Cerebral Aneurysm Characteristics and Surgical Outcomes: An In-Depth Analysis of 346 Cases Operated Using Microsurgical Clipping

Corneliu Toader; Cristian Kakucs; Nicolaie Dobrin; Razvan-Adrian Covache-Busuioc; Bogdan-Gabriel Bratu; Andrei Adrian Popa; Luca-Andrei Glavan; Antonio-Daniel Corlatescu; Matei George Nicolae Grama; Horia-Petre Costin; Alexandru Vladimir Ciurea

doi:10.7759/cureus.56933

Cerebral Aneurysm Characteristics and Surgical Outcomes: An In-Depth Analysis of 346 Cases Operated Using Microsurgical Clipping

Cureus. 2024 Mar 26;16(3):e56933. doi: 10.7759/cureus.56933. eCollection 2024 Mar.

Affiliations

¹ Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU.
² Department of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, Bucharest, ROU.
³ Department of Neurosurgery, "Transilvania" University of Brasov, Faculty of General Medicine, Brasov, ROU.
⁴ Department of Neurosurgery, Clinical Emergency Hospital of Brasov, Brasov, ROU.
⁵ Department of Neurosurgery, Clinical Emergency Hospital "Prof. Dr. Nicolae Oblu", Iasi, ROU.
⁶ Department of Research and Development, Syndical.io, Bucharest, ROU.
⁷ Department of Neurosurgery, Sanador Clinical Hospital, Bucharest, ROU.

Abstract

This comprehensive study analyzes 346 surgically treated intracranial aneurysms, emphasizing the importance of understanding risk factors and prevalent characteristics in patients. Intracranial aneurysms, primarily of the saccular or berry type, significantly contribute to nontraumatic subarachnoid hemorrhages and demonstrate a rising incidence due to advances in imaging techniques. The study highlights a gender discrepancy in aneurysm occurrence and a higher prevalence in individuals over 30 years old. The research delves into various aspects, including aneurysm localization, diameter, neck dimensions, and rupture status, with a focus on the anterior communicating artery and middle communicating artery as predominant locations. Significant findings include the prevalence of ruptured aneurysms and the impact of arterial hypertension, atherosclerosis, obesity, and diabetes on aneurysm epidemiology. The study also investigates the occurrence of vasospasm, a significant factor in delayed morbidity and mortality in aneurysmal subarachnoid hemorrhage. The utilization of the Glasgow Outcome Scale and other quantification scales aids in understanding the severity and postoperative outcomes of intracranial aneurysms. Challenges such as the incidence of reopenings and postoperative osteomyelitis are addressed, underlining the need for refined protocols and multidisciplinary approaches in treatment. The study's results contribute to the existing knowledge base on intracranial aneurysms, emphasizing the importance of ongoing research and tailored treatment strategies. The comprehensive nature of this analysis, covering preoperative, intraoperative, and postoperative factors, provides valuable insights into the complex interplay of risk factors and clinical outcomes in patients with intracranial aneurysms.

Keywords: computed tomography angiography; epidemiology; glasgow out-come scale; hemodynamic strain; intracranial aneurysms; magnetic resonance angiography; risk factors; subarachnoid hemorrhage; surgical treatment; vasospasm.