The experience of diagnosis and treatment on 473 cases of intracranial aneurysms

Objective To provide with our experience on intracranial aneurysm as a reference for clinician by summarizing the clinical epidemiologic characteristic and course of diagnosis and treatment on the disease. Methods It was accomplished that retrospective analysis for 473 cases of intracranial aneurysms admitted in our hospital from Jan-2003 to Jul-2007 to summarize clinical epidemiologic characteristic, clinical manifestation, results of diagnosis and treatment. statistical treatment was completed for all of this clinical data. Results The incidence of aneurismal subarachnoid hemorrhage has a peak at 50 ~ 59 years of age(33.83%), and 75.26% of those patients was at 40~69 years of age. In younger 40 years Groups, Male patients were more than female; but in elder 40 years Groups, status was opposite. There were an 1.17, 1.97-fold female predominance in patients of single-aneurysm and multi-aneurysm, respectively. Percentage of unruptured intracranial aneurysm in all patients was 2.54%. Of patients suffering from aneurysm rupture, constipation, agitation, insobriety, exertion and severe cough were common remote causes of aneurysm rupture, which was 66.59% of those;the cases complicated with one or more of hypertension, diabetes, excessive drinking and smoking was 51.99%. disappropriate lumbar puncture and external ventricular drainage possibly caused rebleeding of aneurysm, which was the rate of 16.67% in all of reasons. The rate of unfavourable prognosis for patients of first and multiple rupture was 19.89% and 38.89%, respectively. Favourable prognosis for patients of gradeⅠ~Ⅲ(Hunt Hess) in early(3 days), intermediate (3～10 days)and late clipping surgery (10 days) was no significant difference. But for cases of grade Ⅳ~Ⅴ, the result of early clipping operation was much better than that at intermediate-late stage(P=0.026). Conclusion The patients with ruptured intracranial aneurysm have a tendency to become younger. Some of female physiological characteristics maybe were one of the etiological factors for intracranial aneurysm. More unruptured aneurysms were found by filting high-risk groups and increasing the rate of final diagnosis at first break maybe were important measures to improve prognosis of the aneurismal patients. Lumbar puncture and external ventricular drainage should be avoided to be used for patients with untreated ruptured aneurysm. Timing of surgery was not matter cause of outcome in patients of grade Ⅰ to Ⅲ. But early operation could take more benefit for patients of grades Ⅳ to Ⅴ.