J Korean Neurosurg Soc.  1999 Nov;28(11):1624-1628.

ICA Bifurcation Aneurysm: Clinical Features and Surgical Outcome

• Kwon TH
• Cho TH
• Park YK
• Chung YG
• Chung HS
• Lee HK
• Suh JK

Abstract

OBJECTIVE
Aneurysms at the internal carotid artery(ICA) bifurcation are uncommon and account for about 3 to 5% of all intracranial aneurysms. Moreover, the surgical treatment of these aneurysms has been discussed in detail only by a few authors. In this report, we present our experienced cases, and discuss the clinical features and surgical outcome of these aneurysms. METHOD: In the last eight years, out of total of 672 patients operated for intracranial aneurysms at our hospital, 17 patients(2.5%) had aneurysms at the ICA bifurcation. The direction of aneurysms were distinguished based upon DaPian's classification; superior, anterior, or posterior. RESULT: There were female preponderance(M:F=1:1.8) and the left side predominance(11 of 17 cases). Nine patients had multiple aneurysms, and in that cases ICA bifurcation aneurysms were responsible for hemorrhage in most cases. All aneurysms were clipped via the standard pterional approach. Thirteen out of 17 patients had good results and 2 patients fair results; the surgical outcome was favorable in 88.2% of cases. One who had rebleeding before surgery died.
CONCLUSION
It is presumed that the perforator occlusion and intraoperative aneurysmal rupture were the main factors aggravating the surgical outcome. In cases with anteriorly- or posteriorly-projecting aneurysm, more careful cautions would be necessary.

Keyword

Internal carotid artery bifurcation; Intracranial aneurysm

MeSH Terms

Aneurysm*
Classification
Female
Hemorrhage
Humans
Intracranial Aneurysm
Rupture