Efficacy of microsurgery for treatment of ruptured intracranial microaneurysms

Objective To investigate the safety and efficacy of microsurgery for treatment of ruptured intracranial microaneurysms.Methods 73 patients with intracranial aneurysms 5 mm detected by digital subtraction angiography (DSA) imaging were analyzed retrospectively. The therapeutic strategies of intracranial microaneurysms were summarized,and the effects of early microsurgery were analyzed.Results Seventy-three patients with 79 aneurysms were diagnosed by DSA before the operation,and 77 of the aneurysms were confirmed by the surgery. Of the 2 untreated aneurysms,one was in a patient with 2 aneurysms,one was treated the other aneurysm was on the contralateral side of the brain; the other patient with an aneurysm at A2 segment,and it was not found during the operation. Of the 77 treated aneurysms,3 were wrapped,59 were clipped,12 were clipped and wrapped,2 were wrapped after cauterization,and 1 was resected. According to the Glasgow Outcome Score (GOS),59 patients had a score 5,10 had score 4,2 had score 3,1 had score 2,and 1 had score 1. Fifty-seven patients were followed up by magnetic resonance angiography (MRA) or DSA for more than 3 months. One wrapped aneurysm was slightly larger than before,2 clipped aneurysms had neck remnants,and the remaining aneurysms were all cured.Conclusions Microsurgery for treatment of ruptured intracranial microaneurysms is a safe,effective and feasible method,it should be performed actively in patients with aneurysmal subarachnoid hemorrhage.