抄録
We have experienced seventy-three cases of incidental unruptured cerebral aneurysms. There were 33 males and 40 females. The mean age was 58. Thirty-two patients were treated by conservative means. The reasons for conservative treatment were as follows: 1) giant or surgically inaccessible aneurysms (7 patients with internal carotid artery aneurysms and 8 patients with basilar artery aneurysms); 2) partially thrombosed aneurysms (6 patients); 3) small aneurysms less than 3mm (7 patients); and 4) persisting major neurological deficits (4 patients). Six patients died from aneurysm rupture during the follow-up period, which averaged 3.9 years. Thus, the risk of fatal bleeding was approximately 4% per year. Forty-one patients harboring 54 incidental aneurysms were treated surgically. Forty-nine aneurysms were clipped, and 5 other aneurysms (3 giant and 2 vertebral artery) were treated using intravascular surgical techniques. There was no surgical mortality nor morbidity in this consecutive series of 41 patients. In conclusion, it is recommended that incidental aneurysms in the anterior circulation should be considered for surgical treatment, if the patient's clinical condition and age are favorable. For surgically high risk patients with giant aneurysms or posterior circulation aneurysms, the surgical indications will be expanded with the use of intravascular surgical techniques.
