Association Between WFNS Grade at Admission & Glassgow Outcome Score after Surgical Clipping in Ruptured Cerebral Aneurysms

Abstract

INTRODUCTION: Intracranial aneurysms are localized dilatations of the arteries in the brain due to weakness of the arterial wall, can lead to serious morbidity and mortality after rupture. Subarachnoid hemorrhage(SAH) usually occurs with rupture and is associated with a high rate of morbidity and mortality. The current study is an institution based study in an attempt to understand the outcome of surgical clipping and its association with WFNS grade at admission in light of established facts and principles in standard literature in a selected group of patient population. AIM OF THE STUDY: To study the association between WFNS grade at admission and Glassgow outcome score after surgical clipping in patients with ruptured intracranial aneurysm at our centre. METHODS: This is a prospective non randomized observational study carried over a period of 2 years and 5 months. All diagnosed cases of ruptured cerebral aneurysm admitted to our institute during the study period and treated by surgical clipping were included in the study. Patients undergoing open surgery were compared in terms of clinical condition before treatment using World Federation of Neurosurgical Societies (WFNS) score and clinical outcome was assessed using the Glassgow outcome scale (GOS). RESULTS: Out of 76 patients who were admitted with the complaints of SAH, 35 patients i.e. half of the study subjects had WFNS grade II. 23 patients with SAH had WFNS Grade III. 35.5% of study subjects had Glassgow outcome score of IV.18.4% of patients in surgical group had Glassgow outcome score of V followed by 15.8% of subjects with a score of III. Mortality rate in surgical group was 28.9% (Glassgow outcome score of I) CONCLUSION: There is a highly significant association between WFNS grades at presentation and post operative Glassgow outcome score. Patients with good WFNS grades at presentation had good Glassgow outcome scores.