Search

Introduction: Prevalence of intracranial aneurysms is estimated to be from 1% to 5% of population, most of them are small and located in the anterior circulation. The real danger is when an aneurysm ruptures, leading to a subarachnoid hemorrhage (SAH). SAH is a catastrophic event with a mortality rate of 25% to 50%. Permanent disability occurs in nearly 50% of the survivors. Fifteen percent of patients expire before reaching the hospital and 25% die within 24 h. The purpose of our study is to report the clinicoradiological data and outcome of microsurgical clipping of ruptured anterior circulation aneurysms in our center. Materials and Methods: This study included ruptured anterior circulation aneurysms admitted to tertiary care hospital in northern India from January 2018 to June 2020. The final outcome of patients was analyzed with Glasgow Outcome Score (GOS) at the time of discharge from the hospital. Results: A total of 53 patients with ruptured anterior circulation aneurysm underwent microsurgical clipping comprising 25 (47.2%) males and 28 (52.8%) females. The mean neck size of all aneurysms was 3.43 ± 1.66 mm. The mean hospital stay was longer in patients having preoperative intraventricular hemorrhage (IVH) (35.96 ± 27.27 days) and postoperative complications (43.36 ± 29.76 days) compared to patients who did not have IVH (21.10 ± 15.47 days) and postoperative complications (18 ± 6.54 days). P value was ≤0.05. Patients with preoperative hydrocephalus had GOS 3.44 ± 1.20 at discharge compared to nonhydrocephalus who had GOS 4.32 ± 1.07 (P = 0.009). Patients with Intracerebral Hemorrhage (ICH) and non-ICH had GOS 3.31 ± 1.38 and 4.28 ± 1.01, respectively (P = 0.009). Conclusion: Poor outcome at the time of discharge after the surgical treatment of anterior circulation aneurysms was associated with poor world federation of neurological surgeons grade on admission, presence of IVH, hydrocephalus, intracerebral hemorrhage, and postoperative cerebral infarcts. [ABSTRACT FROM AUTHOR]

Introduction: Cerebral Venous Thrombosis (CVT) is one of the important causes of stroke which is not very common. It has a varied clinical presentation and pathogenesis. It most often involves the superior sagittal sinus but may occur anywhere in the cerebral venous circulation. Pregnancy and puerperium are in itself a high-risk factor for its occurrence. Aim: To assess the frequency of different clinical features, risk factors and prognostic outcome of patients diagnosed as CVT. Materials and Methods: A hospital based observational study was conducted in the Department of Obstetrics and Gynaecology and the Department of Medicine at Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands, India, from January 2015 to December 2016. All cases of cerebrovascular accidents were followed and those diagnosed as CVT on the basis of Computed Tomogram (CT), Magnetic Resonance Imaging (MRI) and/or Magnetic Resonance Venogram (MRV) were included in the study, managed and followed till discharge from the hospital and at three months post-delivery. Means and percentages were used as statistical analysis. Results: Out of total of 4,767 deliveries in the study period, we found six cases of puerperal CVT. The incidence of puerperal CVT in our study population came out to be 125.8 per 100,000 deliveries. The mean age of women presenting with CVT was 23.6±3.204 years. The most common presenting symptom was headache (6/6, 100%) followed by seizure (4/6, 66.6%), hemiparesis (1/6), diplopia (1/6) and blindness (1/6). The most common area of infarct was superior sagittal sinus (6/6, 100%). The average period between the onset of symptoms and consultation was 1.8 days. Mortality at discharge was 16.6% (1/6). Conclusion: In CVT precise diagnosis is decisive as based on the diagnosis timely and suitable therapy can be started which can reverse the disease process. [ABSTRACT FROM AUTHOR]