Surgery for unruptured intracranial aneurysms in a low-volume neurosurgical unit.
OBJECTIVE
To evaluate outcomes after surgical treatment for unruptured intracranial aneurysms in a low-volume neurosurgical unit.


METHODS
Consecutive patients operated during the years 1988-98 at the Department of Neurosurgery, University Hospital of North Norway, were studied retrospectively. Procedure-related complications were registered. The modified Rankin Scale and the Glasgow Outcome Scale, Extended version (GOS-E), were used for assessment of outcome.


RESULTS
Thirty-six aneurysms were repaired in 32 patients during 34 surgical procedures. Surgery-related central nervous system complications occurred in eight (25%) patients. The complication rate was 35% for the first 17 procedures, and 12% for the last 17. The latter group of procedures were performed during a period of 3 years, whereas the former group was spread over a period of 8 years. A favourable outcome (GOS-E score 6-8) was reached in 27 (84%) patients.


CONCLUSIONS
Decision-making in patients with unruptured intracranial aneurysms must be based on knowledge about institution-specific complication rates, preferably followed on a prospective basis.
Horn
M
M
Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway.
Morgan
M K
MK
Ingebrigtsen
T
T
D000328:Adult; D000368:Aged; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D009664:Norway / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D013503:Surgery Department, Hospital / Q000592:standards* / Q000706:statistics & numerical data*; D013525:Surgical Instruments / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*