Treatment of Intracranial Unruptured Aneurysms

Jeong, Young Gyun; Sim, Jae Hong; Jung, Yong Tae; Lee, Sun Il; Kim, Moo Seong

Abstract

OBJECTIVE
Treatment decisions in patients with unruptured aneurysms required detail assessment of the risk. The most important things to prevent the subarachnoid hemorrhage (SAH) are the measuring of risk of rupture of intracranial aneurysm and the decreasing of operation risk at aneurysm neck clipping.
METHODS
Between January, 1994, and April, 2003, data regarding a series of 1586 aneurysm operations performed by a single neurosurgeon (J.H.S). Among them 158 patients with unruptured intracranial aneurysm (UIA) were analyzed retrospectively from the medical records and radiological findings (CT, CT angiography, MR angiography & angiography). The type of aneurysm was classified by three categories : Group 1 : incidental (asymptomatic, unruptured), Group 2 : symptomatic unruptured, Group 3 : UIA with SAH from a separate aneurysm. Unoperated cases were excluded.
RESULTS
The treated aneurysms were 91 patients with 103 UIAs. Group 1 : 41 patients with 49 UIAs, Group 2 : 5 patients and Group 3 : 45 patients with 49 UIAs. In Group 1 the results of treatment were 0 mortality and below 4% morbidity. The cases with morbidity were a giant aneurysm, old age patient and the UIAs of posterior circulation.
CONCLUSION
The UIA with SAH should be treated surgically and/or endovascular therapy. The treatment of the unruptured, asymptomatic incidental intracranial aneurysm was recommended but the patient's age, size and lcoation of aneurysm, and the skill and experience of neurosurgeon were considered honestly and carefully.