Abstract:
Title: Management of spontaneous aneurysmal intracranial haemorrhage at Charlotte Maxeke
Johannesburg academic Hospital.
Study design: This is a descriptive retrospective study of the clinical characteristics,
Neurological imaging findings, surgical intervention and three months outcome of treatment
amongst 102 patients with ruptured aneurysmal intracranial haemorhage. The patients were
treated at the department of neurological surgery Charlotte Maxeke Johannesburg academic
hospital (incorporating department of Neurosurgery of the university of the
Witwatersrand,South Africa). The medical records of all patients admitted from June 2007 to
May 2009 with spontaneous aneurysmal intracranial haemorrhage were included in the study.
The surgical outcome were evaluated by using the Modified Ranking scale, the relationship of
Hunt and Hess score, Fisher grading on outcome were also examined.
Results: Amongst 102 enrolled cases, the age of the patient ranged between 25 and 78 years
with a mean of 45 years, the peak aneurysmal frequency was in the age of 41- 50 years (4th
decade of life), with the Male: Female ratio of 1: 1.2, majority of aneurysms were located on
anterior circulation (94.6%) over (5.4%) on posterior circulation. The anterior communicating
artery was highly affected with aneurysmal frequency of 43.8%, 36.2% were on middle
cerebral artery and 11.4% on posterior communicating artery. The rate of multiple aneurysms
amongst recruited patients was 2.9%.
The commonest presenting symptom was headache (97%) followed by nausea and vomiting
(63%). Most patients were admitted with Hunt and Hess grade (iii) 71.6%, while 21.6% had
grade (ii).
On Neuro imaging modality on CT scan indicated that60.8% were admitted with Fisher grade
3,35.3% had Fisher grade 4 and none of the patient had Fisher grade 1.
..
