Journal of the Louisiana State Medical Society
Table 2: Complications and Outcome Following Surgical Clipping Complications n (~%) Clinical vasospasm
21 (16.8)
Speech deficit
3 (2.4) 4 (3.2)
Hemiparesis
Hydrocephalus
14 (11.2)
Ventriculoperitoneal shunting
5 (4)
Menintitis
1 (0.8) 2 (1.6) 1 (0.8)
Deep vein thrombosis
Death
Outcome n (%) No. of patients (%)
99 (79.2)
Mean duration of follow-up (range)
19.3 months (1 month - 15 years)
No. of patients with at least 1 year follow-up
52 (55.3)
No. of patients with 1 year angiographic follow-up
45 (45.4%)
Outcome
mRS score
n (~%)
0 1 2 3 4 5
55 (55.0) 28 (28.0) 11 (11.0)
2 (2.0) 2 (2.0) 1 (2.0)
Angiographic obliteration at 1 year
44 (97.7)
using the t-test when appropriate. Univariate analyses were conducted. Differences with a probability value of less than 0.05 were considered statistically significant. RESULTS Between 1992 and 2012, a total of 150 patients with 157 MCA aneurysms were operated on by the senior author (AN). Complete clinical, radiological, and operative data was available for 125 patients with 132 aneurysms, and these were included in the study. PATIENT CHARACTERISTICS The demographic, clinical, and aneurysmcharacteristics of patients are listed in Table 1. There was one patient aged less than 18 years, and 38 patients (30.4%) more than 60 years of age. About two-thirds of the patients were females. Seven patients had bilateral MCA aneurysms. More than half (60.1%) of the aneurysms were located on the left side. There was no association between the side of aneurysm and rupture status. Eighteen (18%) patients presented with
intracerebral hematoma.
RADIOLOGICAL CHARACTERISTICS About half (56.8%) of the aneurysms were less than 10 mm in size. A majority (92%) of the aneurysms were located at MCA bifurcation/trifurcation. All of the giant aneurysms were located at the MCA bifurcation except for one, which was located in the pre-bifurcation segment of the MCA. About one-fifth (22.4%) of patients had multiple aneurysms. These included anterior communicating artery aneurysm in 13 patients, contralateral MCA aneurysm in seven patients, posterior communicating artery aneurysm in five patients, internal carotid artery bifurcation aneurysms in three patients, and basilar bifurcation aneurysm in one patient. Preoperative hydrocephalus was managed with external ventricular drainage. SURGERY All patients underwent surgery via the pterional ap- proach. Intraoperative rupture was encountered in six
162 J La State Med Soc VOL 166 July/August 2014
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