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.