Compare Of Two Basic Approach To Sugically Cure Anterior Communicating Aneurysms In Acute Period

Objective: Explore the advantages and disadvantages of the pterional andinterhemispheric approach to the acute treatment of ruptured anterior communicatinganeurysms surgery as well as compare the treatment results.Methods: Weihai Wendeng Center Hospital neurosurgery disease ward fromOctober2008to October2012has treated35patients with anterior communicatinganeurysms in total,20of them applied pterional clipping the aneurysms,15of themadopted the interhemispheric approach treatment, a retrospective analysis of patientswith clinical data and surgical results.Results:29out of35surgeries have succeeded,6cases of anterior communicatinganeurysms rupture. The bleeding was under control after stabilizing the blood pressureand vacuum-cleaning the blood in the surgical view, the aneurysm was clippedsuccessfully, re-closed the clipper after adjusting the position of the aneurysm clipper.The major complications appeared in these35patients after surgery are thefollowings:1case of death,3cases of cerebral infraction,8cases of hydrocephalus,7cases of electrolyte disturbance,4cases of mental symptom and1case of cerebrospinalfluid infection. The rupture rates of the pterional and interhemispheric approaches totreat aneurysm are20%and13.3%respectively. According to Fisher’s combinedprobability test, SPSS13.0program has produced result as P>0.05, the rupture rate ofthe pterional and interhemispheric approaches to treat aneurysm does not have muchmeaning in the statistics field. The prognosis is assessed when the patients aredischarged from the hospital, it is GOS graded, I, II, III grades are considered as poorand IV, V as good. The good prognosis rate of the pterional and interhemisphericapproaches to treat aneurysm is85%and86.7%respectively, referring to the Fisher’smethod and the result of SPSSS13.0program, there are no significant differencesbetween these two approaches Conclusion:Both pterional or interhemispheric approach to treat anteriorcommunicating aneurysms lead to positive outcome. The indication of the aneurysm aswell as the surgical doctor’s personal experience usually determines the choice of thesetwo approaches. Different directions of the anterior communicating aneurysms comeinto the different prognosis．The prognosis of posterior type is poor.The rupture rate ofthe pterional and interhemispheric approaches to treat aneurysm does not have muchmeaning in the statistics field. Proficiency in the microsurgical technique, familiarity inmicro-dissection of the ubarachnoidal sinuses and brain blood vessels, awareness of thedanger associated with aneurysm surgery and well-prepared contingency plans beforesurgery are the keys to a successful aneurysm surgery.