Seguridad y eficacia del tratamiento quirurgico en aneurismas cerebrales. Experiencia de un neurocirujano en la región de Coquimbo, Chile

Abstract

Introduction: in the last two decades, with the arrival of endovascular treatment, the indication of microsurgical treatment of cerebral aneurysms has decreased. However, recent publications show that most aneurysms are susceptible to be treated with advanced microsurgical techniques and highlight the advantages of microsurgical treatment, such as: low percentage of aneurysmal remnant and treatment durability. Materials and Methods: A clinical series of 65 patients diagnosed with ruptured and unruptured cerebral aneurysms, treated in the Coquimbo region and operated by one surgeon between April 2017 and January 2019, with a prospective follow-up of the clinical results, which were evaluated with the modified Rankin scale. Results: 65 cases were evaluated, female sex predominated (72%), 53.8% of the cases were ruptured aneurysms and 17% corresponded to paraclinoid aneurysms. A favorable neurological result (ERm < 3) was obtained in 86.1% of the patients. 8 patients with unfavorable neurological results corresponded to the group of ruptured cerebral aneurysms. Conclusion and Discussion: The microsurgical treatment in cerebral aneurysms is safe and effective. In this clinical series, all patients were treated only with microsurgical technique and the obtained functional results were satisfactory good functional results are obtained and comparable with the data published internationally, even with centers that have both endovascular and microsurgical treatments, however it is an initial clinical series.