• Tariq Imran Khokar, Zulqarnain Akram Cheema, Ibreeza Fatima, Maimoona Riaz, Haseeb Mehmood Qadri, and Asif Bashir.
• Dr. Tariq Imran Khokar, Associate Professor, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
• Pak J Med Sci. 2024 Dec 1; 40 (12PINS Suppl): S41S46S41-S46.

ObjectiveTo evaluate the surgical outcomes of delayed microsurgical clipping for ruptured intracranial aneurysms (RICAs) of anterior circulation.MethodsThis retrospective, cross-sectional study assessed the surgical outcomes of 50 patients who underwent surgical clipping for "ruptured aneurysms" with subarachnoid haemorrhage after the 21st post-bleed day, from May 01, 2022, till May 01, 2023, at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.ResultsThe mean age of patients was 49.66 ± 6.231 years with a female preponderance of 54%. Out of 50 cases, 21 were midline aneurysms (42%), followed by left-sided laterality in 16 cases (32%). Aneurysm of the anterior communicating artery was the most common accounting for 42% of the patients. Forty-nine patients returned home after first postoperative week without deficits, with a success rate of 98%. Seizures, surgical site infection and cerebrospinal fluid leak were noted in 6%, 4% and 2% patients, respectively.ConclusionDelayed clipping in RICAs after the 21st post-bleed day is advocated, especially in resource-constrained settings. Meticulous surgical technique and asepsis are responsible for great postoperative outcomes.Copyright: © Pakistan Journal of Medical Sciences.

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