To Explore Operation Strategy Of Ruptured Middle Cerebral Artery Aneurysms By Pterional Approach

Objective: To explore operation strategy of ruptured middle cerebral arteryaneurysms by pterional approach to improve patient’s prognosis better.Method: From January2008to December2012, the neurosurgery department inProvincial Hospital had received and cured64patients with cerebral aneurysms,among who34cured by interventional treatment and the other30by emergencymicrosurgical operation via approach.30cases of patients with ruptured middlecerebral artery aneurysm，among which, men have16cases while women have14.The age span is from31to79, with the average age of46.8，accompanied withintracerebral hematoma were adopted by preoperative emergent to determine thelocation, size of aneurysm, following26.4±7. of the hematoma volume. During24hours of onset, the patients were exerted by via pterion approach controllingblood pressure to ideal index within6hours of inpatient,29cases were adopted byaneurysm occlusion and evacuation of hematoma, and1cases were exerted onlysimple hematoma with the impossible occlusion and after operation.Results：All patients were followed up for6months to3years, to judge theoperation result according to Glasgow Outcome Scale，GOS.25cases were,following death of1case, plant survival of1case, severe disability of1case andmoderate disability of2cases.Conclusion： According to the patients with ruptured cerebral aneurysmsaccompanied by of intracerebral hematoma volume and of median line excursion, it would be feasible and effective for removing the hematoma and clipping of theaneurysm via approach, by relieving the volume effect of hematoma, preventingthe of aneurysm and lowing the postoperative-dysfunction.