Khokar Tariq Imran, Cheema Zulqarnain Akram, Fatima Ibreeza, Riaz Maimoona, Qadri Haseeb Mehmood, Bashir Asif
Dr. Tariq Imran Khokar, Associate Professor, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Dr. Zulqarnain Akram Cheema, Post Graduate Resident, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S41-S46. doi: 10.12669/pjms.40.12(PINS).11273.
To evaluate the surgical outcomes of delayed microsurgical clipping for ruptured intracranial aneurysms (RICAs) of anterior circulation.
This retrospective, cross-sectional study assessed the surgical outcomes of 50 patients who underwent surgical clipping for "ruptured aneurysms" with subarachnoid haemorrhage after the 21 post-bleed day, from May 01, 2022, till May 01, 2023, at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.
The 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.
Delayed clipping in RICAs after the 21 post-bleed day is advocated, especially in resource-constrained settings. Meticulous surgical technique and asepsis are responsible for great postoperative outcomes.
评估前循环破裂颅内动脉瘤（RICAs）延迟显微手术夹闭的手术效果。
这项回顾性横断面研究评估了2022年5月1日至2023年5月1日期间在巴基斯坦拉合尔旁遮普神经科学研究所神经外科，对21天出血后发生蛛网膜下腔出血的“破裂动脉瘤”进行手术夹闭的50例患者的手术效果。
患者的平均年龄为49.66±6.231岁，女性占比54%。50例病例中，21例为中线动脉瘤（42%），其次是左侧16例（32%）。前交通动脉瘤最为常见，占患者的42%。49例患者术后第一周后无神经功能缺损出院，成功率为98%。分别有6%、4%和2%的患者出现癫痫发作、手术部位感染和脑脊液漏。
提倡在出血后21天对RICAs进行延迟夹闭，尤其是在资源有限的情况下。精细的手术技术和无菌操作有助于取得良好的术后效果。
