Factors Affecting on the Prognosis in Multiple Intracranial Aneurysms

Abstract

Background: With improvements in diagnostic methods, the incidence of multiple intracranial aneurysms has increased up to35%. Factors influential on outcome in multiple intracranial aneurysms are still debatable. We aimed to determine risk factorsrelated to multiple intracranial aneurysms in patients admitted with subarachnoid hemorrhage caused by a ruptured intracranialaneurysm.Material and Methods: This retrospective study was performed on 105 aneurysms of 48 patients diagnosed with multipleaneurysms using charts, records, and film archives among 250 patients admitted to İstanbul Haydarpaşa Numune Training andResearch Hospital between January 2003-December 2009 who were examined and treated for subarachnoid hemorrhage. Age,gender, medical history, admission/surgery times, clinical features determined on neurological examination at admission (WFNSScore), amount of blood measured on cranial computed tomographic images (Fisher Score), number of aneurysms and systemsto which they belonged, complications, and Glasgow outcome scale indicating the morbidity and mortality were recorded.Results: The mean age was 52.75±14.02(4-90) years. The female/male ratio was 2.2. Most common clinical features wereheadache (83.7%), and hypertension (56.3%). The most common location was the middle cerebral artery, and aneurysm sizewas 2-6 mm (66.7%). The most common intervention was an early clipping of as many aneurysms as possible in one session(84.7%). Vasospasm and hydrocephalus were the most common complications (31.1%, 16.6%, respectively). No differencewas present between early and late interventions regarding mortality. Glasgow outcome Scale was negatively correlated withFisher score (r=-0.306), but not with WFNS score.Conclusions: Age, amount of cisternal blood preoperatively, and postoperative vasospasm are risk factors for mortality, butnot hypertension and postoperative hydrocephalus. WFNS Scoring system is not a reliable mortality predictor.