Determination of indications for early surgical treatment in patients with ruptured anterior communicating artery aneurysms

Aim. To analyze and determine the optimal indications for microsurgical operative interventions in shortest possible time from subarachnoid hemorrhage onset to prevent anterior communicating artery (AcomA) aneurysm re-rupture bleeding. Materials methods. 280 patients with brain aneurysms were examined at Uzhhorod Regional Center of Neurosurgery Neurology City Hospital Urgent Emergency Medical Care under Zaporizhzhia Council. Among them, 98 (48 males 50 females) diagnosed AcomA aneurysms. The age was 20 72 years (mean 47.8 ± 11.0 years). Aneurysms verified using head neck computed tomography angiography (a Toshiba Astelion scanner, 2016, No. 4СС162106), selective cerebral (an system General Energy Optima IGS 330, 2019, 80071260314), magnetic resonance i_Open 0,36 T tomograph, 2005, Toc102633006). Cerebral hemodynamics assessed transcranial dopplerography (“Philips HD7” ultrasound diagnostic system, 2014, 69935). Results. In first three days after hemorrhage, 18 (18 %) admitted ruptured this location, 62 (62 within 4–8 days, 12 (12 9–14 later than 14 – 6 (6 %). All underwent clipping Due severe edema, decompressive craniectomy performed two patients. results surgical treatment evaluated according modified Rankin scale hospital discharge as follows: 65 (65 good; moderate disability; 4 (4 serious disability. 11 (11 died. Conclusions. outcomes significantly dependent on factors related increased risk re-rupture: presence large-sized intracerebral hematoma, index exceeding 2, multi-chamber aneurysm.