A report of 62 cerebral aneurysms that were clipped at the Hospital Regional Docente Vicente Corral Moscoso in the city of Cuenca, Ecuador

Abstract

The purpose of this study was to establish certain epidemiological characteristics of cerebral aneurysm surgery at the Hospital Regional Docente Vicente Corral Moscoso (HVCM), in the city of Cuenca. PATIENTS AND METHODS: We examined the medical records of the patients who were treated at the HVCM, in Cuenca, over a 14 year period after being diagnosed as suffering from aneurysmal subarachnoid haemorrhage (ASAH), which was confirmed using cerebral arteriography. Patients were catalogued according to age, sex, origin, marital status, the number of months the aneurysm had been ruptured, their Hunt and Hess score on admission, incurrent diseases, habit of smoking, neurological signs on admission, the site of the aneurysm, treatment received, complications, surgery-rupture and admission-surgery time and outcomes when discharged. Only patients who had undergone surgical treatment were considered. RESULTS: There were an average of 6.07 cases of ASAH and 4.7 aneurysm operations a year. Most patients were females from the provinces of Azuay and El Oro; the average age was 45.9 years, and incidence was higher in the months of March-April and August-September. The most common site for presentation was the posterior communicating artery, which occurred in 44% of the cases. The most frequently observed preoperative complications were rebleeding and vasospasm. Surgery was performed on a total of 67 patients and none of them were submitted to early surgery. Operative death rate was 6%. Overall results were optimal in 55.2%. CONCLUSIONS: The therapeutic option offered by our service for this pathology is satisfactory. Indeed, it is similar to that employed in other centres throughout Latin America and has improved over the last few years thanks to the experience that has been acquired in this field.