AIMS. The purpose of this study was to establish certain epidemiological characteristics of cerebral aneurysm surgery at the Hospital Regional Docente Vicente Corral Moscoso (HVCM), in the city of Cuenca.

PATIENTS AND METHODS We examined the medical records of the patients who were treated at the HVCM, in Cuenca, over a 14-year period after being diagnosed as suffering from aneurysmal subarachnoid haemorrhage (ASAH), which was confirmed using cerebral arteriography. Patients were catalogued according to age, sex, origin, marital status, the number of months the aneurysm had been ruptured, their Hunt and Hess score on admission, incurrent diseases, habit of smoking, neurological signs on admission, the site of the aneurysm, treatment received, complications, surgery-rupture and admission-surgery time and outcomes when discharged. Only patients who had undergone surgical treatment were considered.

RESULTS There were an average of 6.07 cases of ASAH and 4.7 aneurysm operations a year. Most patients were females from the provinces of Azuay and El Oro; the average age was 45.9 years, and incidence was higher in the months of March-April and August-September. The most common site for presentation was the posterior communicating artery, which occurred in 44% of the cases. The most frequently observed preoperative complications were rebleeding and vasospasm. Surgery was performed on a total of 67 patients and none of them were submitted to early surgery. Operative death rate was 6%. Overall results were optimal in 55.2%.

CONCLUSIONS The therapeutic option offered by our service for this pathology is satisfactory. Indeed, it is similar to that employed in other centres throughout Latin America and has improved over the last few years thanks to the experience that has been acquired in this field.

Objetivo Establecer algunas características epidemiológicas de la cirugía de aneurismas cerebrales en el Hospital Regional Docente Vicente Corral Moscoso (HVCM), de la ciudad de Cuenca.

Pacientes y métodos Se analizaron los expedientes clínicos de los pacientes que se atendieron en el HVCM, de Cuenca, durante un período de 14 años, por presentar el diagnóstico de hemorragia subaracnoidea aneurismática (HSAA) confirmada mediante arteriografía cerebral. Se catalogaron por edad, sexo, procedencia, estado civil, meses de rotura del aneurisma, puntuación de Hunt y Hess al ingreso, enfermedades intercurrentes, hábito de fumar, signos neurológicos al ingreso, ubicación del aneurisma, tratamiento recibido, complicaciones, tiempo rotura­cirugía, ingreso­cirugía y resultados al alta. Se consideraron sólo los pacientes sometidos a tratamiento quirúrgico.

Resultados Hubo un promedio de 6,07 casos de HSAA y 4,7 cirugías de aneurisma por año. La mayoría de pacientes fueron mujeres, procedentes de las provincias de Azuay y El Oro; la edad media fue 45,9 años, con una mayor incidencia en los meses de marzo­abril y agosto­septiembre; el sitio más frecuente de presentación fue la arteria comunicante posterior con el 44% de casos. El resangrado y el vasoespasmo fueron las principales complicaciones preoperatorias. Se operaron 67 pacientes y ninguno se sometió a cirugía temprana. La mortalidad operatoria fue del 6%. Los resultados globales fueron óptimos en el 55,2%.

Conclusiones La opción terapéutica ofrecida en nuestro servicio para esta patología es satisfactoria, comparable a otros centros latinoamericanos y ha mejorado en los últimos años gracias a la mayor experiencia adquirida.