Outcome of In-Hospital Rebleeding and Early AneurysmRupture at the Referral Center

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RAHMANIAN ABDOLKARIM; DERAKHSHAN NIMA; Alibai Ehsan Ali

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Paper Information

Journal: IRANIAN JOURNAL OF NEUROSURGERY Year:2018 | Volume:4 | Issue:2 (13) Page(s): 93-100

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Title

Outcome of In-Hospital Rebleeding and Early AneurysmRupture at the Referral Center

Author(s)

RAHMANIAN ABDOLKARIM | DERAKHSHAN NIMA | Alibai Ehsan Ali | Issue Writer Certificate

Keywords

Cerebral aneurysm

Rupturedaneurysm

Tertiary referralhospital

Outcome

Incidence

Abstract

Background and Aim: In-hospital rebleeding and early aneurysm rupture are major causesof mortality and morbidity in aneurysmal subarachnoid hemorrhage. Rebleeding may occur atthe referring hospital, during transfer or at the referral neurovascular center prior to surgical orendovascular treatment. However, there has been no report regarding the rate of in-hospitalrebleeding and early aneurysm rupture at the referral centers. This study aims to clarify theincidence, significance, management, and Outcome of individuals who suffer in-hospitalaneurysmal rebleeding and early aneurysm rupture at the referral hospital due to anteriorcirculation Cerebral aneurysm to the time when its neck is visualized for clipping. Methods and Materials/Patients: Among 617 patients with anterior circulation cerebralaneurysms who underwent operation between September 2010 and September 2017 atNeurovascular Unit of Namazi Hospital (main referral neurovascular center in southern Iran), 22suffered rebleeding since the time of neuroradiologic diagnosis of aneurysm to intraoperativevisualization of aneurysm for neck dissection. A surgical technique for fast access and securing theaneurysm is described in this article, too. The patients’ demographics were collected via hospitalrecords in a retrospective fashion. Six-month functional Outcome was obtained via OPD records aswell as phone calls. Utilizing Independent t test, 1-way ANOVA, Kruskal-Wallis and Mann-Whitneytests in SPSS22, the effect of each study variable was evaluated during 6 months follow-up period. Results: Rebleeding occurred at different venues from CT angiography to frontal lobe retraction. Anterior communicating artery was the most common aneurysm to suffer in-hospital rebleedingand male gender was found as a risk factor. These patients have significantly higher bleedingamount and longer operative time (P<0. 001), but still have a 68. 2% chance of surviving with goodfunctional recovery. Earlier in-hospital rebleedings are used to have worse Outcomes (P=0. 036 forGOS and 0. 028 for mRS, respectively). Conclusion: Patients with in-hospital rebleeding and early aneurysm rupture at the referralhospitals will have a considerable chance for favorable Outcome if they undergo aggressive surgicalmanagement emergently.

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APA: Copy

RAHMANIAN, ABDOLKARIM, DERAKHSHAN, NIMA, & Alibai, Ehsan Ali. (2018). Outcome of In-Hospital Rebleeding and Early AneurysmRupture at the Referral Center. IRANIAN JOURNAL OF NEUROSURGERY, 4(2 (13)), 93-100. SID. https://sid.ir/paper/351592/en

Vancouver: Copy

RAHMANIAN ABDOLKARIM, DERAKHSHAN NIMA, Alibai Ehsan Ali. Outcome of In-Hospital Rebleeding and Early AneurysmRupture at the Referral Center. IRANIAN JOURNAL OF NEUROSURGERY[Internet]. 2018;4(2 (13)):93-100. Available from: https://sid.ir/paper/351592/en

IEEE: Copy

ABDOLKARIM RAHMANIAN, NIMA DERAKHSHAN, and Ehsan Ali Alibai, “Outcome of In-Hospital Rebleeding and Early AneurysmRupture at the Referral Center,” IRANIAN JOURNAL OF NEUROSURGERY, vol. 4, no. 2 (13), pp. 93–100, 2018, [Online]. Available: https://sid.ir/paper/351592/en

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