Analysis Of Causes Of Death Among Patients With Intracranial Aneurysms

Objective:to explore the causes of deaths among the aneurysm patients, providing a basis for further improving the success rate of aneurysm treatment.Methods:We retrospectively analyzed the patients who death of intracranial aneurysm in the Neurosurgical Department of Sichuan Provincial People's hospital between January 2005 and December 2009. The following data are collected and analyzed:the patients'gender, age, Hunt-Hess score, Fisher score, aneurysm location, size, quantity, times of rupture, intraoperative temporary occlusion, time of occlusion, surgical approach, and complications during the treatment. The factors that may cause deaths are summarized.Results:Based upon the records of Neurosurgical Department of Sichuan Provincial People's hospital between January 2005 and December 2009,50 cases of patients'death of intracranial aneurysm have been chosen for the study, accounting for 7.3 percent of the total 686 cases inhospitalized during the same period. The mean age of male was 51.2±10.1years, of female was 54.2±13.1 years. The proportion of female's mean age was higher than man's. There were no statistical difference between the preoperative groups and postoperative group in the distribution of the patients' age, but statistical difference in the death of the patients who>60 years old between survirul group and death group. Statistical analysis as carried out in survirul group and death group shows that deaths caused by intracranial aneurysms are related to the Hunt-Hess score, Fisher score, but not the size and site of intraeranial aneurysm. There were 20 cases of re-bleeding(6.9%) during hospitalization and 11 cases of cerebral vasospasm(42.3%) in the preoperative groups,6 cases of intraoperative ruptures (25.0%),12 cases of cerebral vasospasm(50.0%) and 11 cases of cerebral infarction(45.8%) in postoperative group.Conclusion:The major causes for deaths of patients with ruptured intracranial aneurysms are: The patient being in critical condition on admission; severe brain damage after bleeding; rather high Hunt-Hess grade and Fisher grade. The factors causing preoperative deaths of patients with ruptured intracranial aneurysms are:recurring of aneurysm ruptures. The causes of intraoperative and postoperative deaths are:intraoperative ruptures cerebral infarction. Cerebral vascular spasm was the factor causing preoperative and postoperative deaths of patients with intracranial aneurysms.