Objective The treatment of ruptured aneurysms of the posterior circulation is a controversy in neurosurgery. The aim of this work is to describe the experience and results of the early surgical treatment of this pathology at Centro Hospitalar do Porto.
Method We retrospectively analyzed the medical records of all patients aged over 18 who, in the period between 1999–2013, were admitted to our center with the diagnosis of ruptured saccular posterior circulation aneurysm. The patients were clinically staged at admission using the Hunt & Hess (H&H) scale. The modified Glasgow Outcome Scale (mGOS) was used to assess the outcome at discharge and after 6 months.
Results Between 1999–2013, 59 patients underwent surgery for ruptured posterior circulation aneurysms. Eighty percent of the patients were female, and their average age was 58.7 years. Posterior-inferior cerebellar artery aneurysms accounted for 49.2% of surgeries, while basilar aneurysms accounted for 28.8%. Upon admission, 86.4% of patients were classified as H&H1–3, and 13.6% as H&H4–5. The outcomes at discharge and at 6 months were as follows: at discharge, mGOS1 in 5.1%, mGOS2–3 in 18.6%, and mGOS4–5 in 76.3%; at 6 months, mGOS1 in 10.2%, mGOS2–3 in 10.2%, and mGOS4–5 in 79.6%. There was a statistically significant correlation between basilar aneurysms and worse outcomes (p = 0.011). No correlation was found between the values of the H&H scale upon admission and outcome.
Conclusions The functional outcome of our group of patients is mainly in line with what is described in other series from the literature. However, there is a trend toward lower mortality but higher morbidity rates.
Surgical Management of Ruptured Posterior Circulation Aneurysms – A Single Center Experience
