1998 年 20 巻 6 号 p. 645-649
Since the development of endovascular treatment, mangement of intracranial aneurysms has been changing. There are several merits and demerits in either mode of treatment. However, in cases of ruptured aneurysms, subarachnoid hemorrhage itself makes the patient's condition critical and not due to the existence of aneurysms.
Retrospective study of 437 cases of cerebral aneurysms including 345 SAH cases over 4 years period has been reported. Out of 345 cases, surgical clipping was performed in 254 cases and endovascular treatment was done in 26 cases. No treatment was performed in 65 cases. In direct surgical treatment group, morality rate was 9.8% and good recovery was seen in 75% of cases. In endovascular intervention group morality rate was 42.3% mainly because of severity of their neurological grading and older age. Six out of 26 cases had complications such as leakage of contrast medium (ruptured) in 4 cases, embolic infarction 2 cases. We have discussed which type of treatment suitable for the aneurysm cases, considering permanent cure.