title: Clinical features and surgical outcomes of ruptured distal anterior cerebral artery aneurysms in 20 consecutively managed patients.
abstract: Optimal surgical management of ruptured aneurysms of the distal anterior cerebral artery continues to provide unique technical challenges. This study presents 20 consecutively managed such patients, with special attention given to the clinical and radiological characteristics, as well as the surgical outcomes. Intracerebral hematoma was seen in 11 of the 20 patients, and intraventricular hemorrhage occurred in 4 (20%). Angiography revealed that 9 (45%) patients had multiple aneurysms. Three patients (15%) had "mirror" distal anterior cerebral arterial aneurysms on the contralateral side. Eleven patients (55%) had aneurysms located at the supracallosal portion of the anterior cerebral artery, while 9 patients (45%) had aneurysms located below the genu of the corpus callosum. The mean aneurysmal diameter was 3.85 mm; 18 aneurysms (90%) were less than 6 mm in diameter. Eighteen patients (90%) underwent a microsurgical procedure; 2 (10%) underwent endovascular coiling due to poor clinical grade. A favorable outcome was achieved in 14 (70%) patients. Advances in microsurgical techniques will be required to further improve clinical outcome.
authors.affiliation: Department of Neurosurgery, National Hospital Organization Disaster Medical Center, 3256 Midori, Tachikawa, Tokyo 190-0014, Japan. naotani@tdmc.hosp.go.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takasato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masaoka
authors.forename: Takanori
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsushige
authors.forename: Kyoko
authors.initials: K
authors.lastname: Sumiyoshi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Miyawaki
authors.forename: Chikashi
authors.initials: C
authors.lastname: Aoyagi
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Go
authors.initials: G
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D004234:Diuretics, Osmotic / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D019586:Intracranial Hypertension / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D019736:Prostheses and Implants; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D004234:Diuretics, Osmotic