gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Temporary clipping seems to affect the incidence of vasospasm after SAH

Das temporäre Clipping scheint einen Vasospasmus provozieren zu können

Meeting Abstract

  • corresponding author Chris Woertgen - Klinik und Poliklinik für Neurochirurgie, Universität Regensburg, Regensburg
  • R. D. Rothoerl - Klinik und Poliklinik für Neurochirurgie, Universität Regensburg, Regensburg
  • R. Albert - Klinik und Poliklinik für Neurochirurgie, Universität Regensburg, Regensburg
  • K. M. Schebesch - Klinik und Poliklinik für Neurochirurgie, Universität Regensburg, Regensburg
  • O. W. Ullrich - Klinik und Poliklinik für Neurochirurgie, Universität Regensburg, Regensburg
  • A. Brawanski - Klinik und Poliklinik für Neurochirurgie, Universität Regensburg, Regensburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.08.11

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0233.shtml

Published: April 23, 2004

© 2004 Woertgen et al.
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Outline

Text

Objective

Patients with large volume SAH are more likely to develop vasospasm after aneurysmatic SAH. Information about the role of surgery and temporary clipping concerning the development of vasospasm is sparse. The aim of this study was therefore to gather more information in this field.

Methods

From 1995 to 2000 we operated on 292 patients (50.6 years mean, 64.4% females) with aneurysmatic SAH. The data were collected in a prospective databank, which included information on severity of SAH, radiological data and operative procedures like temporary clipping. In addition, we registrated TCD data on a daily basis. All patients had a follow-up after 2-3 month according the Glasgow outcome scale (GOS).

Results

Severity according to the WFNS grading and vasospasm correlated significantly to outcome (p<0.0001). The Fisher rating scale significantly correlated to the development vasospasm detected by TCD (> 120 cm/s, p<0.0001). 50.5% of the patients had temporary clipping during surgery. Temporary clipping significantly correlated to the development of vasospasm (63.3% developed vasospasm, p<0.008;). Temporary clipping was significantly more often applied in aneurysms of the arteria cerebri media (p<0.0001) and vasospasm was detected more frequently in this area (p<0.004). In patients with unfavourable outcome there was a tendency for longer clipping times (3.2 versus 2.1 min, mean, p=0.06).

Conclusions

Temporary clipping during surgery seems to be able to provoke vasospasm after aneurysmatic SAH.