抄録
In these 7 years we experienced 461 (431 cases) direct operation of cerebral aneurysms.
Except for the cases which showed vasospasm or had intracerebral hematom, the injury of various kinds of perforate arteries by direct operation were showed in 17 cases (4.2%).
The relationship of injured perforate arteries and position of aneurysms are as follows;
1) ant. choroidal artery were injured in 6 cases of 14 IC-choroidal aneurysms., (following is an.)
2) thalamoperforate aa. were injured in 4 cases of 109 IC-PC an.,
3) medial-striate aa. were injured in 1 case of 13 IC bifurcation an.,
4) medial-striate aa. were also injured in 2 cases of 136 A. com. A. an.,
5) lat. lenticulo-striate aa. were injured in 2 cases of 112 M1-M2 junction an., and
6) Internal peduncular aa. or ant. thalamo-perforate aa. were injured in 2 cases of 9 Basilar top an.
As to the cause of injury or closure of perforating branch (p.b.) in clipping of cerebral aneurysms, following were considered;
1) aneurysms with broad neck, 4 cases,
2) large aneurysm, 2 cases,
3) unconfirmed closure of p.b. due to premature rupture of aneurysm 3 cases,
4) simulationeous closure of b.p. in trapping of aneurysm 1 case,
5) closure of p. b. due to unsuitable clip (such as too long clip), 1 case, and
6) indirect closure of p. b. due to kinking of parent artery in clipping of aneurysms 6 cases.
Prognosis were, generally bad (fair-6, poor-2, and dead-1 ) except for 3 cases. At this points, authors must examine themselves with modesty.
And then, these complications have to be avoidable by sufficient consideration of various arrangement before operation and constant effect of technical elevation of each operators.
