Abstract
Five surgically treated cases of “incidental”aneurysm associated with cerebrovascular disease are presented in this paper. There is still diversity of opinion as to whether or not unruptured aneurysms should be treated surgically. Unruptured intracranial aneurysms fall into the following three categories: 1) symptomatic aneurysms; 2) multiple aneurysms in cases of subarachnoid hemorrhage; 3) so-called “incidental”aneurysms demonstrated during angiographic investigation of a variety of disease process. The last category has proved increasingly common as angiography, DSA, high resolution CT scan, and other innovative techniques have brought unsuspected lesions to medical attention.
During a fifteen month period, cerebral angiography was performed in 104 cases of patients for the following indications: cerebrovascular disease (88 cases), brain tumor (five cases), others (eleven cases). The patients included 71 men and 33 women, with a mean age of 53.3. We found five cases of“incidental”aneurysms.
Preoperatively all five patients had various degrees of neurological dysfunction such as motor dysfunction, aphasia, and dysarthria. Postoperatively three cases improved, but two cases deteriorated. In the latter cases, the parent artery of the “incidental”aneurysm fed both cerebral hemispheres. We suspected that compression of the ischemic brain, spasm of the parent artery caused by surgical procesure, and changes of cerebral circulation during operation and postoperation worsened the patients' prognoses.
In this paper we discuss the treatment of “incidental”aneurysms and the reports in the literature are reviewed.
