Development of a predictive grading system for postoperative ischemia following middle cerebral artery aneurysm clipping.

The current study presents a single-surgeon experience with microsurgical clipping of middle cerebral artery (MCA) aneurysms and introduces a grading system to predict postoperative ischaemia. A retrospective analysis of 222 patients with 251 MCA aneurysms treated between 2015 and 2024 was conducted. Key factors, including aneurysm size, dome morphology, neck location, calcification, and rupture status, were evaluated to identify predictors of radiological infarction.