Brain Aneurysms and the Results of their Surgery in Mashhad Ghaem Hospital during 1998-2007

Introduction & The purpose of this retrospective study is the assessment of the results of early and delayed surgery in patients who have been operated for ruptured aneurysms, and the cognition of the effective agents and the proper ways for recovery and promotion of treatment methods in these patients. This study is performed retrospectively based on hospitalized information in patient files in Ghaem neurosurgical departments since, 1998 to 2007. In this study we classified personality features, background diseases, the time between hemorrhage to admission, imaging findings in patients with brain aneurysm, time of surgery, kind of surgery, complications and the results of them. 183 Patients were admitted in hospital in 10 years. Most of them were between 50 -60 years old and the mean age was 48.06± 1.48 for men and 50.17± 1.09 for women (overall mean age: 49.05 ±0.88). Hypertension and smoking were the most common underlying factors in these patients. Sudden headache and unconsciousness were the most common symptom and sign after rupture of aneurysms. The most common location for their aneurysms was Ant. Com and MCA. 140 cases (76.5%) were operated upon 21 cases (15%) in first three days and 112 patients (80%) after two weeks. In early operated group, severe complication and death was in 52.4 % cases, but in delayed operated group, severe complication and death was in 15.2% cases. The most common factor in mortality and morbidity in this study were neurologic grades of the patients and the time between aneurysmal rupture to surgery. In this study we have shown that increasing in Hunt & Hess grade, increases morbidity and mortality, and that delayed surgery reduces the mortality and complications after surgery in the patients with brain aneurysmal rupture. Other factors such as diabetes, high blood pressure, addiction and smoking, had no significant relationship with the complication rate and mortality. Although the results of this study and other reports implicate that the mortality, morbidity and complications after early surgery of aneurysms (in the first three days) is more than late surgery, but because some of the patients die from rebleeding or vasospasm before late period, we are still in need of comparing the results of early surgery and outcome of patients in late surgery group.