Abstract
Surgical results were analyzed in 17 cases of unruptured aneurysms associated with ischemic cerebrovascular disease (CVD). The age of patients ranged from 26 to 76 and the mean age of the patients was 61. The associated ischemic CVD were minor completed stroke in seven, RIND in four, TIA in four and vertebrobasilar insufficiency (VBI) in two cases. Twenty-two aneurysms were verified in 17 cases and 19 aneurysms were treated surgically. Of the 19 aneurysms, nine were located in the middle cerebral artery (MCA), five in the internal carotid artery (ICA), four in the anterior communicating artery (A coin A) and one in the anterior cerebral artery (ACA). CT scan showed small low density areas in eight cases. Bilateral ICA stenosis was found in one, MCA stenosis in one and MCA occlusion in one cases on the preoperative angiography. Sixteen aneurysms were successfully clipped and three had aneurysmal coating. Superficial temporal artery (STA)-MCA anastomosis was also performed at the same stage of aneurysmal operation in one case with MCA occlusion. Neurological symptoms worsened or developed after operation in five cases. Possible causes of neurological aggravation were cerebral contusion due to excessive brain retraction in two and low cerebral perfusion pressure during operation in three cases. These results indicated the importance of careful and gentle manipulation of ischemic brain and maintenance of adequate cerebral perfusion during operation.
