Microsurgical Treatment Of Poor-Grade Ruptured Middle Cerebral Artery Aneurysms With Intrasylvian Hematomas Assisted By CT Angiography

Abstract： Objective This study was conducted to investigate the result ofmicrosurgical treatment of poor-grade ruptured middle cerebral arteryaneurysms with intrasylvian hematomas assisted by CT angiography.Mehtods：Between Jun2008and Jun2010,30cases with poor-graderuptured middle cerebral artery aneurysms with intrasylvian hematomas weretreated under the assistance of CTA. All of the patients underwent microsugicalclipping aneurysms and decompressive craniotomy after evacuatingintrasylvian homotomas. Results of the treatment for these cases were analyzedto summarize the experience.Results: The prognoses were assessed according to Karnofskyperformance scale (KPS) and the clinical follow-up period is1year. In30cases:2were90-100scores of KPS,8was60-80scores of KPS,10was40-50scoresof KPS,6was10-30scores of KPS,4was0score of KPS. In group Ⅳ:2were90-100scores of KPS,6were60-80scores of KPS,6was40-50scores of KPS,4was10-30scores of KPS. In groupⅤ:2was60-80scores of KPS,4was40-50scores of KPS,2was10-30scores of KPS,4was0score of KPS.Conclusion: For ruptured middle cerebral artery aneurysms ofHunt-Hess grade Ⅳ and Ⅴ with intrasylvian hematomas. CT angiography canprovide adequate imaging information in a short time for the operation. werecommend immediate microsugical clipping aneurysms and decompressivecraniotomy after evacuating intrasylvian.