In this study we present recent clinical results of coil embolization for ruptured cerebral aneurysm.
From May 1996 to March 1997, 99 patients presented with ruptured cerebral aneurysms, of which 82 cases (83%) were treated with endosaccular coil embolization using GDC. There were 32 males and 50 females, and the ages were 26 to 78 (average 50.1) years old. The locations were 28 A-com, 4 ACA, 21 ICA, 14 MCA, 6 VA, 6 BA and 3 of other locations. The sizes of the aneurysms were 63 small (2-7mm), 15 medium (8-14mm) and 4 large (15-20mm). Hunt & Hess grades were 23 Grade I, 25 Grade II, 23 Grade III, 7 Grade IV and 4 Grade V. Seventeen cases were treated with open skull surgery because of anatomical problems for embolization (11 cases) or massive intracerebral hematoma (6 cases). Glasgow outcome scale (GOS) was assessed 2 to 5 months after the embolization.
Overall clinical results were 44 (54%) good recovery, 17 (21%) moderate disability, 12 (14%) severe disability, 1 (1.2%) vegetative and 8 (9.8%) death. The GOS was correlated with the clinical grade of SAH at admission and 44 (91.7%) of 48 Hunt & Hess Grade I or II patients had favorable outcomes. The location of the aneurysm was not associated with the GOS. Vasospasm was seen in 13.9% and influenced the GOS.
The results of embolization as the initial treatment of ruptured cerebral aneurysms are comparable to direct open skull surgery.
View full abstract