Clinical Experience About Microsurgical Treatment For 51 Cases With Intracranial Aneurysm

ObjectiveTo explore the diagnosis, treatment, and prognosis of the intracranial aneurysm.Method51 cases of intracranial aneurysm were analyzed retrospectively with the episode, clinical manifestation, image-examination, size and site, operation and prognosis. Of which, Hunt-Hess scale 0 scale 4cases,â… scale 15 cases,â…¡scale 9cases,â…¢scale 13cases,â…£scale 8cases,â…¤scale 2 cases; micro-aneurysm 2 cases, small aneurysm 16 cases, middle 29 cases, big 5 cases, giant 2 cases;The patient of 0 grade episode with occupied lesion, others manifested with subarachnoid hemorrhage(SAH):headache, meningio-stimulating syndrome, unconsciousness;4 cases suffered with occulomotor nerve paralysis; all cases underwent head CT scan, Three Dimention CT Angiography(3D-CTA),48 cases were diagnosed with aneurysm; 12cases also underwent the Digital Substraction Angiography(DSA), MCA aneurysms 13 cases(16 aneurysms), P.com.A 16 cases, ACA 6 cases, A.com.A 10 cases, ICA 4cases,BA 1cases and PICA 1 case; microsurgical operation was managed for 41 cases in 72 hours after the episode,6 cases more than 3 days(0 grade cases not include) all patients were treated by craniotomy. among them, aneurysm clipping for 45 cases, clip and partial resection for 3 cases, wrapping for 2 cases, isolate the aneurysm-carrying artery for 1 case; the temporary occlusion procedure with the aneurysm-carrying artery for 40 cases, the occlusion time of 20 cases were in 5 minutes,11 cases were in 10 minutes,9 cases longer than 10 minutes, it is very useful method to control bleeding when aneurysm rupture in operation; the operative time within 3 hours were 4cases,4 hours 28 cases,5 hours 14 cases,6 hours 3 cases, more than 6 hours 2 cases.ResultAccording to GOS score,38 cases were good recovery, slight disabled 2 cases, sever disabled 3 cases, and Persisted Vegetable State(PVS)1 case, dead 7 cases.ConclusionThe 3D-CTA is a helpful method in diagnosis of the intracranial aneurysm, DSA also manage when it is necessary; the scale below or equal toâ…¢scale, emergency clipping is the best way to treat it, the case which aboveâ…¢scale usually be treated with conservative procedure, delayed clipping would be performed when the general situation of patient had been improved; temporary occlusion of aneurysm carrying-artery is a useful technique in the operation, general therapy also be indispensible.