Management outcome for vertebrobasilar artery aneurysms by early surgery.
Treatment of vertebrobasilar artery aneurysms remains fraught with complications, even in the present era of microneurosurgery. In a series of 1150 consecutive patients with cerebral aneurysms from a defined catchment area with 870,000 inhabitants, 93 with vertebrobasilar artery aneurysms were treated by two surgeons during a 14-year period. Sixty-three patients had surgery, 36 during the first week after bleeding. There was no surgical mortality among 33 good grade patients. Nine (14%) of the 63 surgical cases had died at 1 year. Forty-nine (53%) of the total group of 93 patients were functioning independently at 1 year. Overall management mortality was 37%. All 11 patients admitted in Grade V died. In spite of improvements in surgical techniques, we are far from achieving ideal results. Early diagnosis and surgery before rupture are urgently needed. Arteriosclerotic giant aneurysms remain untreatable.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001488:Basilar Artery / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality / Q000601:surgery; D002532:Intracranial Aneurysm / Q000401:mortality / Q000601:surgery*; D002538:Intracranial Arteriovenous Malformations / Q000401:mortality / Q000601:surgery*; D007431:Intraoperative Complications / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010166:Palliative Care; D011183:Postoperative Complications / Q000401:mortality; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D014711:Vertebral Artery / Q000002:abnormalities* / Q000601:surgery; D014715:Vertebrobasilar Insufficiency / Q000401:mortality / Q000601:surgery*