Microsurgical Treatment of 86 Anterior Choroidal Artery Aneurysms: Analysis of Factors Influencing the Prognosis

Abstract

Purpose To explore factors affecting the prognosis of choroidal anterior artery aneurysm (AChAA) and provide a reference for improving the postoperative outcome. Methods The clinical data of 86 patients with AChAA who underwent treatment by a single surgeon were collected and analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were conducted to examine 12 factors that possibly affected outcome. Results The five factors that affected the patient outcomes were times of subarachnoid hemorrhage (SAH), characteristics of SAH on computed tomography (CT), Hunt-Hess grade, aneurysm size, and presence or absence of postoperative complications. Characteristics of SAH on CT (odds ratio [OR]: 3.727; p = 0.000; 95% confidence interval [CI], 1.850–7.508), aneurysm size (OR: 6.335; p = 0.000; 95% CI, 2.564–15.647), and presence or absence of postoperative complications (OR: 4.141; p = 0.000; 95% CI, 1.995–8.599) were independent risk factors influencing the prognosis. In addition, the incidence of postoperative ischemia (caused by anterior choroidal artery syndrome) is related to the aneurysm emitting part and presence or absence of intraoperative rupture. Conclusions The analysis of characteristics of SAH on CT, aneurysm size, and presence or absence of postoperative complications can roughly determine the outcome of patients with AChAAs.

Ultra-early endovascular treatment improves prognosis in High grade aneurysmal subarachnoid hemorrhage: A single-center retrospective study

“…Previous studies have confirmed that hydrocephalus is a prognostic factor (35)(36)(37)(38). In this study, we found that 30 cases (48.4%) of hydrocephalus occurred in the ultra-early group, while 11 cases (45.8%) occurred in the delayed group.…”

Risk factors and predictive models of poor prognosis and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage complicated with hydrocephalus

“…Most of these patients are treated conservatively, and further surgical treatment is needed after the condition is stable. Many studies have shown that the higher the Hunt-Hess grade in aSAH patients, the higher the risk of poor prognosis (42)(43)(44). This study found that the Hunt-Hess grade of patients with aSAH complicated with hydrocephalus at 6 months after surgery in the poor prognosis group was higher than that in the good prognosis group, and higher Hunt-Hess grade at admission was an independent risk factor for poor prognosis in patients with aSAH complicated with hydrocephalus at 6 months after surgery.…”

Monitoring of Perioperative Microcirculation Dysfunction by Near-Infrared Spectroscopy for Neurological Deterioration and Prognosis of Aneurysmal Subarachnoid Hemorrhage: An Observational, Longitudinal Cohort Study

“…In the present study, patients who experienced neurological deterioration (END and DND) were not only older but also had a significantly greater proportion of worsening clinical and radiological states than patients without neurological deterioration. Similarly, the higher the Hunt–Hess grade, WFNS grade, and Fisher grade were in patients with aSAH, the greater the risk of poor prognosis was [ 36 – 38 ]. The BNI, which predicts symptomatic vasospasm based on the maximum clot thickness of any pool or fissure, was significantly superior to the Fisher grade in predicting the occurrence of DCI according to multicenter external validation analyses [ 19 ].…”

“…However, the prolonged use of an EVD may complicate the treatment of aSAH and increase the risk of meningitis and/or ventriculitis triggering neurological deterioration. To date, two-sided characterizations of the effectiveness of DC in reducing mortality and the development of neurological deficits due to the loss of brain protection from DC cranial defects and interference with CSF dynamics [ 37 , 38 , 43 , 44 ] have been performed.…”