REVIEW
Introdução: Aneurismas cerebrais são dilatações da parede de uma artéria intracraniana acarretando sintomas quando implicam na compressão de estruturas próximas ou que provocam sangramento. Os aneurismas rotos são considerados emergências médicas, pois sua rutura pode causar sequelas neurológicas graves e levar ao óbito. Portanto, o diagnóstico precoce e o tratamento são necessários para evitar complicações mais graves. Objetivo: Descrever o perfil clínico e epidemiológico de pacientes com rutura de aneurisma cerebral tratados em um serviço de referência em neurocirurgia. Métodos: Estudo observacional retrospetivo baseado em dados do serviço de neurocirurgia endovascular do Hospital Santa Isabel de Blumenau, Santa Catarina, no período de outubro de 2005 a dezembro de 2021. Resultados: Houve 758 aneurismas cerebrais rompidos em pacientes predominantemente do sexo feminino e de idade média de 52,8 anos. Quanto às comorbidades, destacaram-se a hipertensão arterial sistêmica (HAS) (46,9%), seguida pelo tabagismo, dislipidemia e diabetes mellitus. O tipo de aneurisma mais prevalente foi o sacular (95,8%), sendo os pequenos aneurismas (75,5%) os mais encontrados. A maioria dos pacientes apresentava um único aneurisma (77,4%), sendo a artéria comunicante anterior a mais acometida (25,5%). Quanto à gravidade do sangramento, os escores predominantes foram Fisher IV (29,8%) e Hunt-Hess II (44,2%). Quanto ao tratamento endovascular, apenas coils foram utilizadas em 88% dos casos. Em relação à morbimortalidade, o vasoespasmo foi a principal complicação (24,9%), representando 5,2% dos óbitos. Conclusão: Os dados encontrados neste estudo são consistentes com os da literatura, inferindo que a cirurgia endovascular é uma ferramenta eficaz no tratamento de aneurismas rotos.
Introduction: Brain aneurysms are dilations of the wall of an intracranial artery, causing symptoms when they entail compression of nearby structures or cause bleeding. Ruptured aneurysms are considered medical emergencies, as their rupture can cause severe neurological sequelae and lead to death. Therefore, early diagnosis and treatment are necessary in order to avoid more serious complications. Objective: To describe the clinical and epidemiological profile of patients with ruptured cerebral aneurysm treated in a neurosurgery reference department. Methods: This is a retrospective observational study based on data from the endovascular neurosurgery service at Santa Isabel Hospital, Blumenau, Santa Catarina, from October 2005 to December 2021. Results: There were 758 ruptured cerebral aneurysms in predominantly female patients and mean age of 52.8. As for comorbidities, systemic arterial hypertension (SAH) stood out (46.9%), followed by smoking, dyslipidemia and diabetes mellitus. The most prevalent aneurysm type was saccular (95.8%), and small aneurysms (75.5%) were most often found. Most patients had a single aneurysm (77.4%), and the anterior communicating artery was the most affected one (25.5%). As for the severity of bleeding, the predominant scores were Fisher IV (29.8%) and Hunt-Hess II (44.2%). As for endovascular treatment, only coils were used in 88% of the cases. Regarding morbimortality, vasospasm was the main complication (24.9%), accounting for 5.2% of the deaths. Conclusion: The data found in this study are consistent with those in the literature, inferring that endovascular surgery is an effective tool to treat ruptured aneurysms.
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1 Medical student, Medical School, Regional University of Blumenau, Blumenau, SC, Brazil.
2 MD, Endovascular Neurosurgery, Santa Isabel Hospital, Medical School, Blumenau Regional University, Blumenau, SC, Brazil.
Received Feb 5, 2023
Accepted Feb 20, 2023
