: Poor admission status, cerebral infarction, and smoking seem to be crucial factors for unfavorable outcome after SAH from PAA.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aneurysm, Ruptured complications
Aneurysm, Ruptured epidemiology
Cerebral Hemorrhage epidemiology
Cerebral Infarction epidemiology
Decompressive Craniectomy
Female
Follow-Up Studies
Humans
Intracranial Aneurysm complications
Intracranial Aneurysm epidemiology
Logistic Models
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Smoking epidemiology
Subarachnoid Hemorrhage epidemiology
Subarachnoid Hemorrhage etiology
Vasospasm, Intracranial epidemiology
Aneurysm, Ruptured surgery
Anterior Cerebral Artery surgery
Corpus Callosum blood supply
Intracranial Aneurysm surgery
Subarachnoid Hemorrhage surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 99
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 28034814
- Full Text :
- https://doi.org/10.1016/j.wneu.2016.12.079