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KMID : 1005420070090010020
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Journal of Cerebrovascular and Endovascular Neurosurgery
2007 Volume.9 No. 1 p.20 ~ p.29
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Surgical Experiences of Unruptured Intracranial Aneurysms
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Choi Beom-Jin
Rhee Dong-Youl
Park Hwa-Seung
Heo Weon
Yoon Jae-Woong
Kim Do-Hyung
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Abstract
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Object : This study was conducted to evaluate the surgical results of the active treatment of unruptured intracranial aneurysms (UIAs) and to suggest treatment indications.
Methods: Operations were performed on 49 patients with 52 UIAs between 1999 and 2005. Medical records and radiologic studies of the patients with UIAs were retrospectively reviewed. The clinical outcomes were evaluated in each patient by the modified Glasgow Outcome Scale (m-GOS) one month after operation.
Results: UIAs had a high frequency of a middle cerebral artery (MCA) and an internal carotid artery (ICA) aneurysm. Forty-four UIAs (84.6%) ranged between 5 mm to 15 mm in diameter. Fortysix UIAs were treated by clipping, 2 by wrapping, and coil embolization was used in 3 UIAs. In one patient, which had only one UIA, one procedure and one operation was performed. There was no surgical mortality. In most patients, surgical complications or neurological deteriorations were not found. In three patients, minor neurological deficits of ptosis (2 patients) and spinal subdural hematoma (1 patient) were newly developed after operation. However the patients completely recovered within 3 months after operation. Finally, the surgical mortality and morbidity rate was 0%.
Conclusion: If the UIAs are larger than 5 mm in diameter and located in a susceptible area for rupture, surgical treatment should be considered for the UIAs. If operation is performed by an expert neurosurgeon, surgical clipping is one of the best treatment modalities with or without endovascular treatment.
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KEYWORD
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Surgical clipping, Surgical mortality, Morbidity, Unruptured intracranial aneurysm
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