脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
特集:脳卒中治療の中・長期予後
未破裂脳動脈瘤クリッピング術後の中期予後
松本 勝美赤木 功人安部倉 信坂口 健夫富島 隆宏青木 正之山本 和己甲村 英二加藤 天美吉峰 俊樹
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2002 年 30 巻 2 号 p. 83-87

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We investigated surgical immediate and semi-long-term results of the unruptured aneurysms in 113 patients. Between 1992 and 2000, we operated 110 unruptured anterior circulation aneurysms and 3 unruptured posterior circulation aneurysms. The mean age was 57.7 years, mean aneurysm size was 7.0 mm, and mean follow-up period was 4.7 years. Surgical complication was judged at 6 months, and patients with worsening of Modified Rankin Score of more than II were considered surgical morbidity. Patients were subsequently followed to clarify the occurrence of subarachnoid hemorrhage, aneurysm regrowth and occurrence of stroke other than subarachnoid hemorrhage. Surgical mortality was noted in 1 patient (0.9%), and morbidity was noted in 4 patients (3.5%). Subarachnoid hemorrhage after clipping surgery was noted in 1 patient, accounting for 0.19%/year of occurrence. One patient had recurrence of aneurysms and another had de novo aneurysms. The rate of occurrence of aneurysms after clipping of the unruptured cerebral aneurysms was at least 0.56%/year. Six cases had stroke other than subarachnoid hemorrhage. Especially patients whose aneurysm was found during investigation of ischemic stroke had recurrent ischemic disease at a rate of 4.5%/year. These results indicate the necessity of long-term observation of patients previously treated for unruptured aneurysm.
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© 2002 一般社団法人 日本脳卒中の外科学会
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