[Analysis of the results of nine-year experience in the surgical treatment of intracranial arterial aneurysm (author's transl)].
Two series of cerebral aneurysms are compared. The first was composed of 86 cases. The second, 73 cases, benefited from modern techniques, such as microscope, arterial hypotension, Yasargil's clips, bipolar coagulation, as well as from greater experience on the part of the surgical and anesthetic team. To avoid the risk of recurrent subarachnoidal hemorrhage, the surgical procedure has been done during the first week when consciousness is good or when corotid angiography shows a large cerebral hematoma. The surgical procedure is postponed if the patient shows a low state of consciousness or a cerebral vasospasm. In these cases, controlled external ventricular drainage improves patients' conditions and often allows for surgical intervention after three to five days. The Botterrel classification is used to evaluate the surgical results: good results were obtained in 71% of the entire series, as well as in 94% of grades 1 and 2 patients. The overall mortality rate was 15%. That for grades 1 and 2 was 2.7% and that for grades 1, 2 and 3 was 7.5%. The preoperative, operative and postoperative factors affecting results are discussed with particular attention to cerebral vasospasm and hydrocephalus.
D006801:Humans; D007023:Hypotension, Controlled; D002532:Intracranial Aneurysm / Q000401:mortality / Q000601:surgery*; D008722:Methods; D008866:Microsurgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000517:prevention & control
Bilan de neuf ans d'expérience de la chirurgic des anévrysmes artériels intracrâniens