Purpose: Despite technical and medical advances, aneurysmal subarachnoid haemorrhage (SAH) continues to be a challenging pathology, associated with high rates of morbidity and mortality. The purpose of this study is to describe the various prognostic factors of the clinical outcome in the patients ofaneurysmal clipping for spontaneous SAH.

Methods: It was a prospective study where 48 patients had microsurgical clipping for CT angiography confirmed saccular aneurysm. Various parameters studied were age, sex,hypertension, loss of consciousness, World Federation of Neurosurgical Societies (WFNS) grade and Hunt & Hess grade at admission, time of ictus to surgery,
symptomatic vasospasm, Fisher grade of SAH, Hydrocephalus, neck: dome ratio, intra-operative rupture and temporary clipping time. The primary outcome measures were mortality and Glasgow outcome score (GOS) at three-months follow-up. Prognostic study was derived from analysis of these variables.

Results: Parameters found to be associated with unfavourable outcome were increasing age, hypertension, poorWFNS grade on admission, poor Hunt and Hess grade, higher Fisher grade, time of surgery and symptomatic vasospasm. WFNS grade, Hunt and Hess grade and Fisher grade were found having statistically significant correlation with neurological outcome of the aneurysmal SAH patients.

Conclusion: Microsurgical clipping is a safe and time-tested modality for treatment of SAH due to ruptured intracranial aneurysms. Higher WFNS grade, higher Hunt and Hess grade and higher Fisher grade are the factors leading to poor outcome in patients of ruptured intracranial aneurysm presenting with SAH.

Keywords: Prognostic factor; Subarachnoid haemorrhage; Intracranial aneurysm; Microsurgical clipping; Outcome.