In this paper, the authors report on 9 cases of unruptured cerebral aneurysms associated with intracranial arteriovenous malformations (AVMs), and discuss therapeutic problems of unruptured aneurysms.
The following are our conclusions:
1) The rate of combinations of AVMs and aneurysms is not small. Therefore, precise preoperative neuroradiological examinations should be made to confirm the presence or absence of aneurysms in all patients with cerebral AVMs.
2) We were unable to conclude whether or not unruptured aneurysms associated with AVMs should be operated on. However, no decrease in size of aneurysms following excision of AVMs is one important indication for considering a radical operation for aneurysms.
3) The authors reported one case who suffered retrograde thrombosis of the feeding artery, and developed neurological deficits after radical operation for on unruptured aneurysm of the feeding artery. Timing of radical operation for aneurysms following the excision of AVMs must be carefully considered. When surgical treatment of an aneurysm is intended, special attention should be paid to cerebral circulation following excision of AVMs. When an angiographical finding of stagnant arterial flow of feeding arteries is observed, radical operation for aneurysms should be avoided.
