Long-term outcome of surgically treated unruptured cerebral aneurysms.
We report the surgical morbidity and mortality and the results of statistical analysis based on the long-term outcome (average 50.1 months) of 69 patients with unruptured cerebral aneurysms. These patients harbored a total of 76 unruptured cerebral aneurysms, 72 larger than 3 mm in diameter. All the latter were surgically treated. There was no operative mortality. Operative morbidity occurred in 5 patients (7.2%), including hemiplegia in 2 from obliteration of perforator vessels, transient memory impairment in 2 due to brain retraction, and transient oculomotor nerve palsy in 1 patient resulting from an unknown etiology. During the observation period, 53 patients (76.8%) had a good or fair outcome, 11 (15.9%) had a poor outcome, and 5 (7.3%) died from causes unrelated to the aneurysms, such as pneumonia, gastrointestinal bleeding, and heart failure. The 5-year survival rate was 94%. Statistical analysis of the long-term outcome of all patients showed no significantly important factor influencing long-term morbidity. Prophylactic surgery of aneurysm is recommended for low-risk patients who may develop eventual rupture of an aneurysm, but perforator vessels around the aneurysm should be preserved, clips should be properly placed, and brain retraction should be minimized.
Asari
S
S
Department of Neurological Surgery, Okayama University Medical School, Japan.
Ohmoto
T
T
D000328:Adult; D000368:Aged; D001921:Brain / Q000503:physiopathology; D005260:Female; D006470:Hemorrhage; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D007431:Intraoperative Complications; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate