Immediate results of patients treatment with intracranial hemorrhages on account of the arterial aneurisms rupture and their prediction


  • Svitlana Dudukina Intensive Neurocare Unit, Mechnikov Dnepropetrovsk Regional Clinical Hospital, Dnepropetrovsk, Ukraine
  • Olga Matsuga Department of ECM Mathematical Support, Oles Honchar Dnepropetrovsk National University, Dnepropetrovsk, Ukraine



intracranial aneurismal hemorrhage, recurrent cerebral ischemia, factors of risk of complications developing, simvastatin, therapeutic hypothermia, rules of prognosis


The purpose. To identify risk factors of complications and unfavorable results after surgery in patients with intracranial aneurismal hemorrhages and to make rules of their prediction.

Materials and methods. 328 patients with intracranial aneurismal hemorrhages were included into research. Immediate results were estimated just after hospital treatment, after 30 days and 6 months. The relationships between quality indicators were studied on the base of criterion χ2. To determine the strength of the relationship between these indicators based on statistics χ2 were used Cramer coefficient. Prediction terms were built in a form of decision trees using C4.5 algorithm.

Results. Using simvastatin at arterial spasm contributed to improvement treatment outcomes. In patients with intracranial aneurismal hemorrhages and recurrent cerebral ischemia therapeutic hypothermia is reliably decreases the number of unsatisfactory treatment results. Cerebrocardial syndrome, arterial spasm, glycemia above 6.3 mmol/l, leucocytes level above 9.8×109/l revealed at hospitalization were the risk factors of unsatisfactory treatment results. In a case of arterial spasm after surgery in 88% patients had recurrent ischemia; in patients without angiospasm at whom arteries temporary clipping was performed (longer than 6 minutes) secondary ischemia was detected at coronary artery disease. In patients been operated within 6 days after the hemorrhage occurring with complications therapeutic hypothermia and decompressive trepanation are recommended in order to prevent and treat recurrent cerebral ischemia.


Krylov VV, Godkov IM, Genov PG. Intraoperatsionnyye faktory riska v khirurgii tserebral'nykh anevrizm [Intraoperative risk factors in surgery of cerebral aneurysms]. Neyrokhirurgiya. 2009;2:24-33. Russian.

Shakhin NAYu, Tsimeyko OA, Skorokhoda II, Moroz VV, Sydorak AD. Diagnostika i khirurgicheskoye lecheniye anevrizm peredney mozgovoy – peredney soyedinitel'noy arterii [Diagnosis and surgical treatment of aneurysms of the anterior cerebral - anterior communicating artery]. Zb. nauk. prats' spivrobitn. NMAPO im. P.L. Shupyka. 2013;22(3):29–34. Russian.

Langham J, Reeves BC, Lindsay KW, van der Meulen JH, Kirkpatrick PJ, Gholkar AR, Molyneux AJ, Shaw DM, Copley L, Browne JP. Variation in Outcome After Subarachnoid Hemorrhage: A Study of Neurosurgical Units in UK and Ireland. Stroke. 2008;40(1):111-118. CrossRef

Taylor CJ, Robertson F, Brealey D, O'shea F, Stephen T, Brew S, Grieve JP, Smith M, Appleby I. Outcome in Poor Grade Subarachnoid Hemorrhage Patients Treated with Acute Endovascular Coiling of Aneurysms and Aggressive Intensive Care. Neurocritical Care. 2010;14(3):341-347. CrossRef

Sheth S, Hausrath D, Numis A, Lawton M, Josephson S. Intraoperative rerupture during surgical treatment of aneurysmal subarachnoid hemorrhage is not associated with an increased risk of vasospasm. Journal of Neurosurgery. 2014;120(2):409-414. CrossRef

Steiner T, Juvela S, Unterberg A, Jung C, Forsting M, Rinkel G. European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage. Cerebrovascular Diseases. 2013;35(2):93-112. CrossRef

Rosengart A, Schultheiss K, Tolentino J, Macdonald R. Prognostic Factors for Outcome in Patients With Aneurysmal Subarachnoid Hemorrhage. Stroke. 2007;38(8):2315-2321. CrossRef

Schöller K1, Massmann M, Markl G, Kunz M, Fesl G, Brückmann H, Pfefferkorn T, Tonn JC, Schichor C. Aneurysmal subarachnoid hemorrhage in elderly patients: long-term outcome and prognostic factors in an interdisciplinary treatment approach. J Neurol. 2012;260(4):1052-1060. CrossRef

Bekelis K, Missios S, MacKenzie T, Fischer A, Labropoulos N, Eskey C. A predictive model of outcomes during cerebral aneurysm coiling. Journal of NeuroInterventional Surgery. 2013;6(5):342-348. CrossRef

Starke RM, Komotar RJ, Otten ML, Schmidt JM, Fernandez LD, Rincon F, Gordon E, Badjatia N, Mayer SA, Connolly ES. Predicting long-term outcome in poor grade aneurysmal subarachnoid haemorrhage patients utilising the Glasgow Coma Scale. Journal of Clinical Neuroscience. 2009;16(1):26-31. CrossRef

Al-Khindi T, Macdonald R, Schweizer T. Cognitive and Functional Outcome After Aneurysmal Subarachnoid Hemorrhage. Stroke. 2010;41(8):e519-e536. CrossRef

Passier P, Visser-Meily J, Rinkel G, Lindeman E, Post M. Life Satisfaction and Return to Work After Aneurysmal Subarachnoid Hemorrhage. Journal of Stroke and Cerebrovascular Diseases. 2011;20(4):324-329. CrossRef

Taha MM, Nakahara I, Higashi T, Iwamuro Y, Iwaasa M, Watanabe Y, Tsunetoshi K, Munemitsu T. Endovascular embolization vs surgical clipping in treatment of cerebral aneurysms: morbidity and mortality with short-term outcome. Surgical Neurology. 2006;66(3):277-284. CrossRef

Wermer M, Kool H, Albrecht K, Rinkel G. Subarachnoid hemorrhage treated with clipping. Neurosurgery. 2007;60(1):91-98. CrossRef

Jennett B. Assessment of outcome after severe brain damage. A Practical Scale. The Lancet. 1975;305(7905):480-484. CrossRef

Wilson J, Pettigrew L, Teasdale G. Structured Interviews for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for Their Use. Journal of Neurotrauma. 1998;15(8):573-585. CrossRef

Babak VP, Biletskiy AYa, Prystavka OP, Prystavka PO. Statystychna obrobka danykh [Statistical Data Analysis]. Kiev: MIVVTS, 2001. Ukrainian.

Gal R, Smrcka M. Mild hypothermia for intracranial aneurysm surgery. Bratisl Lek Listy. 2008;109(2):66-70.

Hunt W, Hess R. Surgical Risk as Related to Time of Intervention in the Repair of Intracranial Aneurysms. Journal of Neurosurgery. 1968;28(1):14-20. CrossRef

Iankova A. The glasgow coma scale clinical application in emergency departments. Emergency Nurse. 2006;14(8):30-35. CrossRef

Shakhidi A. Derev'ya resheniy – C4.5 matematicheskiy apparat [Decision trees - C4.5 mathematical apparatus]. [Internet]. BaseGroup Labs: 1995-2015. [cited 2014 June 27]. Available at: Russian.

Vorontsov KV. Kombinatornyy podkhod k otsenke kachestva obuchayemykh algoritmov [A combinatorial approach to assessing the quality of training algorithm]. Matematicheskiye voprosy kibernetiki. 2004;13:5-36. Russian.

Zagoruyko NG. Prikladnyye metody analiza dannykh i znaniy [Applied methods of data and knowledge analysis]. Novosibirsk: Institut matematiki SO RAN, 1999. Russian.



How to Cite

Dudukina, S., & Matsuga, O. (2015). Immediate results of patients treatment with intracranial hemorrhages on account of the arterial aneurisms rupture and their prediction. Ukrainian Neurosurgical Journal, (1), 43–50.



Original articles