Treatment and Outcomes of Unruptured Giant Intracranial Aneurysms

Abstract

The treatment and outcomes of 44 large (over 15 mm) or giant (over 25 mm) intracranial aneurysms among 50 consecutive cases have been analyzed. STwenty-three cases received direct surgery, 15 cases underwent parent artery occlusion with or without bypass procedures, and 6 cases were given direct embolization. With regard to the results of these treatments, 70% had excellent or good outcomes. However, internal carotid-ophthalmic and basilar aneurysms had relatively poorer outcomes, with 60% of the former and only 33% of the latter cases having been assessed to have had good or excellent outcomes. Premature ruptures, parent artery stenosis, and/or perforator injuries during surgery were found to be the main causes for cases with poor results. In contrast, good results were obtained when treating aneurysms at other sites. Based on these findings, it thus has been concluded that parent artery occlusion with or without bypass surgery or intravascular surgery may be the better choices of treatment for many patients with giant intracranial aneurysms.