Surgical Experiences of 1,500 Cases of Intracranial Aneurysm

Sim, Jae Hong; Kim, Soo Chun; Jung, Yong Tae; Lee, Sun Il; Kim, Moo Seong

Abstract

The principle role of treatment for ruptured aneurysm has been to obliterate the aneurysmal sac and secure the patient's life from the hazards of rebleeding and vasospasm. The present study was conducted to evaluate the overally surgical results in 1,500 patients with intracranial aneurysms operated in our institution from January 1980 to February 1997. Among these, 547 cases were anterior communicating artery aneurysms, 453 internal carotid artery aneurysms, 400 middle cerebral artery aneurysms, 43 anterior cerebral artery aneurysms and 57 cases of vertebro basilar artery aneurysms. Overall surgical result was favorable outcome in 84% and mortality in 8%. The rebleeding rate of early operation group was 7 percent, as compared to 23 percent in late operation group. In this retrospective study, the incidence of angiographic vasospasm was 34.2 percent and clinical vasospasm in 28.7 percent of good grade patients. Incidental aneurysms constistuted 5.6 percent of the this series, and multiple aneurysm 8.7 percent. The causes of the mortality and morbidity were initial insult of bleeding, rebleeding, vasospasm, surgical complications, and systemic medical problems. Regarding the surgical timing, it is difficult to decide whether early or late surgery would provide a better prognosis.