Background: The study follows the complete series of patients surgically treated in the past 10 years at Targu Mures Neurosurgery Department and the effects of the surgical experience over the clinical outcome.
Material and method: This is a retrospective study including 382 patients operated in our department between 2001 and 2011 by a team of 5 neurosurgeons.
Results: Out of the 382 patients included in the study 62.17% were female, 37.83% were male with a mean age of 51±30 years. The majority of operated aneurysms were located in the anterior circulation: 363 cases (95%) with the following locations: anterior communicating artery, 167 cases (43.65%), middle cerebral artery, 100 cases (26.3%), posterior communcating artery, 61 cases (16%). In the posterior circulation a number of 19 aneurysms have been operated with the majority (7) being top basilar aneurysms. 86.80% of cases have been admitted in Hunt-Hess I-III, 13.2% being in Hunt-Hess IV-V. A number of 244 patients (64%) have been admitted and operated in first 96 hours from aneurysm rupture, 92 patients (24%) have been operated between 5 to 14 days, and the rest of 46 patients (12%) have been operated two weeks after the first SAH. Outcome has been calculated using the GOS scale: 57.23% of patients have been discharged with GOS 5, 17% with GOS 4, 10% with GOS 2 and 3, while overall mortality was 15.8%.
Conclusions: Multimodality and multidisciplinarity treatments of cerebral aneurysms have improved significantly the outcome of patients but still the surgical treatment represents a major option. In our opinion early surgery represents the gold standard in the treatment of cerebral aneurysms.