gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Outcome and prognostic factors after subarachnoid hemorrhage from pericallosal artery aneurysms

Meeting Abstract

  • Nazife Dinc - Klinik für Neurochirurgie, Goethe-Universitätsklinikum, Frankfurt am Main, Germany
  • Stephanie Lescher - Institut für Neuroradiologie, Goethe-Universitätsklinikum, Frankfurt am Main, Germany
  • Johannes Platz - Klinik für Neurochirurgie, Goethe-Universitätsklinikum, Frankfurt am Main, Germany
  • Christian Senft - Klinik für Neurochirurgie, Goethe-Universitätsklinikum, Frankfurt am Main, Germany
  • Volker Seifert - Klinik für Neurochirurgie, Goethe-Universitätsklinikum, Frankfurt am Main, Germany
  • Jürgen Konczalla - Klinik für Neurochirurgie, Goethe-Universitätsklinikum, Frankfurt am Main, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.14.08

doi: 10.3205/16dgnc319, urn:nbn:de:0183-16dgnc3191

Veröffentlicht: 8. Juni 2016

© 2016 Dinc et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Aneurysms from pericallosal arteries are usually rare (2-9%) and treatment is challenging for both modalities, surgical and endovascular. However, data after subarachnoid hemorrhage (SAH) is therefore rare. Aim of the study is to determine the outcome and prognostic factors after subarachnoidal hemorrhage from a ruptured pericallosal artery aneurysm (PAA).

Method: Between 1999 and 2014 32 patients with a SAH from a PAA were admitted to our hospital and analyzed retrospectively. Outcome was measured based on the modified Rankin Scale at 6 months after ictus (mRS 0-2 favorable vs. 3-6 unfavorable).

Results: Only 16 (50%) patients had a good clinical status at admission (WFNS I-III), whereas 12 patients (37.5%) had a comatose status (WFNS V). In 53% of the patients an intracerebral hemorrhage was detected. 28% of the patients had a Fisher 3 bleeding pattern and 53% a Fisher IV. Delayed cerebral infarctions (DCI) occurred in 53%. Nonetheless, 17 patients (52%) achieved a favorable outcome (mRS 0-2) at follow-up. Six patients died (18%), one before aneurysm treatment. In univariate analysis unfavorable outcome was associated with smoking, hydrocephalus, craniectomy, DCI and worse admission status. In multivariate analysis smoking, worse admission status and DCI were detected as independent negative predictors. However, aneurysm treatment (coiling or clipping) wasn’t a predictor.

Conclusions: SAH from PAA is often associated with intracerebral hemorrhage, high Fisher Grade bleedings and worse admission status. Smoking, worse admission status and DCI were associated with unfavorable outcome after SAH from PAA, whereas endovascular and surgical treatment did not affect patients’ outcome.