MANAGEMENT OF CEREBRAL ANEURYSMS OF THE ANTERIOR CIRCULATION OF CIRCLE OF WILLIS IN EGYPT

Abstract

This study included 30 consecrttive patients of verified saccular aneurysms of the anterior cerebral circulation admitted at Ain Shams University hospitals between April 1996 to May 1997. These patients had done clipping surgery of their offending lesions. There were 17 females (56.7%) and 13 males (43.3%). The patients ages ranged between 18-60 years with mean age of 44.1 years. SAH was the presenting clinical picture of all patients. Smoking was a significant finding during history taking of male patients (in 76.9% of them). seven patients (23.3%) were known to be hypertensive before the ictus. History of sentinel warning symptoms were recorded in 9 patients (30%), one to six weeks before SAH. The clinical grading (Hunt and Hess Scale) was assessed on admission, re­ evaluated and reported just before surgery so that the total number of good grade patients was 22 (73.3%). Non-enhanced brain CT scan was the first step in the investigation of all patients and Fischr's• grading for CT scan findings was applied. Lumbar puncture was done for 2 patients (6.7%), having manifestations of SAH and normal cranial CT scan, that revealed xanthochromia. MRI and MRA were done for 2 patients (6.7%) to study partial thrombosis of their aneurysmal