In this paper, 45 cases of cerebral aneurysm accompanied with cerebro-vascular-diseases are reported. Sixteen of the cases were accompanied with cerebral infarction including TIA and RIND, 18 cases with hypertensive intracerebral hematoma, two with moyamoya disease, four with AVM, two with SLE, and three with chronic subdural hematoma. The clinical characteristics and surgical indications are discussed.
1) There is no correlation between the side on which the cerebral infarction occurs and the site of the cerebral aneurysm, however there is a tendency for the site of the cerebral aneurysm to exist on the same side as a hypertensive intracerebral hematoma (14/18, 78%). Such sites are especially observed with bifurcation or trifurcation of the middle cerebral artery (9/14, 64%).
2) It is likely that surgery is indicated for a ruptured cerebral aneurysm with cerebro-vascular-diseases in patients showing Hunt-Kosnik grade I~III in the preoperative stage. It is necessary to delay the operation for two weeks after controling systemic blood pressure.
3) Surgery is indicated for an unruptured cerebral aneurysm with cerebro-vascular-diseases in patients showing ADL1-3 in the preoperative stage more than one month after the first operation or first attack of cerebro-vascular-disease.
4) Some post-operative complications, such as epidural hematoma, convulsion, subdural effusion and temporary focal ischemic symptom due to hypo-perfusion, are seen in case of unruptured aneurysms with cerebral infarction.
