The rate of vascular variations in patients with aneurysms was 57.8%. Arterial hypoplasia and aplasia were the most common variations. ACS was the most common region that variations were located in; they were mostly detected on the right side. Coexistence of ACoA aneurysm was higher than PCoA and MCA aneurysms. In the PCS variations group, PCoA aneurysms were the most common aneurysms that accompanying the variation and multiple variations were more common than in the other two groups. The variations in MCS were most common in males.

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ABSTRACTaneurysmal SAHs have been investigated in several studies.The aim of the present retrospective study is to examine the various prognostic factors of the clinical outcomes of 104 patients who underwent a neurosurgical clipping of aneurysms due to aneurysmal SAH between 2008 and 2014. █ mATERIAl and mEThODSThe data of 104 patients that had suffered an aneurysmal SAH were analyzed. The patients were recruited between 2008 and 2014 at the Neurosurgery Clinic of Haydarpasa Numune Training and Research Hospital. █ INTRODUCTION D espite the technical and medical advances, aneurysmal subarachnoid hemorrhage (SAH) continue to be a challenging pathology, associated with high rates of morbidity and mortality. The current treatment of the condition involves the early repair of the aneurysm to prevent re-bleeding and associated problems, including cerebral vasospasm, hydrocephalus, electrolyte imbalances, infections and seizures.In this regard, a definition is required of the various prognostic factors of an SAH. The factors affecting the outcomes of AIm: Despite technical and medical advances, aneurysmal subarachnoid hemorrhages (SAH) continue to be a challenging pathology, associated with high rates of morbidity and mortality. In this regard, a definition is required of the various prognostic indicators of an SAH. The aim of the present retrospective study is to examine the various prognostic factors of the clinical outcomes of the patients who underwent a neurosurgical clipping of aneurysms due to aneurysmal SAH. mATERIAl and mEThODS:The data of 104 patients that had suffered an aneurysmal SAH were analyzed. The baseline demographic, clinical and radiological data were all analyzed. The prognostic study was derived from an analysis of these variables. Relationship between prognostic factors and outcome was evaluated by univariate and logistic multivariate regression analysis. RESUlTS:This study has identified unfavorable outcomes on the Glasgow Outcome Scale at discharge after the surgical treatment of aneurysmal SAH associated with increased age, poor World Federation of Neurosurgical Societies (WFNS) grade on admission, higher Fisher's grade on admission computed tomography scan, larger aneurysm, and clinical vasospasm. In a multivariate logistic regression analysis, age, high WFNS grade, positive clinical vasospasm and size of aneurysm were found to be independent risk factors for mortality. The presence of hydrocephalus, number of aneurysms, positive risk factors, and the presence of Doppler vasospasm did not reach statistical significance. CONClUSION:The most important prognostic factors in patients undergoing surgery due to aneurysmal subarachnoid hemorrhage were WFNS grade, age, size of aneurysm and clinical vasospasm.

Ozone (O 3 ) is a gas that contains three atoms of oxygen with a cyclic structure (5). It induces antioxidant stress and promotes resistance against oxidative stress (13,15) and has been used as an antioxidant agent in inflammation (26). Oxygen-ozone therapy is known to be a bio-oxidative procedure (2) and application of low-dose ozone inhibits prostaglandin synthesis, release of bradykinin and algogenic substances, and proteinase secretion from macrophages and polymorphonuclear leukocytes (8).█ INTRODUCTION C erebral vasospasm is one of the main causes of poor prognosis after subarachnoid hemorrhage (SAH) (17). While the search for the treatment of post hemorrhagic cerebral vasospasm continues, the underlying mechanisms still rema-ins obscure (1). Oxidation products such as glutathione peroxidase (24) and lipid peroxides (16,20), and inflammation (1,14) following SAH are among the causative substances of cerebral vasospasm and poor outcome (16,29).AIm: Oxidation products following subarachnoid hemorrhage (SAH) are among the causative substances of cerebral vasospasm and poor outcome. Ozone (O 3 ) is a gas that contains three atoms of oxygen with a cyclic structure. It has been suggested that application of low-dose ozone has an antioxidant effect and provides resistance to oxidative stress. We investigated the effect of oxygen-ozone therapy on rat femoral artery vasospasm. mATERIAl and mEThODS: Twenty-four male Sprague-Dawley rats were randomly separated into vasospasm, vasospasm + ozone and control groups. The femoral artery vasospasm model was used. Rats in the vasospasm + ozone group were given 4 mL of ozone (20 µ/mL) daily for 7 days. Femoral arteries were examined by light microscopy for histological changes and morphometric analysis. Kruskal Wallis test and Mann Whitney u tests were used for the statistical analysis. The values of p<0.01 and p<0.05 were recognized as statistically significant. RESUlTS:Ozone treatment reduced the morphometric changes as irregularity of the elastic lamina, disruption of the endothelial cells, vacuolization and hemorrhages that caused by vasospasm. The measurements of the wall thickness (p=0.003; p<0.01) and lumen diameter (p=0.001; p<0.01) showed statistically significant difference (p < 0.01) between the vasospasm and vasospasm+ozone groups.CONClUSION: Ozone therapy may be useful in the treatment of post-hemorrhagic vasospasm.

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