{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T07:53:05Z","timestamp":1744185185740,"version":"3.37.3"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003The initial clinical status after aneurysm rupture, whether primary or secondary, determines the final outcome. The most common cause of patient deterioration is a high Hunt and Hess (HH) score, which correlates closely with a high mortality rate. Poor-grade aneurysmal subarachnoid hemorrhage (SAH) is determined as an HH score 4 or 5. The aim of this study was to evaluate the clinical characteristics of poor graded aneurysmal SAH at our institution.<\/jats:p><jats:p>\n          Patients and Methods\u2003During the 5-year period, 415 patients with intracranial aneurysm were admitted to our institution. Patients with poor-grade aneurysmal SAH accounted 31.08% (n\u2009=\u2009132) of the total number of ruptured aneurysms. Interventional treatment was predominantly in the form of surgery, whereas conservative treatment included medication and external ventricular drainage. Final outcome was assessed with a modified Rankin score (mRs). Statistical analysis was performed using SPSS version 23.0 with a significance level set to 5% (\u03b1\u2009=\u20090.05).<\/jats:p><jats:p>\n          Results\u2003The majority of patients (57.6%) were in the age range from 51 to 69 years. Twenty-five patients (18.9%) had an HH score of 4, whereas 107 patients (81.1%) had an HH score of 5. Depending on the location, the majority of patients (n\u2009=\u200943) had an aneurysm on the medial cerebral artery (MCA). The final aneurysm occlusion was performed in 71 patients, of whom 94.36% were treated surgically. A positive outcome (mRs 0\u20134) was found in 49.25% of patients who underwent primarily surgical, treatment with a mortality of 42.3%. Although the outcome was better in patients with an HH score 4, both groups benefited from surgical treatment.<\/jats:p><jats:p>\n          Conclusion\u2003Poor-grade aneurismal SAH is a condition of the middle and older age, with most patients with an HH 5 score and deep comatose state. There was better outcome in patients with an HH score of 4 compared to an HH score of 5 and both groups benefited from surgical treatment, which resulted in a positive outcome in almost 50% of surgically treated patients.<\/jats:p>","DOI":"10.1055\/s-0043-1764118","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T23:03:26Z","timestamp":1679958206000},"page":"132-138","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Characteristics of Poor-Grade Aneurysmal Subarachnoid Hemorrhage Treatment"],"prefix":"10.1055","volume":"18","author":[{"given":"Adi","family":"Ahmetspahi\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, Clinical Center of University in Sarajevo (CCUS), Sarajevo, Bosnia and Herzegovina"},{"name":"Faculty of Medicine, Sarajevo School of Science and Technology (SSST), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragan","family":"Jankovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center of Mainz, Mainz, Germany"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4273-3937","authenticated-orcid":false,"given":"Eldin","family":"Burazerovic","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, Clinical Center of University in Sarajevo (CCUS), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7298-3240","authenticated-orcid":false,"given":"Bekir","family":"Rov\u010danin","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, Clinical Center of University in Sarajevo (CCUS), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amina","family":"\u0160ahbaz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sarajevo School of Science and Technology (SSST), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esma","family":"Hasanagi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sarajevo School of Science and Technology (SSST), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Almir","family":"D\u017eurli\u0107","sequence":"additional","affiliation":[{"name":"Clinic for Neurosurgery, Clinical Center of University in Sarajevo (CCUS), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nermir","family":"Granov","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Clinical Center of University in Sarajevo (CCUS), Sarajevo, Bosnia and Herzegovina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-3648","authenticated-orcid":false,"given":"Alberto","family":"Feletti","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, Institute of Neurosurgery, University of Verona, AOUI Verona, Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"ref1","first-page":"70","article-title":"Cranial anatomy and surgical approaches","author":"A L Rhoton Jr","year":"2003","journal-title":"Neurosurgery;"},{"key":"ref2","first-page":"3730","volume-title":"Youmans. 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