The outcome after aneurysmal sub arachnoid hemorrhage: a study of various factors

BACKGROUND Aneurysmal subarachnoid hemorrhage (A-SAH), despite improvement in surgical and medical treatments, is still a serious disease with high fatality and morbidity rates. Despite the huge advances in neurosurgical management of the disease, there has not been a proportional improvement in outcome of this condition. PURPOSE We studied various factors which can influence the final outcome and these included: World federation of neurosurgical societies (WFNS), Hunt & Hess (H&H) and Fisher grade, size of aneurysm, intra operative rupture (IOR), temporary clipping (TC) - and correlate their individual impact in final outcome. METHODS We studied 100 patients of aneurysmal subarachnoid hemorrhage prospectively all of whom were operated upon .Post operative course was followed and final outcome studied. RESULTS Pre operatively, higher WFNS and H&H grades had a worse outcome. This correlation was not found for Fisher grade. Nonetheless, presence of IVH(Fisher grade 4) acted as an independent risk factor for poor outcome. CONCLUSION Diabetes and smoking led to a worse outcome in contrast to hypertension . IOR led to poor outcome while temporary clipping did not.