Tóm tắt
Objective: To evaluate clinical characteristics, neuroimaging features, prognostic scales, and outcomes based on the modified Rankin Scale at discharge, 30 days, 90 days post-onset and factors associated with prognosis .
Subjects and Methods: A prospective descriptive study was conducted on 118 patients with subarachnoid hemorrhage due to ruptured cerebral aneurysms who underwent endovascular coil embolization over a 2-year period, from January 2024 to December 2025 at Thanh Hoa provincial general hospital.
Results: The mean age was 63.8 ± 12.6 years (median age 63 years), females accounted for 59.3%, hypertension was 51.7%, diabetes mellitus was 14.4%, smoking (21.2%), history of stroke(4.2%), headache(100%), nuchal rigidity (78.0%), cranial nerve palsy(25.4%), hemiparesis/hemiplegia(17.8%), seizures (10.2%), and altered consciousness or coma(16.9%). The proportions of Grade II on the PAASH(Prognosis on Admission of Aneurysmal Subarachnoid Hemorrhage), Hunt-Hess, WFNS, and modified Fisher scales were 44.1%, 46.6%, 34.7%, and 38.2%, respectively. The most common location of ruptured aneurysms was the anterior communicating artery (34.7%), saccular aneurysms with a daughter sac accounted for 48.3%, and aneurysm size between 7-10 mm represented the highest proportion at 41.5%. The most frequent complication was pneumonia (17.8%), intervention within 24 hours from onset was 27.1%, and the mean hospital stay was 15.9 ± 7.82 days. Favorable clinical outcomes according to the modified Rankin Scale(mRS 0-2) at discharge, 30 days, and 90 days were 50.8%, 60.2%, and 75.4%, respectively. Mortality at 90 days accounted for 6.8%. Both modified Fisher score ≤ 2 and Hunt-Hess grade ≤ 2 had prognostic value of favorable recovery in this study (OR = 6.59, 95% CI: 2.61-16.68, p < 0.001); (OR = 2.99, 95% CI: 1.23-7.29, p = 0.017).
Conclusion: Endovascular coiling for ruptured intracranial aneurysms is feasible in a provincial hospital setting. Early intervention within 24 hours from ictus is associated with more favorable clinical outcomes. The modified Fisher and Hunt-Hess scales associated with prognostic value for functional recovery.
