Ruptured aneurysm of the distal anterior cerebral artery: clinical features and surgical strategies.
Ruptured aneurysms of the distal anterior cerebral artery (ACA) are relatively rare and surgical management provides some unique technical challenges. This retrospective analysis of 20 patients with distal ACA aneurysms evaluated the clinical features and surgical strategies. The characteristic findings were small and common concurrent aneurysms, and frequent intracerebral hematoma (ICH). Aneurysms were divided by location on the genu (n = 13), infracallosal (n = 5), and supracallosal portions (n = 2). All patients except one underwent surgery via an interhemispheric route. Unilateral craniotomy was performed for aneurysms on the genu portions without massive ICH. Bilateral craniotomies were selected for aneurysm located on the infracallosal portion or combined with massive ICH. No intraoperative rupture was observed. Favorable outcomes were achieved in 15 of 20 patients, and only one patient died. The preoperative Hunt and Kosnik grade was closely correlated with the outcome.
Oshiro
Shinya
S
Department of Neurosurgery, Fukuoka University, Faculty of Medicine, Japan. s-oshiro@fukuoka-u.ac.jp
Tsugu
Hitoshi
H
Sakamoto
Seizaburou
S
Nonaka
Masani
M
Iwaasa
Mitsutoshi
M
Hayashi
Shuji
S
Hirakawa
Katsuyuki
K
Tsuchimochi
Hirohito
H
Fukushima
Takeo
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome