کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5634303 1581452 2017 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Predictors of Postoperative Cerebral Ischemia in Patients with Ruptured Anterior Communicating Artery Aneurysms
ترجمه فارسی عنوان
پیش بینی های ایسکمی مغزی بعد از عمل در بیماران مبتلا به نارسایی عروق خونی ارتباطی قدامی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی عصب شناسی
چکیده انگلیسی

ObjectiveCerebral ischemia is a major contributor to poor outcome after ruptured anterior communicating artery aneurysms (ACoAs), and is not well classified. In this article, we develop a classification and identify risk factors of cerebral ischemia after ruptured ACoAs.MethodsThree hundred sixty patients with ruptured ACoAs undergoing microsurgical clipping were collected. Sex, age, smoking status, Hunt-Hess grade, Fisher grade, hospital stay, surgical timing, hypertension, diabetes, postoperative cerebral ischemia, and postoperative modified Rankin Scale score were collected. Postoperative ischemic changes are classified according to a novel grade (ischemic grade I-IV).ResultsPredictive factors of postoperative ischemia (grade I-IV) included sex (odds ratio [OR], 1.956; 95% confidence interval [CI], 1.262-3.032; P = 0.003) and Fisher grade (OR, 1.813; 95% CI, 1.144-2.871; P = 0.011). Male sex had a tendency to develop postoperative cerebral ischemia (61.3% in the ischemia group vs. 45.7% in the nonischemia group), while surgical timing did not. However, in patients with postoperative ischemia, early surgery within 3 days (OR, 3.334; 95% CI, 1.411-7.879; P = 0.006) and advanced age greater than 55 years (OR, 2.783; 95% CI, 1.214-6.382; P = 0.016) were risk factors for postoperative neurologic deficits (grade III-IV).ConclusionsMale sex and higher Fisher grade predict postoperative ischemia (grade I-IV), whereas surgical timing does not. However, in patients with postoperative cerebral ischemia, early surgery within 3 days and age greater than 55 years can increase the frequency of postoperative neurological deficits (grade III-IV). Older male patients undergoing early microsurgery had a tendency to develop neurologic deficits.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: World Neurosurgery - Volume 103, July 2017, Pages 241-247
نویسندگان
, , , ,