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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0042-1743400
Original Article

Surgical Clipping of Ruptured Intracranial Aneurysm: Experience of a Tertiary Centre in Western India

Vijay Kumar 
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Manish Agrawal
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Vinod Sharma
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
D.K. Purohit
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
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Abstract

Background Surgical clipping has been a gold standard procedure for management of intracranial aneurysms. Outcome studies of surgical clipping at institutional level are important to identify modifiable factors and further improve the results. These are even more important in areas where resources are limited, and patient presents late due to ignorance and lack of education. This study is a review of our institutional experience in microsurgical clipping of ruptured intracranial aneurysms.

Methods A retrospective study of patients who underwent surgical clipping for ruptured intracranial aneurysms from January 2014 to February 2020. The medical records of patients were reviewed for demographic data, clinical presentation, radiological investigations, surgery performed and neurological outcome. Outcome at discharge and outcome at follow-up were measured by modified Rankin scale (mRS).

Results In this study of 289 patients, 194 patients (67.13%) had good outcome at discharge (mRS0–2), while 95 patients (32.87%) had poor outcome at discharge (mRS 3–6) and 50 patients (17.30%) expired during hospital stay. Out of 289 patients, 208 patients (71.97%) were admitted after more than 3 days of ictus. Significant factors affecting outcome were neurological status determined by Glasgow coma scale (GCS) score, World Federation of Neurosurgical Societies (WFNS) grade or Hunt and Hess Grade, time interval from onset of subarachnoid hemorrhage to admission, and time interval from admission to surgery.

Conclusion The present study identifies factors for improving outcome in patients of ruptured aneurysm at institutional and community level. Time from ictus to admission and admission to surgery are important modifiable factors in our study.

Keywords

ruptured intracranial aneurysm - surgical clipping - modified Rankin scale - WFNS Grade


Publication History

Article published online:
26 April 2022

© 2022. Neurological Surgeons' Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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