The Clinical and Angiographic Analysis of Anterior Communication Artery Aneurysm

Kim, D N; Park, H S; Rhee, D Y

Abstract

Based upon the relationship between clinical, and radiographic(brain CT and angiograms) finding, the authors analyzed 87 cases of ruptured anterior communicating artery aneurysms that were operated on at the Department of Neurosurgery if Wallance Memorial Baptist Hospital from January 1987 to December 1992. The results of anlysis were summarized as follows : 1) On the preoperative brain CT, ventricular enlargement, cerebral or ventricular hemorrhage were 20% and in those cases, Hunt & Hess grade was high and prognosis was poor. 2) On the basis of preoperative angiograms, the anterior communicating artery aneurysms were categorized as 4 directions. Anterior direction was 53%, superior 21%, inferior 22%, and posterior direction was 5% but there was no significant relationship between direction of aneurysm and prognosis. 3) The anatomical side dominance of anterior communicating artery were as follows ; right dominance of A1 diameter in 19(22%), left dominance of A1 diameter in 39 cases(45%), no dominance of side in 29 cases(33%). 4) The size of the aneurysms in angiogram was as follows ; smaller than 5mm in 17 cases(20%), 6-10mm in 51 cases(59%), 11-15mm in 16 cases(18%), larger than 16mm in 3 cases(3%). 5) The distance from the planum sphenoidale to aneurysmal neck in angiogram was as follows ; below 6mm in 24 cases(23%), 7-12mm in 47 cases(54%), above 13mm in 16 cases(18%), 12 out of 16 cases above 13mm was operated in through anterior interhemispheric approach. 6) In anterior direction, of aneurysm there was high incidence of ventricular enlargement and cerebral or ventricular hemorrhage but there was no significant relationship between vasospasm and direction of aneurysm. 7) There was no significant relationship between direction of aneurysm, and prognosis and the better H & H grade noted the better prognosis.