Surgery of Intact Intracranial Aneurysm

Lee, Kyu Chang; Lee, Kyu Sung

Abstract

The authors have reviewed and analyzed 105 cases of unruptured cerebral aneurysms in 94 patients from the medical records of 407 patients who had aneurysm sugery consecutively since the advent of microsurgery at the Department of Neurosurgery of Yonsei University. This study was done to define the clinical characteristics of intact intracranial aneurysms and to determine the principles of their management. There was no surgical mortality among 75 cases of intact intracranial aneurysms in 68 patients. Two cases of morbidity were not directly related to the surgery of intact aneurysms. As a result of the analysis of the cases, it was concluded that all symptomatic aneurysms should be treated immediately after the diagnosis, because they tend to be large in size and prone to rupture. If asymptomatic multiple unruptured aneurysms are accessible during surgery for a ruptured aneurysm, they should be treated at the same time. The decision for the treatment of unruptured aneurysms located opposite to ruptured ones or detected incidentally, should be made at the surgeon's discretion. The authors' belief is that intact intracranial aneurysms should be corrected regardless of their size when detected in young patients, in hypertensive patients, in hypertensive patients, or in patients with such high flow lesions as arteriovenous malformation.