title: Clinical outcomes of surgical clipping for intracranial aneurysms in patients with a Hunt and Hess grade 4 or 5.
abstract: We retrospectively evaluated the records of 49 grade 4 and 5 patients with 42 intracranial aneurysms treated within 72 h of subarachnoid hemorrhage (SAH). In total, 35 patients (71%) were grade 4, and 14 (29%) were grade 5. A total of 42 (85%) patients had one aneurysm, 6 (12%) had two aneurysms, and 1 (3%) had three aneurysms. Out of 49 patients, one technical (2%) and one clinical (2%) complication occurred at surgery. Twenty-one (43%) patients recovered well, including 7 with postoperative hematoma requiring an immediate evacuation of a clot. Fourteen (29%) patients had hydrocephalus and required a ventriculo-peritoneal shunt; 12 patients underwent tracheotomy postoperatively due to coma and pulmonary infection. We found that patients with Hunt and Hess grade 4 and 5 aneurysms can undergo successful neurosurgical clipping of the aneurysms after SAH. However, the morbidity and mortality rates remain high because of their poor clinical condition and a high incidence of vasospasm during treatment.
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Hou
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Jinchuan
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Xianfeng
authors.initials: X
authors.lastname: Gao
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Neurosurgery, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Neurosurgery, Changchun, Jilin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Jilin University, The First Affiliated Hospital, Jilin University, Department of Anesthesiology, Changchun Jilin , China, The First Affiliated Hospital of Jilin University, Department of Anesthesiology, Changchun, Jilin, China.
authors.forename: Xiaona
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*; D013525:Surgical Instruments / Q000009:adverse effects; D016896:Treatment Outcome