[A retrospective analysis of the outcomes of patients with aneurysmal subarachnoid hemorrhages: a focus on the prognostic factors]

Abstract

The authors report a clinical analysis of the outcomes of aneurysmal subarachnoid hemorrhages in 112 patients. Cerebral angiography was conducted on 85 patients. Clipping or wrapping of the aneurysm was performed on 81 patients. The overall good outcome (GR and MD in the Glasgow Outcome Scale) ratio and mortality rate were 43% and 34%, respectively. The good outcome ratio and mortality rate in operative cases were 59% and 12%, respectively. With regard to the timing of the operation, 77 cases (95%) underwent early operation and 4 cases (5%) underwent delayed operation. The good outcome ratio of patients with grade I to III at surgery using the Hunt and Kosnik grading system was 74%. There was no difference in outcome between the patients with a ruptured aneurysm in the anterior circulation and those with one in the posterior circulation. The retrospective analysis of the overall outcomes showed the risk factors as being: age over 70 years, cerebral atherosclerosis, poor grade on Hunt and Kosnik grading system and symptomatic vasospasm. Preoperative bleeding of the aneurysm, severe brain swelling at surgery, and postoperative symptomatic vasospasm were factors which worsen the outcome of surgically treated patients. Patients with more than 2 factors showed worse outcomes than those with only one factor. The utilization of these prognostic factors should be important to improve the outcome of patients with aneurysmal subarachnoid hemorrhage.