Clinical features and outcome in 48 patients with unruptured intracranial saccular aneurysms: a prospective consecutive study.
During a 5-year period (1978-1983) the clinical features and operative morbidity/mortality were registered prospectively for all patients in Denmark with an unruptured symptomatic (27 patients) or incidental (21 patients) intracranial saccular aneurysm. A follow-up examination was performed 2 years after diagnosis of the aneurysm. Thirty symptomatic aneurysms in 27 patients most frequently involved the visual pathways or ocular motility (66%). The median diagnostic delay for patients with impaired visual acuity was 7 months but only 14 days for patients with impaired ocular motility. The localisation of the 30 symptomatic and 23 incidental aneurysms were: internal carotid artery (73% approximately 35%), anterior communicating artery (3% approximately 26%) and middle cerebral artery (7% approximately 35%). The diameters of 73% of the symptomatic aneurysms were greater than 10 mm, while the diameter of 74% of the incidental aneurysms were below 10 mm. The total operative morbidity and mortality were 15% and 4%, respectively. The mortality rate in the follow-up period was 10-11% mainly due to fatal bleeding from unoccluded aneurysms. In 21 survivors, a normal mental status was found in 43% and mild dementia was found in another 43%. The impaired visual acuity was unchanged in 67% of patients, while the ocular motility had normalised in 75%. A normal daily functional capacity was enjoyed by 57% while 43% had a moderate reduction, mostly due to visual disturbances.
Eskesen
V
V
Department of Neurosurgery, Copenhagen Municipal Hospital, Hvidovre, Denmark.
Rosenørn
J
J
Schmidt
K
K
Espersen
J O
JO
Haase
J
J
Harmsen
A
A
Hein
O
O
Knudsen
V
V
Marcussen
E
E
Midholm
S
S
D003718:Denmark; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies