الفهرس Only 14 pages are availabe for public view
 |  | from | 334 |  |  |
| | | from | 334 | | |
Abstract
Aneurysmal surgery in cases of SAH as well as dealing with other surgical lesions which may be associated with SAH as ASDH, ICH , IVH and hydrocephalus. Patients and methods: Fifty two (52) patients with SAH admitted at Neurosurgical Department in Zagazig University Hospitals in the period between March 2002 to September 2006, 30 patients had SAH due to intracranial aneurysms operated for aneurysmal clipping. (17 females and 13 females) in ratio of 1.3 to 1. In our series, we found that the most common site is AComA (50%), followed by MCA (23.3%), then ICA (20%), and posterior circulation aneurysms in the form of PCA (6.7%). In our study, the sudden severe headache was the most common symptom (86.7%). This headache was accompanied by nausea and vomiting in 69% of them. The conscious level was not affected in the majority of cases (73.3%) but varying degrees of deteriorated consciousness to the level of coma was noticed in the remaining patients (26.7%). We excluded patients of SAH due to AVM (2 patients), patients of aneurysms that treated endovascularly (2 patients), patients of angionegative SAH (4 patients) and patients died before surgery (14 patients). These 30 patients had undergone microsurgical clipping of their aneurysms after 14 days of SAH (late surgery). The conceptual frameworks from which perioperative and surgical strategies developed for each patient and the follow up data were prospectively collected. Result : Good outcome was93.3% the overall mortality was 6.7%(one patient died from intraoperative rupture, another one died from pulmonary embolism as a complication of DVT) conclusion : We conclude that selected patients population harboring intracranial aneurysms can be satisfactory handled by delayed surgery if a meticulous intraoperative technique is employed, even though sophisticated technology and equipments are not available.