Posterior communicating artery aneurysms: Analysis of predictors of surgical outcome

Background: Although aneurysms of the posterior circulation are not as common as those of the anterior circulation, the threat they pose can be reduced with timely surgical intervention. The study analyses factors that influence the outcome in surgically clipped posterior communicating artery (PCoA) aneurysms. Methods: A retrospective analysis of 85 cases of surgically clipped PCoA aneurysms was carried out, taking into consideration, the presenting signs and World Federation of Neurological Societies (WFNS) grade at admission, the timing of the surgery and the outcome of the surgery as per the Glasgow Outcome Scale. Results: About 56.8% of cases were clinically WFNS Grade I at admission. About 75.9% of all patients and 90% of patients who were Grade I and 74% of patients who were Grade II had a good recovery as per the Glasgow Outcome Scale. The overall mortality was 6.9%, and all patients who did not survive despite surgery were initially WFNS Grade IV patients. Conclusion: A higher or clinically worse WFNS grade of subarachnoid haemorrhage at the time of admission in patients with PCoA aneurysms predicts a poor surgical outcome, regardless of the timing of the surgery.