http://www.lifesciencesite.com ) 6 2014;11( Life Science Journal 598 Outcome of Microsurgical Clipping of Ruptured Intracranial Aneurysms at a University Hospital in Saudi Arabia Saleh S Baeesa, MBChB, FRCSC Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia sbaeesa@kau.edu.sa Abstract: Objective: To describe treatment outcome in patients who had undergone microsurgery for clipping of cerebral aneurysm. Methods: A retrospective chart review of the clinical, radiological and operative records of patients who had undergone surgery for ruptured intracranial aneurysms (IAs) between January 2001 and December 2012 at King Abdulaziz University Hospital, Jeddah. The patient’s demographic a clinical data, including their neurological status and graded according to the World Federation of Neurological Surgeons (WFNS), cerebral imaging findings, and surgical notes were reviewed. Outcome was assessed according the Glasgow outcome score (GOS). Fisher’s exact and chi-square tests were performed to determine the association between GOS and the study variables. Results: Thirty-three patients were included; with a mean (SD) age of the patients was 43.5 (12.0) years (range, 17-65 years). Females constituted 63.6% of the sample. The average aneurysm size was 11.5 (5.2) mm, and they were, in most cases, located in the anterior communicating artery. Most patients (n=13; 39.4%) had a clinical grade of 1; only one patient (3.0%) had a clinical grade of 4. Approximately 60% of the patients showed evidence of SAH on CT scan; in about one third of the cases, the findings were normal. Twenty-eight patients (84.8%) had a good GOS. Good GOS were more likely in patients without postoperative vasospasm (P=0.04), hydrocephalus (P =0.021), and in patients with aneurysms < 10 mm in diameter (P =0.044). Conclusion: Patients who undergo surgery for clipping of IAs have a good outcome. Aneurysm size, and the presence of preoperative brain edema, hydrocephalus, and postoperative vasospasm were found to significantly affect the outcome in our patients. [Saleh S Baeesa. Outcome of Microsurgical Clipping of Ruptured Intracranial Aneurysms at a University Hospital in Saudi Arabia. Life Sci J 2014;11(6):598-603]. (ISSN: 1097-8135). http://www.lifesciencesite.com . 92 Key Words: Subarachnoid hemorrhage; Cerebral aneurysms, Clinical grading; Surgical clipping; Glasgow outcome score; Saudi Arabia 1. Introduction Intracranial aneurysms (IAs) are relatively common, occurring in approximately 2% of the general population; however, the risk of subarachnoid hemorrhage (SAH) caused by a ruptured aneurysm is relatively low [1]. As a result, the risks associated with either surgical or endovascular treatment must be even lower for treatment to be justified. As more cases of incidental unruptured IAs are being diagnosed owing to better diagnostic methods, it is critical to understand the evolving treatment paradigms for intracranial aneurysms. Recent data show that for ruptured IAs that can be managed by surgery or minimally invasive techniques, major treatment strategies mainly favor endovascular coiling over surgical clipping [2-5]. Although the findings of these studies cannot be readily extrapolated to patients with unruptured IAs, and no prospective, randomized trial has been performed for cases of unruptured IAs, several studies show that an increasing proportion of interventional radiologist or neurosurgeons perform endovascular coiling for patients with unruptured IAs [6-9]. In most of these studies, the authors demonstrated that the outcome was better in patients who had undergone endovascular versus surgical treatment. However, the overall outcome for unruptured IAs treatment was unchanged [9]. Besides the treatment, the following influences outcomes: patient factors, such as previous aneurysmal SAH, age, and coexisting medical conditions; aneurysm size, location, and morphology; and factors in management, such as the experience of the surgical team and the treating hospital [10]. In Saudi Arabia, few isolated studies [11-15], mainly case reports, describe the success of endovascular [11] and surgical treatment [12-15]. The author conducted this study on patients who had undergone surgery for ruptured IAs at King Abdulaziz University Hospital to describe treatment outcome. 2. Materials and Methods The medical records of all patients with ruptured IAs who were treated at King Abdulaziz University Hospital (KAUH) between January 2001 and December 2012 were reviewed. Patients were included provided they had undergone microsurgical treatment for IAs. Patients were excluded in this study that had, unruptured IAs, endovascular treatment, infectious or traumatic IAs, or those who are transferred to another hospital or untreated. The Biomedical Ethics Research Committee of King Abdulaziz University approved the study.