Surgical treatment of patients with cerebral aneurysms in the acute stage of rupture: dynamics of results during 2006

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Belousova O.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Pilipenko Iu.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Kheireddin A.S.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Okishev D.N.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Shekhtman O.D.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Mikeladze K.G.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Konovalov An.N.

Burdenko Neurosurgical Institute, Moscow, Russia

Abramyan A.A.

Burdenko Neurosurgical Center, Moscow, Russia

Varyukhina M.D.

Pirogov Russian National Research Medical University, Moscow, Russia

Kurdyumova N.V.

Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia

Tabasaranskiĭ T.F.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Baranich A.I.

Burdenko Neurosurgery Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047

RSCI AuthorID: 1006875
Scopus AuthorID: 57202735861
ORCID: 0000-0002-1167-0742

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Surgical treatment of patients with cerebral aneurysms in the acute stage of rupture: dynamics of results during 2006—2018

Authors:

Éliava Sh.Sh., Belousova O.B., Pilipenko Iu.V., Kheireddin A.S., Okishev D.N., Shekhtman O.D., Mikeladze K.G., Konovalov An.N., Abramyan A.A., Varyukhina M.D., Kurdyumova N.V., Tabasaranskiĭ T.F., Baranich A.I., Yakovlev S.B.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2019;83(5): 5‑13

DOI: 10.17116/neiro2019830515

Downloaded: 67

To cite this article:

Éliava ShSh, Belousova OB, Pilipenko IuV, et al. . Surgical treatment of patients with cerebral aneurysms in the acute stage of rupture: dynamics of results during 2006—2018. Burdenko's Journal of Neurosurgery. 2019;83(5):5‑13. (In Russ., In Engl.)
https://doi.org/10.17116/neiro2019830515

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Treatment of cerebral aneurysms in the acute stage of subarachnoid hemorrhage (SRH) especially on the background of cerebral vasospasm continues to be a difficult task. Objective — assessment of dynamics of the surgical treatment results of patients with cerebral aneurysms in acute period of SRH. Material and methods. A comparative analysis of the results of patients’ surgical treatment in NMRCN Burdenko about aneurysm in 1—21 days after hemorrhage was made. The following periods were selected: 2006—2014 (343 patients) and 2015—2018 (356 patients). Most patients had microsurgical operations in both periods. The tactics of choosing the surgery time was the main difference between the periods: particularly in 2015—2018 period the surgery was not postponed at patients with severe. Results. Analysing the post surgical mortality, it was found that since 2006 there is a consistent trend towards a decrease in the number of patients who died after surgery. When calculating the average post surgical mortality for the studied periods this trend is confirmed — number of lethal cases in 2015—2018 reliably decreased when comparing with 2006—2014 — from 6.8 till 3.2%; p=0.03. At the same time, the number of patients with outcome of vegetative status (from 0.3 till 5%). Conclusion. The tactics of surgical treatment of patients with cerebral aneurysms in the acute period of SRH regardless of severity of patient’s condition and time of hemorrhage did not lead to worse treatment. In contrast, post surgical mortality rates show a consistent decline. We associate this fact with a number of changes that have occurred in the management and treatment of patients. In particular, we have high hopes for developing new approaches to the treatment of vasospasm, which remains the leading cause of lethal cases. More definite conclusions will be made at the end of the treatment analysis of the respective patient groups.

Keywords:

cerebral aneurysms

acute period of SRH

cerebral vasospasm

mortality at SRH

Authors:

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Belousova O.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Pilipenko Iu.V.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Kheireddin A.S.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Okishev D.N.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Shekhtman O.D.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Mikeladze K.G.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Konovalov An.N.

Burdenko Neurosurgical Institute, Moscow, Russia

Abramyan A.A.

Burdenko Neurosurgical Center, Moscow, Russia

Varyukhina M.D.

Pirogov Russian National Research Medical University, Moscow, Russia

Kurdyumova N.V.

Tabasaranskiĭ T.F.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Baranich A.I.

Burdenko Neurosurgery Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047

RSCI AuthorID: 1006875
Scopus AuthorID: 57202735861
ORCID: 0000-0002-1167-0742

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

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