title: [Giant supratentorial intracranial aneurysms. Analysis of 22 cases].
abstract: BACKGROUND
  Giant intracranial aneurysms represent 2 to 5% of all aneurysms. They are well characterized from the anatomical and clinical point of view. Their natural history shows its potential lethality. Surgical treatment of giant aneurysms is a challenge for neurosurgeons.
  
  
  METHODS
  Twenty-two patients were operated on through pterional craniotomy, specialized neuroanesthesia and microneurosurgical technics. Auxiliary methods like transitory clipping and retrograde decompression-suction technique were applied. Patients were followed at intensive care units and they were evaluated three months after the operation. Nineteen patients were in the fourth and sixth decade of life. Seventeen were females. Aneurysms were located at middle cerebral artery bifurcation; paraclinoidal carotid artery; proximal anterior cerebral artery and carotid bifurcation. Ninety one percent of aneurysms were clipped. Retrograde decompression-suction technique was performed in thirteen cases.
  
  
  RESULTS
  Seventeen patients had good outcome and one patient died (4.5%). There were 6 postoperative complications and in four disappeared three months later.
  
  
  CONCLUSIONS
  Giant aneurysms were operated on following main neurosurgical rules helped by auxiliar procedures to reduce aneurysms size and wall, aneurysms tension. New knowledge about giants aneurysms and the development of new techniques will permit better results.
authors.affiliation: Servicio de Neurocirugía. Hospital Provincial Manuel Ascunce Domenech. Camagüey. Cuba.
authors.forename: S D
authors.initials: SD
authors.lastname: Vega-Basulto
authors.forename: S
authors.initials: S
authors.lastname: Silva-Adán
authors.forename: A
authors.initials: A
authors.lastname: Laserda-Gallardo
authors.forename: R
authors.initials: R
authors.lastname: Peñones-Montero
authors.forename: A
authors.initials: A
authors.lastname: Varela-Hernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology