Microsurgical aneurysmal clipping based on computed tomography angiography

Objective:- To evaluate the efficacy of Microsurgical Aneurysmal Clipping Based on the computerized tomographic angiography (CTA). Material and methods:- This study was carried out in Neurosurgery Department, Nishtar Hospital, Multan from June 2009 to December 2009. A total of 10 patients who were operated upon for craniotomy and clipping of the aneurysms. All the patients presented with spontaneous sub-arachanoid hemorrhage were worked up for the cause of their intracranial bleed. Computerized tomographic angiography was the initial investigation. Patients with ruptured aneurysm wee considered for surgery. Results:- Ten patients were operated upon during a time span of six months and showed excellent compliance in their follow up visits. There was no mortality in any of the surgically operated cases. Only three (33.3%) patients suffered from minor morbidity which recovered in a short period of time with the steroids and physiotherapy. Preoperative angiographic studies were compared with the postoperative angiographic studies and the isolation of the aneurysm was assessed independently by a radiologist who was not the member of study team. Conclusion:- CTA being a nonoinvasive and quick method to visualize the angioarchitecture of the brain in an alternative method for the planning of the aneurismal surgery. The sensitivity of the CTA for the aneurysms of the brain in 80-85% with a specificity of 90-97% compared with the digital sub-traction angiography (DSA).