Risk of Dependency Following Microsurgical Clipping in Good Grade Patients With Ruptured Anterior Circulation Aneurysms
محل انتشار: مجله جراحی مغز و اعصاب ایران، دوره: 7، شماره: 1
سال انتشار: 1399
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 102
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شناسه ملی سند علمی:
JR_IJN-7-1_006
تاریخ نمایه سازی: 9 شهریور 1400
چکیده مقاله:
Background and Aim: Most good grade (WFNS I and II) patients who undergo microsurgical clipping achieve a favorable outcome. However, some independent patients before surgery face unfavorable outcomes after the operation, signifying the impact of microsurgical clipping. This study aimed to identify the risk of developing dependency in patients without previous neurological deficits.
Methods and Materials/Patients: We reviewed ۵۰ consecutive good grade patients with ruptured anterior circulation aneurysms who underwent microsurgical clipping between May ۲۰۱۷ and May ۲۰۲۰ in the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan. The clinical outcome at discharge and three months follow-up was assessed using the Glasgow Outcome Scale (GOS).
Results: In this study, seven patients (۱۴%) became dependent (GOS II and III) following clipping. Of whom, five patients (۱۰%) suffered surgical insult in the form of intraoperative rupture (۴%), post-op infarct (۴%), and direct brain damage (۲%).
Conclusion: Patients without neurologic deficit pre-operatively still suffer unfavorable outcomes mainly due to operative complications. Vascular injuries remain the main cause of morbidityproducing dependency. Therefore, all surgical techniques must minimize the risk to vessels, both during dissection and at clip placement.
کلیدواژه ها:
نویسندگان
Sundus Ali
۱. Punjab Institute of Neurosciences, Lahore, Pakistan ۲. Department of Neurosurgery, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
Fauzia Sajjad
Punjab Institute of Neurosciences, Lahore, Pakistan
Asif Shabbir
Punjab Institute of Neurosciences, Lahore, Pakistan
Akmal Azeemi
Punjab Institute of Neurosciences, Lahore, Pakistan