Abstract
BackgroundThe prognostic factors and outcome of aneurysms appear to be dependent on its locations. Therefore, we compared left- and right- sided aneurysms in patients with aneurysmal subarachnoid hemorrhage (SAH) in terms of differences in outcome and prognostic factors.MethodsPatients with SAH were entered into a prospectively collected database. A total of 509 patients with aneurysmal subarachnoid hemorrhage were retrospectively selected and stratified in two groups depending on side of ruptured aneurysm (right n = 284 vs. left n = 225). Midline aneurysms of the basilar and anterior communicating arteries were excluded from the analysis. Outcomes were assessed using the modified Rankin Scale (mRS; favorable (mRS 0–2) vs. unfavorable (mRS 3–6)) six months after SAH.ResultsWe did not identify any differences in outcome depending on left- and right-sided ruptured aneurysms. In both groups, the significant negative predictive factors included clinical admission status (WFNS IV+V), Fisher 3- bleeding pattern in CT, the occurrence of delayed cerebral ischemia (DCI), early hydrocephalus and later shunt-dependence. The side of the ruptured aneurysm does not seem to influence patients´ outcome. Interestingly, the aneurysm side predicts the side of infarction, with a significant influence on patients´ outcome in case of left-sided infarctions. In addition, the in multivariate analysis side of aneurysm was an independent predictor for the side of cerebral infarctions.ConclusionThe side of the ruptured aneurysms (right or left) did not influence patients’ outcome. However, the aneurysm-side predicts the side of delayed infarctions and outcome appear to be worse in patients with left-sided infarctions.
Highlights
Published data have shown differences in prognostic factors and outcome depending on aneurysm location[1,2]
The aneurysm side predicts the side of infarction, with a significant influence on patientsoutcome in case of left-sided infarctions
The in multivariate analysis side of aneurysm was an independent predictor for the side of cerebral infarctions
Summary
Published data have shown differences in prognostic factors and outcome depending on aneurysm location[1,2]. Studies have reported different results concerning strokes that occur in the dominant or non- dominant hemisphere in terms of patientsoutcome. On the other hand in stroke with infarctions in the dominant hemisphere Sundseth et al showed no statistical or clinical difference in functional outcome and quality of life in patients with speech-dominant stroke compared to non-dominant side infarction[4]. We compared all left- and right-sided aneurysms in patients with aneurysmal subarachnoid hemorrhage (SAH) in our department in terms of differences in outcome and prognostic factors. We compared left- and right- sided aneurysms in patients with aneurysmal subarachnoid hemorrhage (SAH) in terms of differences in outcome and prognostic factors
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