title: Result of surgery for ruptured intracranial aneurysms in Nepal.
abstract: Although aneurysmal subarachnoid haemorrhage appears to be fairly common in the developing countries, the data on the results of management appear to be relatively sparse. This is a retrospective study of 40 patients with 44 intracranial aneurysms operated upon at the National Neurosurgical Referral Centre in Kathmandu, Nepal from 1991 to 1999. The female male ratio was 1.5:1. Age ranged from 16 to 69 years with a mean of 43.2. In location, 18 (41%) were anterior communicating, 10 (23%) posterior communicating, nine (20%) middle cerebral, five (11%) internal carotid other than posterior communicating, two (5%) distal anterior cerebral and one (2%) posterior circulation. Multiple aneurysms were present in four (10%) and giant in three (8%). The timing of surgery ranged from 3 days to 3 months from the day of bleeding. Microsurgical clipping was possible in 37 (93%) and wrapping had to be done in three (7%). Overall mortality was four (10%), two (5%) had a surgery-related death and a further two (5%) died later due to pulmonary embolism. The remaining (90%) made a good recovery. The results compare favourably with that of the International Cooperative Study. Further reduction in mortality will have to await the introduction of endovascular techniques.
authors: Neurosurgical Unit, Bir Hospital, Kathmandu, Nepal.
authors: U P
authors: UP
authors: Devkota
authors: K R
authors: KR
authors: Aryal
mesh_terms: D000293:Adolescent; D000368:Aged; D017542:Aneurysm, Ruptured / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000401:mortality / Q000592:standards; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000401:mortality / Q000592:standards; D012189:Retrospective Studies; D016896:Treatment Outcome