Microsurgical Treatment of Intracranial Aneurysms

Objective To explore the diagnostic procedure, operative time and microsurgical technique in the patients with intracranial aneurysms. Method Of 87 patients with intracranial aneurysms who underwent microsurgical clipping through a pteronal approach, 30 received the operation within 3 days after the cerebral hemorrhage and 57 from 3 days to 2 weeks after the hemorrhage. Results The postoperative DSA examination, which was performed only in 70 patients, showed that the aneurysms disappeared in 66 cases and the neck aneurysms remained partly in 4. Of the 87 patients, 74 gained excellent outcome, 6 good, 3 poor, 1 vegetative state and 3 died. Of 72 patients with Hunt 0～Ⅲ grades, 70 achieved excellent outcome and 2 good. Of 15 patients with Hunt Ⅳ～Ⅴ grades, 4 achieved excellent outcome, 4 good, 3 poor, 1 vegetative state and 3 died. Conclusions CT and MRI can provide important information for diagnosing the intracranial aneurysms, but its definite diagnosis should be made by DSA. DSA combined with 3D-CTA shall diagnose the aneurysms if DSA do not show it. Pteronal approach is the best one of the operation to treat anterior circulation aneurysms. Microsurgical clipping of the intracranial aneurysms still is one of the most reliable, and mature methods. The clipping of the bleeding intracranial aneurysms should be early or ultra-early performed.