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KMID : 0371620090240010001
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Journal of Wonkwang Medical Science
2009 Volume.24 No. 1 p.1 ~ p.5
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Surgery Related Complication of Unruptured Cerebral Aneurysm
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Koo Hee-Sang
Kang Sung-Don
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Abstract
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Background: With advances in neuroimaging, unruptured cerebral aneurysms are being diagnosed more frequently. Surgery is warranted if surgical risk are less than the risk of natural history. In this study, we investigated the surgery related complications and its prognosis after clipping of unruptured cerebral aneurysms.
Methods: The study consists of a retrospective review of 100 patients who underwent surgery performed by one surgeon for 110 unruptured aneurysms between January, 1990 and December, 2006. One hundred and two aneurysms(92.7%) were successfully clipped, and 8(6.4%) were either wapped or trapped. The clinical outcomes were evaluated in each patient by the Glasgow Outcome Scale at discharge.
Results: Thirty(30%) of the patients were asymptomatic, while the remainder(70%) had various symptoms. Regarding the aneurysmal size, 4(3.6%) were giant aneurysms, and 88(80%) were small aneurysms less than 10mm in diameter. The location of the aneurysms were internal carotid artery, middle cerebral artery, anterior cerebral artery in order of frequency. Ninety eight patients recovered without any neurological deficits. A procedure-related surgical complication was diagnosed in 2 cases(2%). Complications included hemiparesis(moderately disabled) following cerebral infarction.
Conclusion: The morbidity rate associated with treating unruptured aneurysms is not negligible with increasing trend of active management decision in patients with unruptured aneurysms. Treatment requires accurate assessment of the risk/benefit ratio considering natural history of the disease, and unpredictable complication ratio should be closely monitored.
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KEYWORD
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Unruptured Aneurysm, Surgery, Complications
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