• World Neurosurg · Feb 2014

    Long-term outcome in surviving patients after clipping of intracranial aneurysms.

    • Sunil Kumar Gupta, Rajesh Chhabra, Sandeep Mohindra, Arpita Sharma, Suresh Narain Mathuriya, Ashis Pathak, Manoj Kumar Tewari, Kanchan Kumar Mukherji, Navneet Singla, Praveen Salunke, Alok Arvind Umredkar, and Virender Kumar Khosla.
    • Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: drguptasunil@gmail.com.
    • World Neurosurg. 2014 Feb 1;81(2):316-21.

    ObjectiveThe quality of life and functional outcome may be significantly impaired in patients of aneurysmal subarachnoid hemorrhage. The purpose of the present study was to assess the status of patients undergoing surgical clipping of intracranial aneurysms in a long-term follow-up and to identify factors affecting outcome.Methods494 patients who underwent clipping of their intracranial aneurysms with a minimum follow-up of 1 year after their discharge were studied. Preoperative factors such as age, Hunt and Hess grade, Fisher grade, time interval between ictus and surgery, and site of aneurysm were recorded. The long-term status was assessed using Glasgow Outcome Scale (GOS), Modified Rankin Scale (MRS), Barthel index (BI), and Mini-Mental State Examination (MMSE).ResultsSite of aneurysm and ictus-surgery interval did not have any effect on any parameter at long-term follow-up. Majority of patients who were discharged continued to improve as measured by GOS, Modified Rankin Scale, and Barthel index. However a significant proportion of patients had impaired MMSE at long-term follow-up. Multivariate analysis showed a significant effect of age on MMSE and also a positive correlation between number of aneurysms and GOS.ConclusionsMost patients who survived and were discharged continued to improve in the postoperative period even though the immediate postoperative outcome was not favorable in many. However, a substantial subset had impaired cognitive function.Copyright © 2014 Elsevier Inc. All rights reserved.

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