title: [Surgical management of proximal anterior cerebral artery (A1) aneurysms].
abstract: OBJECTIVE
  To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients.
  
  
  METHODS
  Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded.
  
  
  RESULTS
  The patients consisted of 15 men and 8 women with an age range of 16 to 72 years (mean 51.3 years). The average diameter of the aneurysms was 5.8 mm, ranging from 3.2 to 9.7 mm. Twenty-two saccular aneurysms were found in these patients; 21 patients presented with SAH and two had vascular malformation. All the A1 aneurysms were managed through the pterional approach, and the mean postoperative Glasgow Outcome Scale score was 4.8.
  
  
  CONCLUSIONS
  Thorough analysis of the angiographic data is essential for the diagnosis and treatment of A1 aneurysms. Preservation of the perforators and prevention of aneurysm rupture are critical during the surgery. Full exposure of the Sylvian fissure and temporary occlusion of the parent artery ensures safe and effective dissection of A1 aneurysms.
authors.affiliation: Department of Neurosurgery, General Hospital of PLA, Beijing 100853, China.E-mail: Dr_whw@126.com.
authors.forename: Hua-Wei
authors.initials: HW
authors.lastname: Wang
authors.forename: Zhe
authors.initials: Z
authors.lastname: Xue
authors.forename: Yu-Dong
authors.initials: YD
authors.lastname: Ma
authors.forename: Wen-Xin
authors.initials: WX
authors.lastname: Wang
authors.forename: Chen
authors.initials: C
authors.lastname: Wu
authors.forename: Zheng-Hui
authors.initials: ZH
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000517:prevention & control; D020771:Anterior Cerebral Artery / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000517:prevention & control; D055815:Young Adult