前方循環未破裂脳動脈瘤の手術成績と合併症  [in Japanese] Surgical Outcomes and Complications of Open Surgery for Unruptured Cerebral Aneurysms in Anterior Circulation  [in Japanese]

We analyzed surgical results and complications of 100 consecutive cases with unruptured intracranial aneurysms of the anterior circulation that were treated by 1 neurosurgeon over a period of 7 years beginning in 2001. Forty-one cases were internal carotid aneurysms, 35 were middle cerebral aneurysms, and 21 were anterior cerebral aneurysms. The size of aneurysms was 3-5mm in 16 cases, 5-10mm in 68, 10-15mm in 8 and more than 15mm in 8 cases. Neck clipping was performed in 97 cases and bypass plus trapping was selected in 3 cases. Postoperative angiography revealed complete disappearance in 99 cases, and no subarachnoid hemorrhage occurred during post-surgical follow-up. Permanent surgical morbidity and mortality were 2% and 0%, respectively. Unruptured cerebral aneurysms in anterior circulation can be treated with low morbidity and mortality, but cranial nerve injury and ischemic complication should be avoided particularly in case of anterior communicating artery aneurysms, paraclinoid aneurysms and proximal middle cerebral artery aneurysms.