Neuroevidence - A Journal of Medicine
http://www.neuroevidence.periodikos.com.br/article/64694c23a9539564237442e2
Neuroevidence - A Journal of Medicine
Original Original

Patients with aneurysmal subarachnoid hemorrhage who arrived late for microneurosurgical treatment.

Angel J. Lacerda Gallardo MD Ph.D , Daysi Abreu Pèrez MD ScM, Jose A. Galvez MD

Neuroevidence, Ahead of Print, 2023
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Abstract

Abstract: Background: To evaluate the surgical results in patients with intracranial aneurysms of the anterior circulation whom, for different reasons, could not be operated on in the acute phase of evolution. Materials and Methods: A descriptive study was carried out with patients with intracranial aneurysms whom, for different reasons, were not operated on in the acute phase of evolution. All of them were operated on through a supraorbital keyhole. Results: 154 patients were studied, and total 186 aneurysmal sacs were treated, 154 ruptured (82,8 %) (p≤ 0.001) and 32 (17,2 %) not ruptured forming part of aneurysmal multiplicity. The results according to the modified Rankin scale showed the more frequent patients in grade 0, without symptoms, 80 (51,94 %) (p≤0.000). Regarding mortality, two patients (1.3 %) died. Conclusions: patients with aneurysmal subarachnoid hemorrhage who survive the acute phase and access neurosurgical treatment late, have a high survival rate. The quality of life of these patients is closely related to the clinical status at the time of surgery

Keywords

 Intracranial aneurysms; Supraorbital keyhole; Microneurosurgery.

References

  1. Gittins A, Talbott N, Gilani AA, Packer G, Browne R, Mullhi R et al. Outcomes following acute poor-grade aneurysmal subarachnoid bleed – Is early definitive treatment better than delayed management? Journal of the Intensive Care Society 2021; 22(3): 198–203.
  2. Steiner T, Juwel S, Unterberg A, et al. European Stroke
    Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis 2013; 35: 93–112.
  3. Sattur MG, Abi-Aad KR, Welz ME, Aoun RJ, Krishna C, Purnell C et al. Extended Lateral Orbital Craniotomy: Anatomic Study
    and Initial Clinical Series of a Novel Minimally Invasive
    Pterional Approach. J Neurol Surg B 2020; 81:88–96.
  4. Chandra P S, Tej M, Sawarkar D, Agarwal M, Doddamani RS. Fronto-Orbital Variant of Supraorbital Keyhole Approach for Clipping Ruptured Anterior Circulation Aneurysms (f-Sokha). Neurol India 2020;68:1019-27.
  5. Carmona Rammsy P. Abordaje minimamente invasivo lateral Key-hole. Experiencia de 64 casos. Rev. Chil. Neurocirugía. 2011; 36: 11-19.
  6. Mori K, Watanabe S. Keyhole Approach in Cerebral Aneurysm Surgeries. Adv Tech Stand Neurosurg. 2022;44:265-275.
  7. Chiappini A, Marchi F, Reinert M, Robert T. Supraorbital approach through eyebrow skin incision for aneurysm clipping: how I do it. Acta Neurochir (Wien). 2018; 160(6):1155-1158.
  8. Cheng C-M, Noguchi A, Dogan A, Anderson GJ, Hsu FPK, McMenomey SO et al.  Quantitative verification of the keyhole concept: a comparison of area of exposure in the parasellar region via supraorbital keyhole, frontotemporal pterional, and supraorbital approaches. JNS. 2013; 118 (2): 264-69.
  9. Yu LB, Huang Z, Ren Z-G, Shao J-S, Zhang Y, Wang R et al. Supraorbital keyhole versus pterional craniotomies for ruptured anterior communicating artery aneurysms: a propensity score-matched analysis. Neurosurg Rev. 2020 Apr;43(2):547-554.
  10. Wu X, Zhang S, Cheng Z, Aung TT, Fang Y, Li C. Comparison of supraorbital and pterional keyhole approach for clipping middle cerebral artery aneurysm: A Chinese population-based study. World Neurosurg 2019;121:e596-604.  
  11. Drake CG. Report of world federation of neurosurgical surgeon committee on a universal SAH grading scale. JNS. 1988; 68: 985-6.
  12. Patriota GC, da Silva-Júnior JM, Evangelista Santos Barcellos AC, de Sousa Silva Júnior J B, Oliveira Toledo D P,  Campos Gomes Pinto F  et al.  Determining ICH Score: can we go beyond?. Arq Neuro-Psiquiatr [Internet]. 2009 Sep [cited 2012 June 25]; 67(3a): [aprox. 4p.]. Available from: http://dx.doi.org/10.1590/S0004-282X2009000400006.
  13. Spagnuolo E, Quintana L. Hemorragia subaracnoidea por aneurisma cerebral roto. Guías de manejo clínico actualizadas 2010. Una propuesta al capítulo vascular de la FLANC. Rev. Chil. Neurocirugía 2010; 35: 72-86.
  14. Marbacher S, Niemelä M, Hernesniemi J, Frösén J. Recurrence of endovascularly and microsurgically treated intracranial aneurysms-review of the putative role of aneurysm wall biology. Neurosurg Rev  2019; 42(1):49-58.
  15. Marbachera S, Diepersc M, Kahlesb T, Nedeltchevb K, Remondac L, Fandinoa J. Interdisciplinary decision-making and treatment of
    intracranial aneurysms in the era of complementary
    microsurgical and endovascular techniques. Swiss Med Wkly. 2016; 146:w14372.
  16. Zheng Y, Zheng L, Sun Y, Lin D, Wang B, Sun Q and Bian L. Surgical Clipping of Previously Coiled Recurrent Intracranial Aneurysms: A Single-Center Experience.Front. Neurol. 2021; 12: 680375. https://doi.org/ 10.3389/fneur.2021.680375
  17. Mori M, Watanabe S. Keyhole Approach in Cerebral Aneurysm Surgeries. Adv Tech Stand Neurosurg. 2022;44:265-275.              
  18. Yao Z, Hu X, Ma L. Timing of surgery for aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Int J Surg 2017; 48: 266–274.
  19. Giammattei L, Starnoni D, Maduri R, Bernini A, Abed-Maillard S et al. Implementation of cisternostomy as adjuvant to decompressive
    craniectomy for the management of severe brain trauma. Acta Neurochirurgica 2020; 162:469–479. https://doi.org/10.1007/s00701-020-04222-y
  20. Chau CYC, Craven CL, Rubiano AM, Adams H, Tülü S, Czosnyka M et al. The evolution of the role of external ventricular drainage in traumatic brain injury. J Clin Med 2019; 8:1422.
  21. Perneczky A, Reisch R, Kindel S, Tschabitscher M. Keyhole Approaches in Neurosurgery. Concept and surgical technique. Austria: Springer-Verlag wien; 2008.
  22. Yu L-B, Huang Z, Ren ZG, Shao JS, Zhang Y, Wang R et al.  Supraorbital keyhole versus pterional craniotomies for ruptured anterior communicating artery aneurysms: a propensity score-matched analysis. Neurosurg Rev. 2020 Apr;43(2):547-554.
  23. Figueiredo E, Deshmukh V, Deshmukh P, Crusius MU, Crawford N,   Speztler R, et al. An Anatomical Evaluation of the Mini-Supraorbital Approach and Comparison with Standard Craniotomies. Neurosurgery 2006; 59 (Suppl 4): 212-220.
  24. Butron OM. Abordajes craneanos mínimamente invasivos tipo keyhole para patología neuroquirúrgica. REV. MED. CLIN. CONDES 2008; 19(5): 590-594.
  25. Arnaout MH, Luzzi S, Galzio R, Aziz K. Supraorbital keyhole approach: Pure endoscopic and endoscope-assisted perspective. Clin Neurol Neurosurg. 2020 Feb;189:105623.
  26. McLaughlin N, Cutler A, Martin NA. Technical nuances of temporal muscle dissection and reconstruction for the pterional keyhole craniotomy. Technical note. JNS. 2013; 118(2): 309-14.

Submitted date:
01/06/2023

Reviewed date:
04/10/2023

Accepted date:
04/24/2023

64694c23a9539564237442e2 neuroevidence Articles
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