抄録
We have had five cases of rebleeding after aneurysm surgery from 1973 to 1985. Three cases were anterior communicating aneurysms, and two were internal carotid aneurysms. The anterior communicating aneurysms were directed backward and the internal carotid aneurysms were large“no neck”aneurysms. Neck clipping was performed in two cases, clipping with coating in two cases and clipping with trapping in one case. Retrospectively, the causes of rebleeding were thought to be the incomplete obliteration of the aneurysmal bud with coating, the incomplete obliteration of the neck behind the anterior communicating artery and the fragility of the aneurysmal wall in the large internal carotid“no neck”aneurysm. It can be concluded that it is important to choose an approach which fully discloses the aneurysmal neck behind the parent artery and select an optimal clip to prevent any part of the neck remaining. And because of wall fragility in large“no neck”aneurysms, we must think not only of clipping but also of trapping with bypass surgery.
