Abstract
We performed the direct procedure on 12 cases of unruptured cerebral aneurysms associated with ischemic cerebrovascular diseases (TIA, two cases; RIND, five cases; completed stroke, five cases). In the postoperative course of all cases of TIA and RIND, no permanent ischemic deficit was observed. However, in two cases of completed stroke with angiographic occlusive lesion, the deterioration of existing ischemic deficits was permanent. In these two cases, the operative approach was on the same side as the deficit. Therefore, a direct procedure for cerebral aneurysms should be performed in cases of TIA and RIND. However, additional considerations may be necessary for cases of completed stroke with angiographic occlusive lesion, when the side of the operative approach would be ipsilateral to the side of the ischemic cerebrovascular disease.
