抄録
We have reported a statistical analysis of the long-term outcome of 118 patients with 142 unruptured cerebral aneurysms during the past 11-year period. Unruptured aneurysms were classified into the following 4 groups: Group 1, intact aneurysm in patient with multiple aneurysms, one of which had ruptured; Group 2, unruptured aneurysms discovered incidentally in patient with other intracranial diseases; Group 3: symptomatic unruptured aneurysm; Group 4: unruptured aneurysm screened by noninvasive method.
In the 53 unoperated patients, the 5-year survival rate was 56%. During the follow-up period, 10 patients had subsequent rupture and 9 of them died. The high probability of subsequent aneurysm rupture shown by the statistical analysis of the long-term outcome was as follows: Group 3, less than 70 years old, 10-19 mm in size, VA·BA and MCA in location, and multilobed shape. The last two factors were the most important ones leading to aneurysm rupture.
Among the 65 operated patients, there was no operative mortality. Transient postoperative morbidity was 3.1 percent, while permanent morbidity was 3.1 percent. The 5-year survival rate was 94%. There were no significant factors which affected the long-term outcome.
Concerning the indication for surgery of unruptured aneurysm, in Group 1 and 2 at first the treatment of SAH or the underlying disease should be considered, while Group 3 aneurysms have a high probability of ruptured and require operative treatment. In Group 4, patients who have the significant variables of subsequent rupture should be treated surgically.
