Analysis of Mortality Cases of Transcranial Aneurysm Surgery

Ahn, Jae Sung; Kwon, Soon Chan; Kim, Jae Myeong; Kim, Jung Hoon; Kwon, Yang; Kwun, Byung Duk; Lee, Jung Kyo

Abstract

OBJECTIVES
The authors analyze the causes of mortality cases after transcranial aneurysm surgery for comparing the safety of the treating methods and for the improvement of treatment outcomes of transcranial surgery.
METHODS
Patients recordings and radiological studies were retrospectively reviewed. Causes of postoperative mortality were divided into death related to vasospasm, procedure-related, medical complications and preoperative poor neurological conditions.
RESULTS
Postoperative mortality cases were 61 (5.78%) of 1054 transcranial aneurysm surgery during a period of from Jul. 1996 to Nov. 2001. Delayed ischemia related to cerebral vasospasm was a leading cause of death following transcranial aneurysm surgery and accounts for 2% (n=21) of all transcranial surgery and 34.4% of all mortality cases. Procedure-related death were 1.23% (n=13) and were related to inadvertent major artery occlusion, vital perforator injury or intraoperative aneurysm rupture. Death related to medical complications (n=8, 0.75%) were mainly from pneumonia (n=6) in the old age (>65) patients. Patients of initial poor neurological grade (Hunt-Hess grade IV-V, n=19) were mainly from large intracranial hematoma (>30 cc) in temporal lobe or sylvian fissure or multiple aneurysmal bleeding before admission.
CONCLUSION
The procedure-related mortality of the transcranial aneurysm surgery is about 1% in this large transcranial aneurysm surgery series and transcranial surgery can be a safe mean of treating intracranial aneurysms compared with other tratment modalities.